Harms H M, Schlinke E, Neubauer O, Kayser C, Wüstermann P R, Horn R, Külpmann W R, von zur Mühlen A, Hesch R D
Abteilung Klinische Endokrinologie im Zentrum Innere Medizin, Medizinische Hochschule Hannover, Germany.
J Clin Endocrinol Metab. 1994 Jan;78(1):53-7. doi: 10.1210/jcem.78.1.8288713.
Pulsatile secretion of PTH in human subjects has been described recently. However, the pattern of PTH secretion in primary hyperparathyroidism (pHPT) remains to be characterized. In this study intact PTH was measured in 9 female patients with pHPT. As a control group we present data from 10 postmenopausal women. In addition to parameters of calcium metabolism and bone mass, PTH was measured in samples drawn over 4 or 6 h every 2 min by central venous blood sampling. The mean intact PTH concentration was 39.0 +/- 20.3 ng/L in healthy women and 193.2 +/- 127.9 ng/L in female patients with pHPT (P < 0.01). Pulse rhythm analysis showed significant differences between both groups for total PTH secretion per h (patients, 1196.4 +/- 485.3 ng/L; control group, 271.7 +/- 132.2 ng/L), basal PTH secretion per h (patients, 852.4 +/- 459.1 ng/L; control group, 185.6 +/- 126.1 ng/L), and average PTH secretion per pulse (patients, 112.6 +/- 54.8 ng/L; control group, 23.2 +/- 7.1 ng/L). Both patients and control subjects had, on an average, five pulses per h, and the pulsatile secretion accounted for about 50% of the total secretion. Differences in power spectrum analysis were consistent with these findings. The cross-correlation of PTH and calcium indicates an impaired feedback regulation in pHPT. PTH secretion in female patients with pHPT results from both an increased basal secretion and an increased amplitude of PTH pulses. Other features of secretion are the same as those in normal women. Feedback regulation of PTH and calcium is impaired in pHPT.
近期已报道了人类受试者甲状旁腺激素（PTH）的脉冲式分泌。然而，原发性甲状旁腺功能亢进症（pHPT）中PTH的分泌模式仍有待明确。在本研究中，对9例pHPT女性患者测定了完整PTH。作为对照组，我们提供了10例绝经后女性的数据。除了钙代谢参数和骨量外，通过中心静脉血采样，每2分钟采集样本并测定4或6小时内的PTH。健康女性的平均完整PTH浓度为39.0±20.3 ng/L，pHPT女性患者为193.2±127.9 ng/L（P<0.01）。脉冲节律分析显示，两组每小时的总PTH分泌量（患者组，1196.4±485.3 ng/L；对照组，271.7±132.2 ng/L）、每小时基础PTH分泌量（患者组，852.4±459.1 ng/L；对照组，185.6±126.1 ng/L）以及每个脉冲的平均PTH分泌量（患者组，112.6±54.8 ng/L；对照组，23.2±7.1 ng/L）均存在显著差异。患者和对照受试者平均每小时有5个脉冲，脉冲式分泌约占总分泌量的50%。功率谱分析的差异与这些结果一致。PTH与钙的互相关表明pHPT中反馈调节受损。pHPT女性患者的PTH分泌是基础分泌增加和PTH脉冲幅度增加共同作用的结果。分泌的其他特征与正常女性相同。pHPT中PTH与钙的反馈调节受损。
