Gannagé-Yared Marie-Hélène, Younès Nada, Azzi Anne-Sophie, Sleilaty Ghassan
Endocrinology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
Department of Biostatistics, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
Int J Endocrinol. 2020 Mar 16;2020:5230985. doi: 10.1155/2020/5230985. eCollection 2020.
112 patients (of which 72.3% females) underwent MIP by the same surgeon. Age, sex, body mass index (BMI), pre- and postoperative serum calcium, creatinine, 25(OH)D levels, PTH at baseline (PTH T0), and PTH at 10 minutes after adenoma resection (PTH T10) were recorded. Both PTH 2G and PTH 3G assays were assessed using the Diasorin assays.
The mean age was 56.1 ± 14.7 years. Mean value of BMI, preoperative calcium, 25(OH)D, and CKD-EPI-eGFR were, respectively, 26.8 ± 4.8 kg/m, 110.9 ± 7.9 mg/L, 19.3 ± 9.2 ng/mL, and 88.6 ± 25.6 mL/min/1.73 m. PTH 2G and PTH 3G assays were well correlated at PTH T0 and PTH T10 (respectively, correlation coefficient 0.74 and 0.72 for intraclass correlation type 3). The median PTH fall was, respectively, of 79.9% and 82.5% for PTH 2G and PTH 3G. Multivariate analysis using the combined PTH 2G and PTH 3G as a dependent variable with 2 repeated measurements (at PTH 0 and PTH 10) showed a significant effect of preoperative calcium on IOPTH fall (=0.001, effect size 0.13), while no significant effects were observed for sex, age, BMI, and 25(OH)D.
PTH 2G and PTH 3G assays resulted in a similar drop in IOPTH values. Elevated preoperative calcium levels are the only independent predictor of IOPTH decline. Further studies are needed to determine other factors that can influence PTH kinetics.
112例患者（其中72.3%为女性）由同一位外科医生进行微创甲状旁腺切除术（MIP）。记录患者的年龄、性别、体重指数（BMI）、术前和术后血清钙、肌酐、25(OH)D水平、基线甲状旁腺激素（PTH T0）以及腺瘤切除术后10分钟时的甲状旁腺激素（PTH T10）。使用迪亚索林检测法评估PTH 2G和PTH 3G检测。
平均年龄为56.1±14.7岁。BMI、术前钙、25(OH)D和慢性肾脏病流行病学合作组织估算肾小球滤过率（CKD-EPI-eGFR）的平均值分别为26.8±4.8kg/m²、110.9±7.9mg/L、19.3±9.2ng/mL和88.6±25.6mL/min/1.73m²。PTH 2G和PTH 3G检测在PTH T0和PTH T10时相关性良好（组内相关类型3的相关系数分别为0.74和0.72）。PTH 2G和PTH 3G的甲状旁腺激素下降中位数分别为79.9%和82.5%。以联合的PTH 2G和PTH 3G作为因变量，进行2次重复测量（PTH 0和PTH 10时）的多变量分析显示，术前钙对甲状旁腺激素即刻下降有显著影响（P = 0.001，效应大小0.13），而性别、年龄、BMI和25(OH)D未观察到显著影响。
PTH 2G和PTH 3G检测导致甲状旁腺激素即刻值有相似下降。术前钙水平升高是甲状旁腺激素即刻下降的唯一独立预测因素。需要进一步研究以确定其他可影响甲状旁腺激素动力学的因素。
