The Ca*Cl/P Ratio: A Novel and More Appropriate Screening Tool for Normocalcaemic or Overt Primary Hyperparathyroidism

作者全名：Yu, Yanling; Qiu, Jingwen; Chuan, Fengning; Feng, Zhengping; Long, Jian; Zhou, Bo

作者地址：[Yu, Yanling; Feng, Zhengping; Long, Jian; Zhou, Bo] Chongqing Med Univ, Dept Endocrinol, Affiliated Hosp 1, Chongqing, Peoples R China; [Qiu, Jingwen] Chongqing Med Univ, Dept Endocrinol & Metab, Affiliated Hosp 2, Chongqing, Peoples R China; [Chuan, Fengning] Chongqing Univ, Dept Endocrinol, Fuling Hosp, Chongqing, Peoples R China

通信作者：Zhou, B (通讯作者)，Chongqing Med Univ, Dept Endocrinol, Affiliated Hosp 1, Chongqing, Peoples R China.

来源：ENDOCRINE PRACTICE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001236991700001

JCR分区：Q2

影响因子：3.7

年份：2024

卷号：30

期号：3

开始页：231

结束页：238

文献类型：Article

关键词：diagnosis; calcium; phosphorus; chlorine; normocalcaemia; primary hyperparathyroidism

摘要：Objective: The main purpose of this study was to explore the diagnostic performance of the Ca*Cl/P ratio for primary hyperparathyroidism (PHPT), especially normocalcaemic PHPT (NPHPT), to assist health care providers in making reliable and rapid clinical identifications. Methods: From January 1, 2013, to March 31, 2023, 230 PHPT patients, including 65 with NPHPT and 230 sex- and age -matched controls, were enrolled in this retrospective study. Differences between hypercalcaemic PHPT (HPHPT) and NPHPT and between them and their respective controls were analyzed. The diagnostic accuracy of the Ca*Cl/P ratio, Ca/P ratio, Cl/P ratio and albumin -corrected calcium was assessed by the area under the receiver operating characteristic curve. Results: Compared with corresponding controls, NPHPT and HPHPT patients both had significantly higher Ca * Cl/P ratios (271.64 +/- 51.74 vs 192.71 +/- 26; 419.91 +/- 139.11 vs 199.14 +/- 36.75, P < .001). In the overall cohort, the ROC-AUC of the Ca*Cl/P ratio (0.964, 95% CI = 0.943-0.979) for diagnosis of PHPT patients was superior to albumin -corrected calcium (0.959, 95% CI = 0.934-0.973), the Ca/P ratio (0.956, 95% CI = 0.934-0.973), and the Cl/P ratio (0.923, 95% CI = 0.895-0.946). A Ca * Cl/P ratio above 239.17 mmol/L, with sensitivity (0.952), specificity (0.922), PPV (0.924), NPV (0.951) and accuracy (0.937), can distinguish PHPT patients from healthy individuals. Furthermore, the Ca * Cl/P ratio yielded a sensitivity of 0.831, specificity of 0.938, PPV of 0.931, NPV of 0.847 and accuracy of 0.885 for NPHPT. Conclusion: The Ca*Cl/P ratio provides excellent diagnostic power for diagnosis of PHPT, especially NPHPT. <(c)> 2023 AACE. Published by Elsevier Inc. All rights reserved.

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