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Clin Chem. 2002 Oct;48(10):1731-8.

Kinetic analyses of parathyroid hormone clearance as measured by three rapid immunoassays during parathyroidectomy.

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  • 1Clinical Institute for Medical and Chemical Laboratory Diagnostics, AKH Vienna, A1090 Vienna, Austria. christian.bieglmayer@univie.ac.at

Abstract

BACKGROUND:

Rapid intraoperative parathyroid hormone (PTH) measurements are an important prerequisite for minimally invasive parathyroidectomy, serving as a feasible marker for "cure" because of the short half-life of PTH. Because automated analysis may facilitate monitoring, two automated PTH assays were compared with an established manual method.

METHODS:

We collected 109 plasma samples during minimally invasive surgery on 20 patients with primary hyperparathyroidism and single-gland disease. PTH was analyzed manually with a test from Nichols and by two automated assays from Diagnostic Product Corporation (DPC) and Roche, respectively. PTH half-life and residual concentrations were calculated by two kinetic models.

RESULTS:

Despite good overall correlations between methods [DPC = 1.07(Nichols) - 12 ng/L; r = 0.95, S(y/x) = 26 ng/L and Roche = 1.16(Nichols) - 2.82 ng/L; r = 0.98; S(y/x) = 16 ng/L], marked interindividual differences were observed. The iterative kinetic model failed with a nonuniform PTH decrease, but the interpolative model produced valid results. The mean (SD) half-life of 3.7 +/- 1.4 min with DPC differed significantly (P <0.05) from the 4.3 +/- 1.6 min with Roche (Nichols, 4.0 +/- 1.6 min). DPC produced significantly lower mean residual PTH (15 ng/L) vs Roche (27 ng/L); Nichols results were between them (20 ng/L). However, these differences were clinically irrelevant.

CONCLUSIONS:

Automated methods are as suitable as the manual test. The preoperative baseline PTH is necessary but is insufficient for kinetic calculations.

PMID:
12324490
[PubMed - indexed for MEDLINE]
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