Drezner M K, Neelon F A, Curtis H B, Lebovitz H E
Metabolism. 1976 Oct;25(10):1103-12. doi: 10.1016/0026-0495(76)90018-4.
Measurement of total urine cyclic 3':5'-adenosine monophosphate (cyclic AMP) only incompletely discriminates between normal, hyperparathyroid, and nonparathyroid hypercalcemic patients. Only a fraction of total urine cyclic AMP is contributed by parathyroid hormone (PTH) action on the proximal nephron (renal cyclic AMP); the remainder is derived from plasma by glomerular filtration. We dtermined total urine and plasma cyclic AMP and PTH (by carboxy-terminal specific radioimmunoassay) in control, hyperparathyroid, nonparathyroid hypercalcemic, and surgically hypoparathyroid patients. Renal cyclic AMP was calculated as total urine cyclic AMP minus the filtered component. Of these determinations, only renal cyclic AMP segregated normal from hyperparathyroid, and hyperparathyroid from nonparathyroid hypercalcemic patients with complete accuracy. These data suggest that measurement of renal cyclic AMP provides an accurate index of parathyroid activity and allows clinical discrimination and appropriate treatment of the sub-groups of patients with malignancy and nonparathyroid hypercalcemia from those with hyperparathyroidism.
仅通过测量尿中环磷酸腺苷（cAMP）总量并不能完全区分正常、甲状旁腺功能亢进和非甲状旁腺性高钙血症患者。尿中cAMP总量只有一部分是由甲状旁腺激素（PTH）作用于近端肾小管产生的（肾cAMP）；其余部分是通过肾小球滤过从血浆中得来的。我们测定了对照组、甲状旁腺功能亢进组、非甲状旁腺性高钙血症组以及手术导致甲状旁腺功能减退患者的尿和血浆cAMP及PTH（采用羧基末端特异性放射免疫测定法）。肾cAMP通过尿cAMP总量减去滤过部分来计算。在这些测定中，只有肾cAMP能完全准确地区分正常人与甲状旁腺功能亢进患者，以及甲状旁腺功能亢进患者与非甲状旁腺性高钙血症患者。这些数据表明，测量肾cAMP可提供甲状旁腺活性的准确指标，并有助于临床区分和适当治疗恶性肿瘤及非甲状旁腺性高钙血症患者亚组与甲状旁腺功能亢进患者。
