PMID- 2889282
OWN - NLM
STAT- MEDLINE
DCOM- 19871116
LR  - 20190515
IS  - 0300-9734 (Print)
IS  - 0300-9734 (Linking)
VI  - 92
IP  - 2
DP  - 1987
TI  - Optimal discrimination of mild hyperparathyroidism with total serum calcium, 
      ionized calcium and parathyroid hormone measurements.
PG  - 147-76
AB  - The serum concentrations of calcium, albumin and parathyroid hormone (PTH) and 
      the plasma levels of ionized calcium were determined in 124 healthy subjects, 89 
      patients with primary hyperparathyroidism (HPT), 23 of whom had the syndrome of 
      multiple endocrine neoplasia type 1 (MEN-1) and 43 patients who had 
      hypercalcaemia of other causes than HPT (non-HPT), in most cases due to 
      widespread malignancies. The total serum calcium was corrected for the serum 
      albumin concentration (CaM). Healthy females over the age of 50 had higher CaM, 
      than younger females and the women of all ages also had, higher serum PTH levels 
      than males. For all study groups both the intra- and inter-diurnal variations 
      were small for all the studied variables. Discriminant function and optimal 
      discriminatory limits were calculated with the help of computer programs. A 
      consideration of all the individuals in the discriminant analysis, revealed that 
      measurements of CaM alone separated most HPT patients both from the healthy 
      subjects and from the non-HPT patients. However, when only those who had 
      borderline values (defined as CaM between 2.45 and 2.75 mmol/l) were included it 
      turned out that measurements of ionized calcium markedly improved the delineation 
      of mild HPT from the healthy subjects and that, in addition, PTH measurements 
      helped to exclude those with non-HPT hypercalcaemia. The optimal discriminatory 
      levels of serum calcium were calculated as the levels which caused the minimum 
      loss in terms of misclassification when attention was paid to the relative 
      importance of false positive to false negative classifications and to the 
      prevalence of HPT. The optimal discriminatory level for serum calcium for a 
      weighting ratio between false positive to false negative of 1:1, and a prevalence 
      of HPT of 1%, was calculated to be 2.68 mmol/l and for a prevalence of 50% 2.56 
      mmol/l. In the latter situation a weighting ratio of 10:1 for false positive to 
      false negative gave a level of 2.63 mmol/l while a weighting ratio of 1:10 
      corresponded to an optimal discriminatory level of 2.47 mmol/l.
FAU - Benson, L
AU  - Benson L
AD  - Department of Clinical Chemistry, University Hospital, Uppsala, Sweden.
FAU - Ljunghall, S
AU  - Ljunghall S
FAU - Groth, T
AU  - Groth T
FAU - Falk, H
AU  - Falk H
FAU - Hvarfner, A
AU  - Hvarfner A
FAU - Rastad, J
AU  - Rastad J
FAU - Wide, L
AU  - Wide L
FAU - Akerstrom, G
AU  - Akerstrom G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Sweden
TA  - Ups J Med Sci
JT  - Upsala journal of medical sciences
JID - 0332203
RN  - 0 (Parathyroid Hormone)
RN  - 0 (Serum Albumin)
RN  - SY7Q814VUP (Calcium)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Analysis of Variance
MH  - Calcium/*blood
MH  - *Diagnosis, Computer-Assisted
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Hypercalcemia/blood/etiology
MH  - Hyperparathyroidism/blood/*diagnosis/etiology
MH  - Hyperparathyroidism, Secondary/blood/diagnosis/etiology
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia/complications
MH  - Neoplasms/complications
MH  - Parathyroid Hormone/*blood
MH  - Predictive Value of Tests
MH  - Serum Albumin/*analysis
EDAT- 1987/01/01 00:00
MHDA- 1987/01/01 00:01
CRDT- 1987/01/01 00:00
PHST- 1987/01/01 00:00 [pubmed]
PHST- 1987/01/01 00:01 [medline]
PHST- 1987/01/01 00:00 [entrez]
AID - 10.3109/03009738709178686 [doi]
PST - ppublish
SO  - Ups J Med Sci. 1987;92(2):147-76. doi: 10.3109/03009738709178686.