Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.

Alkaline phosphatase improves predictive power of Cl/PO4 ratio for primary hyperparathyroidism

15 Jul 2017

The chloride/phosphate ratio (Cl/PO4) combined with alkaline phosphatase (ALP) is a simple and effective predictor of primary hyperparathyroidism (PHPT) in a Chinese population, a new study shows.

Compared with normal controls, ALP and Cl/PO4 levels were significantly higher in patients with normocalcaemic PHPT (NPHPT; 107.0 vs 61.5 U/L; p<0.001; 2.6 vs 2.4; p=0.001) and hypercalcaemia PHPT (114 vs 61.5 U/L; p<0.001; 43.1 vs 29.9; p<0.001).

Stepwise multiple regression showed that Cl/PO4 was an independent risk factor for the hypercalcaemia PHPT (odds ratio [OR], 0.832; 95 percent CI, 0.769 to 0.900; p<0.001) and NPHPT (OR, 0.797; 0.667 to 0.951; p=0.012) after adjusting for confounders like age, BMI and sodium levels.

While Cl/PO4 alone (area under the receiver operating curve [ROC-AUC], 0.73; 0.587 to 0.899) was a good predictor for NPHPT, including ALP in the model significantly increased predictive power (ROC-AUC, 0.913; 0.744 to 1.000).

The combined model also had greater specificity and sensitivity (83 and 94 percent, respectively) than CL/PO4 (80 and 73.7 percent, respectively) and ALP (66 and 94.7 percent, respectively) alone.

CL/PO4 alone was also a good predictor in the hypercalcaemia PHPT group (ROC-AUC, 0.897; 0.851 to 0.942). Including ALP in the model similarly increased its predictive value (ROC-AUC, 0.932; 0.897 to 0.966).

Sensitivity and specificity of the combined model (98 and 92.8 percent, respectively) were again greater than the models with Cl/PO4 (88.9 and 80 percent, respectively) and ALP (67.3 and 92 percent, respectively) alone.

The study included 172 PHPT patients categorized as having either NPHPT (n=19; mean age 59.1±14.3 years; 26.3 percent male) or hypercalcaemic PHPT (n=153; mean age 56.3±16.0 years; 21.6 percent male).

Exclusion criteria included vitamin D deficiency, secondary hyperparathyroidism, patients without surgery, renal diseases and use of diuretics among others.

A parallel control group of 50 normal, healthy individuals (mean age 45.5 years; 60.0 percent male) was also established.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.