SFEBES2023 Poster Presentations Bone and Calcium (41 abstracts)
Age-specific reference intervals of Abbott intact parathyroid hormone (PTH) in adults
Tejas Kalaria 1 , Alexander Lawson 2 , Joanne Duffy 2 , Ashishkumar Agravatt 3 , Steve Harris 1 , Clare Ford 1 , Rousseau Gama 1,4 , Craig Webster 2 & Neil Gittoes 2,5
1The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom. 2University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom. 3PDU Medical college, Rajkot, India. 4University of Wolverhampton, Wolverhampton, United Kingdom. 5University of Birmingham, Birmingham, United Kingdom
Background: Assays for parathyroid hormone (PTH) are not standardized and therefore method-specific reference intervals are necessary for interpretation of results. PTH increases with age in adults but age-specific reference intervals for the Abbott intact PTH (iPTH) assay are not available. It is challenging and resource intensive to derive age-specific reference intervals by direct method because, depending on number of age partitions, samples from a large number of healthy individuals are required.
Methods: Age-specific reference intervals for Abbott iPTH were derived by an indirect method by means of refineR algorithm using deidentified serum PTH results between September 2015 to November 2022 retrieved from the laboratory information system of a laboratory serving a cosmopolitan population in the West Midlands region of England. The PTH results were retrieved for individuals aged 18 years and older if serum albumin-adjusted calcium and serum phosphate were within reference intervals, serum 25-hydroxyvitamin D was > 50 nmol/l and estimated glomerular filtration rate (eGFR) was ≥ 60 mL/min. The refineR algorithm identifies non-pathological results from Box-Cox transformed normal distribution which is then used to derive reference intervals with bootstrap iterations.
Results: PTH increased with age and correlated with age when controlled for 25-hydroxyvitamin D, eGFR and adjusted calcium (r= 0.093, P<0.001). The iPTH reference intervals for 18 to 45 years, 46 to 60 years, 61 to 80 years, and 81 to 95 years were 1.6–8.6 pmol/l, 1.8–9.5 pmol/l, 2.0–11.3 pmol/l and 2.3–12.3 pmol/l, respectively. PTH was higher in women compared to men (P< 0.001). Age and sex-specific reference intervals could not be derived because of sample size limitation.
Conclusions: Application of the derived age-specific reference intervals will impact the diagnosis and management of normocalcemic hyperparathyroidism, based on current definitions, and secondary hyperparathyroidism.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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