Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Osteocalcin (serum bone-Gla protein, sBGP), serum alkaline phosphatase (sAP) and urinary hydroxyproline/creatinine ratio (uOH-Prol/creatinine) have been measured in 21 patients with primary hyperparathyroidism (PHPT) and in nine patients with hypercalcaemia of malignancy (HM). A positive linear correlation between sBGP and uOH-Prol/creatinine ratio (y = 0.023 + 0.0025x; r = 0.705; p less than 0.01) and between sBGP and sAP (y = 35.6 + 2.14x; r = 0.430, p less than 0.05), have been observed in the PHPT patients. No correlation was found in the HM patients. PHPT patients have been grouped according to their uOH-Prol/creatinine ratio (group A: uOH-Prol/creatinine greater than 0.034; group B: uOH-Prol/creatinine less than or equal to 0.034). Group A presented sBGP higher than the control group (11.06 +/- 5.7 vs. 4.2 +/- 1.2 ng/ml; p less than 0.001) (mean +/- SD). Group B presented sBGP similar to the control group (4.4 +/- 1.96 ng/ml) (mean +/- SD). Group A presented serum calcium (sCa) higher than group B (3.11 +/- 0.28 vs. 2.78 +/- 0.09 mmol/l; p less than 0.01) (mean +/- SD). In HM patients uOH-Prol/creatinine ratio was elevated as compared with the control group (0.074 +/- 0.036 vs. 0.024 +/- 0.004; p less than 0.001) (mean +/- SD), but sBGP was normal or low (range: indetectable-5.1 ng/ml). The simultaneous estimations of sBGP and uOH-Prol/creatinine ratio improve the differential diagnosis between these two forms of hypercalcaemia: high uOH-Prol/creatinine ratio with concomitant high sBGP point to the presence of PHPT. Elevated uOH-Prol/creatinine ratio with normal or low sBGP suggest the existence of HM.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Osteocalcin and urinary hydroxyproline/creatinine ratio in the differential diagnosis of primary hyperparathyroidism and hypercalcaemia of malignancy. 349 57

Biochemical indices of bone formation (serum osteocalcin and bone alkaline phosphatase isoenzyme) and osteoclastic function (plasma tartrate resistant acid phosphatase) were measured in 43 patients undergoing chronic hemodialysis and in 27 patients with primary hyperparathyroidism. The mean values for bone alkaline phosphatase isoenzyme and plasma tartrate resistant acid phosphatase but not for osteocalcin were significantly higher in primary hyperparathyroidism as compared with dialyzed patients. A significant positive correlation was found between the biochemical indices of osteoblasts and osteoclasts both in primary hyperparathyroidism and in dialyzed patients, indicating biological coupling between bone resorption and formation under these conditions. The regressions of osteocalcin vs bone alkaline phosphatase isoenzyme and/or plasma tartrate resistant acid phosphatase in dialyzed patients paralleled those in primary hyperparathyroidism but their distance differed significantly. It is concluded that in patients with renal failure, an increase in circulating osteocalcin by a relatively constant portion reflects decreased renal clearance. Any additional increase in osteocalcin serum level indicates an increased skeletal production of osteocalcin. The clinical value of bone alkaline phosphatase isoenzyme and plasma tartrate resistant acid phosphatase appears to be comparable with that of serum osteocalcin in primary hyperparathyroidism, and more exact than osteocalcin in renal failure.
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PMID:Serum osteocalcin, bone alkaline phosphatase isoenzyme and plasma tartrate resistant acid phosphatase in patients on chronic maintenance hemodialysis. 350 96

We related the weight of the parathyroid adenoma to biochemical variables of bone turnover in 53 patients submitted to parathyroidectomy for primary hyperparathyroidism. There was a positive correlation (r = 0.61, p less than 0.01) between iPTH (c-assay) and adenoma weight. No correlations were found between either concentration of circulating iPTH or weight of parathyroid adenoma and severity of skeletal change expressed by total activity of serum alkaline phosphatase and its bone isoenzyme and urinary excretion of hydroxyproline. We conclude that the severity of bone changes in individual patients with primary hyperparathyroidism does not result from the direct tissue effect of a single hormone (parathyroid hormone).
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PMID:Correlation between mass of parathyroid adenoma and biochemical indicators of bone turnover in patients with primary hyperparathyroidism. 355 19

From 1965 to 1985, 412 patients were operated on for primary hyperparathyroidism (pHPT). Of these, 35 (8.7%) were without specific symptoms and findings. The follow-up investigations after six months to 14 years (median: 31 months) revealed a normalization of the preoperative pathological parameters of alkaline phosphatase, uric acid, creatinine and hypertension in the majority of patients apart from the improvement of their general condition. All patients were normocalcemic. According to these results, the indication for early surgical therapy of the asymptomatic pHPT is to be advocated in order to avoid long-term complications.
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PMID:[Asymptomatic hyperparathyroidism. An indication for surgery?]. 356 55

The sensitivity of bone to parathormone in pseudoparathyroidism is not well known. Six patients with Type I pseudohypoparathyroidism (4 with Albright's osteodystrophy) had increased alkaline phosphatase levels (5 patients) and radiological signs of periosteal resorption in the hand in one case. All patients had histological signs of increased surfaces of resorption and periosteocytic lacunae, increased osteoid surfaces and relative osteoid volume with no change of the index of osteoid thickness. These changes are identical to those observed in hyperparathyroidism which leads on to the discussion of the role of the increased parathormone secretion induced by the lack of calcium on the remodeling of bone. Our six cases show that there is no bone resistance to parathormone. The diversity of bone changes in hyperparathyroidism, similar to that of primary hyperparathyroidism, is without doubt dependent on the degree of renal insensitivity to PTH through the inactivation of vitamin D.
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PMID:[Sensitivity of bone to parathyroid hormone in type I pseudohypoparathyroidism. 6 cases]. 376 89

The clinical value of measuring serum immunoreactive parathyroid hormone (iPTH) for the diagnosis of primary hyperparathyroidism is sometimes debated, and the clinical significance of an elevated postoperative serum iPTH level is unknown. Therefore we studied 141 consecutive patients with primary hyperparathyroidism before and after parathyroidectomy to determine the clinical value of measuring serum iPTH by a mid-region-specific radioimmunoassay. Eighty-eight percent of the patients with primary hyperparathyroidism had an absolute increase in the level of serum iPTH (greater than 40 microliter Eq/ml) before surgery, and the remaining patients had an inappropriately increased level of serum iPTH for the simultaneous serum calcium level. Preoperative serum iPTH level correlated positively with serum calcium level and parathyroid tumor size. Postoperative elevation of serum iPTH level was common (as high as 40%) and was associated with higher preoperative levels of blood urea nitrogen, serum creatinine, and alkaline phosphatase and larger tumors. An elevated postoperative serum iPTH level without hypercalcemia did not indicate a failed parathyroidectomy, whereas negative parathyroid exploration and postoperative hypercalcemia were the best predictors of persistent hyperparathyroidism. We conclude that preoperative serum iPTH measurement is a very sensitive diagnostic test for primary hyperparathyroidism, but postoperative serum iPTH measurement is not a good predictor for persistent or recurrent hyperparathyroidism.
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PMID:Parathyroid hormone: before and after parathyroidectomy. 378 59

Osteocalcin is synthesized by osteoblasts and its concentration in serum is increased when bone metabolism is raised. Radioimmunoassay of serum from 88 healthy adults gave a mean osteocalcin value for the whole group of 4.11 +/- 1.43 ng/ml. The level rose with age. In seven patients with primary hyperparathyroidism the mean value was markedly raised to 19.37 +/- 9.2 ng/ml, in 23 with metastasizing carcinoma of the breast it was elevated to 6.57 +/- 2.98 ng/ml. Serial measurements in 14 female patients over seven months revealed different changes in osteocalcin and alkaline phosphatase in some of them. In patients with breast cancer and soft-tissue metastases or without metastases both osteocalcin and alkaline phosphatase levels were normal. Three of 17 patients with multiple myeloma had increased osteocalcin levels. These results indicate that it is clinically helpful to know osteocalcin levels in primary hyperparathyroidism. Determination of osteocalcin concentration, in addition to that of alkaline phosphatase, can be of value in the postmastectomy management of patients with breast cancer, especially in the early recognition of bone metastases. The diagnostic value of osteocalcin levels in multiple myeloma remains undecided.
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PMID:[Osteocalcin, a marker in diseases with elevated bone metabolism]. 387 69

Controversy has arisen regarding the indications for elective surgical intervention in asymptomatic primary hyperparathyroidism (HPT). The present study was designed to answer two questions: Is untreated primary HPT a progressive disease over time? If not, are the risks attendant on long-term conservative management comparable to those obtained from surgery? Forty-seven patients with primary HPT, established by a persistently elevated serum calcium level and an inappropriately elevated parathormone value, who were managed conservatively and followed for a minimum of 5 years were identified. Serial data collection included calcium, phosphorus, albumin, creatinine, alkaline phosphatase, parathormone levels, skeletal x-ray films, and complications known to result from primary HPT. For each patient the collected data were divided into three equal periods of time (minimum of 20 months per period). In addition, the patients were classified into three groups based on their average serum calcium levels during the first observation period. No patient in any of the three groups experienced a significant progressive increase in serum calcium levels during the periods of observation. Sixteen of the 47 untreated patients (34%) experienced a complication usually associated with primary HPT: peptic ulcer disease (eight patients), decrease in renal function (five patients), renal calculus (one patient), hypercalcemic crisis (one patient), and ventricular conduction defect (one patient). Four deaths were attributed to these complications. In conclusion, the course of primary HPT and attendant complicating features are not accompanied by worsening of the hypercalcemia initially observed. None of the parameters studied offered an accurate prediction of likelihood, progression, or severity of complications. The risks associated with long-term nonoperative management of asymptomatic primary HPT are nevertheless considerable and exceed the morbidity and mortality rates resulting from neck exploration.
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PMID:Observations on the course of untreated primary hyperparathyroidism. 387 2

Bone gamma-carboxyglutamic acid-containing (Gla) protein (BGP, osteocalcin) is a noncollagenous protein of bone present in plasma and removed by the kidney. Plasma BGP has been shown to be elevated in patients with certain bone diseases. The present study evaluates serum BGP (S-BGP), serum alkaline phosphatase (S-AP), and urinary hydroxyproline excretion (U-OHP) in diseases with differing bone turnover rates, and compares the accuracy of these measurements for estimating bone mineralization (m) and resorption (r) rates. S-BGP, S-AP, U-OHP, and creatinine clearance (Clcr) were measured in patients with primary hyperparathyroidism (n = 13), hyperthyroidism (n = 6), and hypothyroidism (n = 6). Bone mineralization and resorption rates were calculated from a 7-d combined calcium balance and 47Ca turnover study. A highly significant correlation (r = 0.69, P less than 0.001) was found between S-BGP and m. Multiple regression analysis disclosed a partial correlation between S-BGP and m when Clcr was taken into account (r = 0.82, P less than 0.001), and between S-BGP and Clcr when m was taken into account (r = -0.62, P less than 0.005). In accordance with this, a stronger correlation (r = 0.89, P less than 0.0001) was found between S-BGP X Clcr and m than between S-BGP and m. A less significant correlation was found between S-AP and m (r = 0.45, P less than 0.05). Furthermore, U-OHP showed a highly significant positive correlation to r (r = 0.78, P less than 0.001). Thus, in the studied disorders of calcium metabolism, individual serum levels of BGP depend on both mineralization rate and renal function. Serum levels of BGP corrected for alterations in renal function are superior to uncorrected S-BGP and to S-AP levels in the estimation of bone mineralization rates.
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PMID:Estimation of bone turnover evaluated by 47Ca-kinetics. Efficiency of serum bone gamma-carboxyglutamic acid-containing protein, serum alkaline phosphatase, and urinary hydroxyproline excretion. 387 67

A radioimmunoassay for bovine osteocalcin has been developed. Human osteocalcin reacted identically with the bovine standard, allowing the use of this assay to measure human plasma osteocalcin. Levels were determined in 212 healthy subjects (124 men, 88 women) with an age range of 20 to 66 years. The distribution of these was skewed to the right, with the mean being 14.7 ng/ml (range 4 to 40) and the geometric mean 12.2 ng/ml. There was no alteration with age and no difference between males and females. High levels were found in chronic renal failure, Paget's disease of bone, and in primary hyperparathyroidism with severe bone disease, and there was a significant positive correlation of osteocalcin with plasma alkaline phosphatase. Low levels were found in pregnancy. Evidence is presented which suggests that the high levels measured probably reflect intact osteocalcin and not immunoreactive fragments. Our data are compared with those reported by others. Areas of disagreement are noted and discussed.
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PMID:Plasma osteocalcin in man. 387 1


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