Department of Clinical Chemistry, Laverty Pathology, North Ryde, NSW, Australia.
Clin Endocrinol (Oxf). 2018 Feb;88(2):311-317. doi: 10.1111/cen.13486. Epub 2017 Oct 18.
Age-related changes in parathyroid hormone (PTH) have been previously documented in adults. However, because of the limitations of traditional approaches to establishing reference intervals, age-related reference intervals have not been defined. We sought to use a data mining approach to derive age-related PTH reference intervals.
Results from patients undergoing PTH testing over a 4-year period were extracted from the database of a private pathology laboratory in New South Wales, Australia. Patients were included in the study if they were 18 years or older and had simultaneous determination of PTH, serum calcium, estimated glomerular filtration rate and 25-hydroxyvitamin D (25-OHD). Patients with abnormalities of serum calcium or renal function were excluded.
Bhattacharya analysis of log-transformed data was used to derive age-related PTH reference intervals across adulthood.
Results were available for 33 652 subjects. Among patients with optimal 25-OHD status, older age was associated with higher PTH concentrations. Age-related reference intervals were derived and showed a 63% increase in the upper and lower reference limits between the youngest (18-29 years of age) and the oldest (80 years of age or older) age partitions. The appropriateness of using a single reference interval for patients of all ages was evaluated against objective criteria and was found to be unsatisfactory.
Data mining was demonstrated to be a useful tool for establishing age-related PTH reference intervals. The technique demonstrated that increasing age is associated with higher PTH concentrations and that age-related reference intervals are important for accurate result interpretation.
甲状旁腺激素（PTH）的年龄相关性变化已在成人中得到证实。然而，由于传统建立参考区间方法的局限性，尚未确定与年龄相关的参考区间。我们试图使用数据挖掘方法来推导与年龄相关的 PTH 参考区间。
从澳大利亚新南威尔士州一家私人病理实验室的数据库中提取了 4 年内进行 PTH 检测的患者的结果。如果患者年龄在 18 岁或以上，并且同时测定了 PTH、血清钙、估计肾小球滤过率和 25-羟维生素 D（25-OHD），则将其纳入研究。排除了血清钙或肾功能异常的患者。
对数转换数据的 Bhattacharya 分析用于推导出整个成年期与年龄相关的 PTH 参考区间。
结果可用于 33652 例患者。在 25-OHD 状态最佳的患者中，年龄较大与较高的 PTH 浓度相关。推导出了与年龄相关的参考区间，在年龄最小（18-29 岁）和年龄最大（80 岁或以上）的年龄组之间，上下参考限增加了 63%。使用所有年龄段的患者的单一参考区间的适当性根据客观标准进行了评估，结果并不令人满意。
数据挖掘被证明是建立与年龄相关的 PTH 参考区间的有用工具。该技术表明，随着年龄的增长，PTH 浓度会升高，与年龄相关的参考区间对于准确的结果解释很重要。
