%0 Journal Article %T Serum PTH reference values established with an automated 3rd-generation assay in vitamin D-replete subjects with normal renal function. Consequence for the diagnosis of primary hyperparathyroidism and the classification of dialysis patients %+ CHU Necker - Enfants Malades [AP-HP] %+ Centre d'Investigation Clinique [Rennes] (CIC) %+ Récepteurs stéroïdiens : physiopathologie endocrinienne et métabolique %+ Service de génétique moléculaire, pharmacogénétique et hormonologie %+ Hôpital Cochin [AP-HP] %+ Centre Hospitalier Universitaire Sart Tilman %+ Service d'endocrinologie %A Souberbielle, Jc %A Massart, Catherine %A Brailly-Tabard, Sylvie %A Cormier, Catherine %A Cavalier, Etienne %A Delanaye, Pierre %A Chanson, Philippe %< avec comité de lecture %@ 0804-4643 %J European Journal of Endocrinology %I BioScientifica %V 174 %N 3 %P 315-323 %8 2016-03 %D 2016 %R 10.1530/EJE-15-0595 %M 26628583 %K vitamin D %K parathyroid hormone %K primary hyperparathyroidism %K reference values %K dialysis %Z Life Sciences [q-bio] %Z Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biologyJournal articles %X Objective - To determine parathyroid hormone (PTH) reference values in French healthy adults, taking into account serum 25-hydroxyvitamin D (25OHD), renal function, age, gender, and BMI. Participants and main biological measurements - We studied 898 healthy subjects (432 women) aged 18-89 years with a normal BMI and estimated glomerular filtration rate (eGFR), 81 patients with surgically proven primary hyperparathyroidism (PHPT), and 264 dialysis patients. 25OHD and third-generation PTH assays were implemented on the LIAISON XL platform. Results - Median PTH and 25OHD values in the 898 healthy subjects were 18.8  ng/l and 23.6  ng/ml respectively. PTH was lower in subjects with 25OHD ≥30  ng/ml than in those with lower values. Among the 183 subjects with 25OHD ≥30  ng/ml, those aged ≥60 years (n=31) had higher PTH values than younger subjects, independent of 25OHD, BMI, and eGFR (P<0.001). Given the small number of subjects aged ≥60 years, we adopted the 95% CI of PTH values for the entire group of 183 vitamin D-replete subjects (9.4-28.9  ng/l) as our reference values. With 28.9  ng/l as the upper limit of normal (ULN) rather than the manufacturer's ULN of 38.4  ng/l, the percentage of PHPT patients with 'high' PTH values rose to 90.1% from 66.6% (P<0.001), and 18.6% of the dialysis patients were classified differently in view of the KDIGO target range (two to nine times the ULN). Conclusion - When only subjects with 25OHD ≥30  ng/ml were included in the reference population, the PTH ULN fell by 22.4%, diagnostic sensitivity for PHPT improved, and the classification of dialysis patients was modified. %G English %2 https://univ-rennes.hal.science/hal-01239803/document %2 https://univ-rennes.hal.science/hal-01239803/file/Serum%20PTH%20reference%20values%20established%20EJE-NPTH%20Liaison.pdf %L hal-01239803 %U https://univ-rennes.hal.science/hal-01239803 %~ INSERM %~ UNIV-RENNES1 %~ UNIV-PSUD %~ APHP %~ HL %~ CIC %~ CIC203 %~ STATS-UR1 %~ UR1-UFR-SVE %~ UR1-HAL %~ UR1-SDV %~ UNIV-PARIS-SACLAY %~ UNIV-PSUD-SACLAY %~ TEST-UNIV-RENNES %~ TEST-UR-CSS %~ UNIV-RENNES %~ CHU-UNIV-PARIS5 %~ UR1-BIO-SA %~ PHYSENDO