Sinha T K, Miller S, Feming J, Khairi R, Edmondson J, Johnston C C, Bell N H
J Clin Endocrinol Metab. 1975 Dec;41(06):1009-13. doi: 10.1210/jcem-41-6-1009.
It had been reported previously that there is a diurnal variation in serum parathyroid hormone (PTH) in normal subjects but not in patients with primary hyperparathyroidism. Studies were performed to determine whether there is a diurnal variation in serum PTH in primary or secondary hyperparathyroidism and whether the nocturnal increase in serum PTH, if present, could be prevented by induced hypercalcemia. Serum PTH and calcium were measured in five normal subjects, two patients with pseudohypoparathyroidism, and fourteen patients with primary hyperparathyroidism, twelve of whom were subsequently found to have parathyroid adenomas. In the normals, there was a mean decline in serum PTH of 0.07 ng/ml before noon and a mean increase of 0.04 ng/ml after 8 PM. In primary hyperparathyroidism there was a mean decline in serum PTH before noon of 0.11 ng/ml and a mean increase of 0.11 ng/ml after 8 PM. In both groups, the lowest mean serum calcium values were noted between midnight and 6:00 AM. Patients with pseudohypoparathyroidism showed a nocturnal increase in serum PTH. In each of two normal subjects, two patients with primary hyperparathyroidism, and two patients with pseudohypoparathyroidism, calcium, 4 mg/kg body weight per hour for 4 hours (8:00 PM to 12 midnight), produced hypercalcemia and prevented the nocturnal increase in serum PTH. We have concluded that a diurnal variation in serum PTH often occurs in both normal subjects and in patients with primary or secondary hyperparathyroidism and that nocturnal increases in serum PTH can be prevented by induced hypercalcemia.
此前已有报道称，正常受试者血清甲状旁腺激素（PTH）存在昼夜变化，但原发性甲状旁腺功能亢进患者不存在这种变化。本研究旨在确定原发性或继发性甲状旁腺功能亢进患者血清PTH是否存在昼夜变化，以及如果存在血清PTH夜间升高的情况，是否可通过诱导高钙血症来预防。对5名正常受试者、2名假性甲状旁腺功能减退患者和14名原发性甲状旁腺功能亢进患者测定了血清PTH和钙，其中12名原发性甲状旁腺功能亢进患者随后被发现患有甲状旁腺腺瘤。正常受试者中，中午前血清PTH平均下降0.07 ng/ml，晚上8点后平均升高0.04 ng/ml。原发性甲状旁腺功能亢进患者中午前血清PTH平均下降0.11 ng/ml，晚上8点后平均升高0.11 ng/ml。两组中，午夜至凌晨6点之间血清钙均值最低。假性甲状旁腺功能减退患者血清PTH出现夜间升高。在2名正常受试者、2名原发性甲状旁腺功能亢进患者和2名假性甲状旁腺功能减退患者中，每小时按4 mg/kg体重给予钙，持续4小时（晚上8点至午夜12点），可导致高钙血症并预防血清PTH夜间升高。我们得出结论，正常受试者以及原发性或继发性甲状旁腺功能亢进患者血清PTH常出现昼夜变化，且诱导高钙血症可预防血清PTH夜间升高。
