Endocrinology and Metabolism Department, Ataturk Education and Research Hospital, Yildirim Beyazit University, 06800 Ankara, Turkey.
Int J Endocrinol. 2014;2014:628010. doi: 10.1155/2014/628010. Epub 2014 Sep 1.
Purpose. In the present study, we aimed to investigate postural change of PTH in normal individuals and in patients with primary hyperparathyroidism (PHPT). Methods. Twenty-two patients with PHPT and nine healthy controls were enrolled. Following 12 h of fast, patients stayed in recumbent position for an hour and PTH and total Ca measurements were performed at the 45th and 60th minutes of resting. Afterwards, the patients resumed an upright posture for an hour and again blood samples were taken at the 45th and 60th minutes of standing. Results. In the PHPT group, mean PTH was calculated as 153.9 pg/mL in the recumbent position while it was 206.3 during upright position (Δ change was 47.7) (P < 0.001). In the control group mean serum PTH was measured as 41.2 pg/mL in the recumbent position while it was 44.8 pg/mL in the upright position (Δ change was 1.7) (P = 0.11). In both groups, serum Ca was higher in the upright position compared to the recumbent position (P < 0.001). Conclusion. Postural change of serum PTH is significant only in PHPT group. Postural PTH test may give a clue to the clinician when the diagnosis of PHPT is equivocal.
目的。在本研究中，我们旨在研究正常人和原发性甲状旁腺功能亢进症（PHPT）患者的 PTH 姿势变化。
方法。纳入 22 例 PHPT 患者和 9 例健康对照者。禁食 12 小时后，患者取仰卧位 1 小时，分别在第 45 和 60 分钟测量 PTH 和总钙。之后，患者恢复直立位 1 小时，再次在第 45 和 60 分钟取血样。
结果。在 PHPT 组，仰卧位时平均 PTH 为 153.9pg/mL，直立位时为 206.3pg/mL（Δ变化为 47.7）（P<0.001）。在对照组，仰卧位时血清 PTH 平均为 41.2pg/mL，直立位时为 44.8pg/mL（Δ变化为 1.7）（P=0.11）。两组中，血清钙在直立位均高于仰卧位（P<0.001）。
结论。只有在 PHPT 组中，血清 PTH 的姿势变化才有意义。当 PHPT 的诊断不确定时，直立位 PTH 试验可能为临床医生提供线索。
