{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:54:37Z","timestamp":1792151677407,"version":"4.4.0"},"reference-count":35,"publisher":"The Endocrine Society","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The reliable diagnosis of primary hyperparathyroidism depends on the measurement of PTH. The PTH assays in widespread use measure not only the hormone but also hormone fragments, thus limiting the clinical utility of the assays. A new immunoradiometric assay (IRMA) using an antigenic determinant at the extreme amino-terminal of the PTH molecule detects only full-length PTH (1\u201384). We compared three PTH assays and determined the presence of PTH (1\u201384) and PTH fragments in serum and parathyroid adenomas of patients with primary hyperparathyroidism. We studied 56 patients with primary hyperparathyroidism. PTH levels were increased in 63% using the midmolecule RIA; in 73% in the \u201cintact\u201d IRMA; and in 96% in the PTH (1\u201384)-IRMA. The PTH (1\u201384)-IRMA correlated with the other assays (midmolecule RIA R = +0.736; P &amp;lt; 0.0001; \u201cintact\u201d-IRMA R = +0.951; P &amp;lt; 0.0001) and indices of disease activity (serum calcium R = +0.511, P &amp;lt; 0.0001; alkaline phosphatase R = +0.489, P = 0.001; and radius bone density R = \u22120.366, P &amp;lt; 0.01). In 21 consecutive patients undergoing parathyroidectomy, 18 had parathyroid adenomas. Intact PTH was higher than PTH (1\u201384)-IRMA in both serum and glandular homogenates from these patients. Similar proportions of PTH (1\u201384) and hormone fragments were found in both adenomas [66 \u00b1 3% of \u201cintact\u201d PTH-reflected PTH (1\u201384) and sera (73 \u00b1 2% of \u201cintact\u201d PTH reflected PTH (1\u201384)]. We conclude that the PTH (1\u201384)-IRMA offers improved diagnostic sensitivity in patients with primary hyperparathyroidism than other currently available assays. This study also provides evidence that both PTH (1\u201384) and PTH fragments are produced in parathyroid adenomas and that peripheral metabolism of hormone and fragment does not alter the proportion of bioactive hormone.<\/jats:p>","DOI":"10.1210\/jc.2002-021266","type":"journal-article","created":{"date-parts":[[2003,10,13]],"date-time":"2003-10-13T17:42:51Z","timestamp":1066066971000},"page":"4725-4730","source":"Crossref","is-referenced-by-count":81,"title":["Clinical Utility of an Immunoradiometric Assay for Parathyroid Hormone (1\u201384) in Primary Hyperparathyroidism"],"prefix":"10.1210","volume":"88","author":[{"given":"Shonni J.","family":"Silverberg","sequence":"first","affiliation":[{"name":"Departments of Medicine (S.J.S., I.B., J.P.B.), New York, New York 10032;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Gao","sequence":"additional","affiliation":[{"name":"Scantibodies Laboratory (P.G., T.L.C.), Santee, California 92071"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ijeoma","family":"Brown","sequence":"additional","affiliation":[{"name":"Departments of Medicine (S.J.S., I.B., J.P.B.), New York, New York 10032;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"LoGerfo","sequence":"additional","affiliation":[{"name":"Surgery (P.L.), College of Physicians and Surgeons, Columbia University, New York, New York 10032;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom L.","family":"Cantor","sequence":"additional","affiliation":[{"name":"Scantibodies Laboratory (P.G., T.L.C.), Santee, California 92071"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Bilezikian","sequence":"additional","affiliation":[{"name":"Departments of Medicine (S.J.S., I.B., J.P.B.), New York, New York 10032;"},{"name":"Pharmacology (J.P.B.), New York, New York 10032;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071618244737700_R1","first-page":"157","article-title":"Advances in immunoassays for PTH: clinical applications to skeletal disorders of bone and mineral metabolism In: Bilezikian JP, Marcus R, Levine MA, eds","author":"Nussbaum","year":"1994","journal-title":"The parathyroids. New York: Raven Press;"},{"key":"2020071618244737700_R2","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1073\/pnas.49.5.613","article-title":"Immunoassay of bovine and human parathyroid hormone.","volume":"49","author":"Berson","year":"1963","journal-title":"Proc Natl Acad Sci USA"},{"key":"2020071618244737700_R3","first-page":"1","article-title":"Current clinical concept: assessment of parathyroid function with an N-terminal specific radioimmunoassay for intact parathyroid hormone","author":"Potts","year":"1983","journal-title":"Los Angeles: Nichols Institute;"},{"key":"2020071618244737700_R4","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1093\/clinchem\/33.8.1364","article-title":"Highly sensitive two-site immunoradiometric assay of parathyrin and its clinical utility in evaluating patients with hypercalcaemia.","volume":"33","author":"Nussbaum","year":"1987","journal-title":"Clin Chem"},{"key":"2020071618244737700_R5","first-page":"143","article-title":"Immunoassays for PTH and PTHrP: clinical applications","author":"Deftos","year":"2001","journal-title":"In: Bilezikian JP, Marcus R, Levine MA, eds. The parathyroids. 2nd ed. New York: Academic Press;"},{"key":"2020071618244737700_R6","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1056\/NEJM197911153012005","article-title":"The peripheral metabolism of parathyroid hormone.","volume":"302","author":"Martin","year":"1979","journal-title":"N Engl J Med"},{"key":"2020071618244737700_R7","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1093\/clinchem\/44.4.805","article-title":"A non-(1\u201384) circulating parathyroid hormone (PTH) fragment interferes significantly with intact PTH commercial assay measurements in uremic samples.","volume":"44","author":"Lepage","year":"1998","journal-title":"Clin Chem"},{"key":"2020071618244737700_R8","doi-asserted-by":"crossref","first-page":"4287","DOI":"10.1210\/jcem.84.11.6236","article-title":"A novel immunoradiometric assay detects full-length human PTH but not amino-terminally truncated fragments: Implications for PTH measurements in renal failure.","volume":"84","author":"John","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071618244737700_R9","first-page":"17","article-title":"Parathyroid hormone biosynthesis and metabolism","author":"Kronenberg","year":"2001","journal-title":"In: Bilezikian JP, Marcus R, Levine MA, eds. The parathyroids. 2nd ed. New York: Academic Press;"},{"key":"2020071618244737700_R10","doi-asserted-by":"crossref","first-page":"4252","DOI":"10.1021\/bi00261a011","article-title":"Metabolism of parathyroid hormone by Kupffer cells: analysis by reverse-phase high- performance liquid chromatography.","volume":"21","author":"Bringhurst","year":"1982","journal-title":"Biochemistry"},{"key":"2020071618244737700_R11","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1042\/cs0570435","article-title":"Distribution of circulating immunoreactive components of parathyroid hormone in normal subjects and in patients with primary and secondary hyperparathyroidism: the role of the kidney and of serum calcium concentration.","volume":"57","author":"Dambacher","year":"1979","journal-title":"Clin Sci"},{"key":"2020071618244737700_R12","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1172\/JCI110052","article-title":"Effects of hepatectomy, nephrectomy, and nephrectomy, uremia on the metabolism of parathyroid hormone in the rat.","volume":"67","author":"Segre","year":"1981","journal-title":"J Clin Invest"},{"key":"2020071618244737700_R13","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1359\/jbmr.2001.16.4.605","article-title":"Development of a novel immunoradiometric assay exclusively for biologically active whole parathyroid hormone 1\u201384: implications for improvement of accurate assessment of parathyroid function.","volume":"16","author":"Gao","year":"2001","journal-title":"J Bone Miner Res"},{"key":"2020071618244737700_R14","first-page":"145","article-title":"Intact parathyroid hormone over-estimates the presence and severity of parathyroid-mediated osseous abnormalities in uremia.","volume":"75","author":"Quarles","year":"1992","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071618244737700_R15","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/S0085-2538(15)47156-X","article-title":"A novel mechanism for skeletal resistance in uremia.","volume":"58","author":"Slatopolsky","year":"2000","journal-title":"Kidney Int"},{"key":"2020071618244737700_R16","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/00002060-199801000-00005","article-title":"Bone mineral density and indices of bone metabolism in spinal cord injury.","volume":"77","author":"Szollar","year":"1998","journal-title":"Am J Phys Med Rehabil"},{"issue":"Suppl 1","key":"2020071618244737700_R17","first-page":"S446","article-title":"Measuring the biologically active or authentic whole PTH with a novel IRMA without cross-reaction to the PTH(7\u201384) fragment","volume":"14","author":"Gao","year":"1999","journal-title":"J Bone Miner Res"},{"key":"2020071618244737700_R18","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1056\/NEJM199910213411701","article-title":"The natural history of treated and untreated asymptomatic primary hyperparathyroidism: a ten year prospective study.","volume":"341","author":"Silverberg","year":"1999","journal-title":"N Engl J Med"},{"key":"2020071618244737700_R19","doi-asserted-by":"crossref","first-page":"593","DOI":"10.7326\/0003-4819-114-7-593","article-title":"Diagnosis and management of asymptomatic primary hyperparathyroidism: consensus development conference statement.","volume":"114","year":"1991","journal-title":"Ann Intern Med"},{"key":"2020071618244737700_R20","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1002\/jbmr.5650040302","article-title":"Skeletal disease in primary hyperparathyroidism.","volume":"4","author":"Silverberg","year":"1989","journal-title":"J Bone Miner Res"},{"key":"2020071618244737700_R21","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1177\/039139889001300204","article-title":"Comparison of different parathyroid hormone radioimmunoassays in uremic patients with secondary hyperparathyroidism.","volume":"13","author":"Togashi","year":"1990","journal-title":"Int J Artif Organs"},{"key":"2020071618244737700_R22","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1210\/jcem-68-2-340","article-title":"Serum bioactive parathyroid hormone in hemodialysis patients.","volume":"68","author":"McCarthy","year":"1989","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071618244737700_R23","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1093\/clinchem\/46.5.697","article-title":"Influence of glomerular filtration rate on non-(1\u201384) parathyroid hormone (PTH) detected by intact PTH assays.","volume":"46","author":"Brossard","year":"2000","journal-title":"Clin Chem"},{"key":"2020071618244737700_R24","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1055\/s-0029-1210582","article-title":"The secretion of parathyroid hormone and its fragments from dispersed cells of adenomatous parathyroid tissue at different calcium concentrations.","volume":"88","author":"Kubler","year":"1986","journal-title":"Exp Clin Endocrinol"},{"key":"2020071618244737700_R25","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1210\/endo-104-6-1778","article-title":"Effects of plasma calcium concentration on the relative proportion of hormones and carboxyl fragments in parathyroid venous blood.","volume":"104","author":"Mayer","year":"1979","journal-title":"Endocrinology"},{"key":"2020071618244737700_R26","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1210\/jcem-63-5-1075","article-title":"Calcium-dependent release of carboxyl-terminal fragments of parathyroid hormone by hyperplastic human parathyroid tissue in vitro.","volume":"63","author":"Hanley","year":"1986","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071618244737700_R27","first-page":"E680","article-title":"Influence of serum Ca concentration on circulating molecular forms of PTH in three species","volume":"251","author":"D\u2019Amour","year":"1986","journal-title":"Am J Physiol"},{"key":"2020071618244737700_R28","first-page":"525","article-title":"Modulation of circulating parathyroid hormone immunoheterogeneity in man by iodized calcium concentration.","volume":"75","author":"D\u2019Amour","year":"1992","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071618244737700_R29","first-page":"413","article-title":"Carboxyl-terminal fragments of parathyroid hormone are not secreted preferentially in primary hyperparathyroidism as they are in other causes of hypercalcemia.","volume":"77","author":"Brossard","year":"1993","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071618244737700_R30","doi-asserted-by":"crossref","first-page":"4732","DOI":"10.1210\/endo.136.11.7588200","article-title":"Characterization of a novel parathyroid hormone (PTH) receptor with specificity for the carboxyl-terminal region of 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