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Circadian rhythms for calcium, inorganic phosphorus, and parathyroid hormone in primary hyperparathyroidism: functional and practical considerations.

Publication ,  Journal Article
Lobaugh, B; Neelon, FA; Oyama, H; Buckley, N; Smith, S; Christy, M; Leight, GS
Published in: Surgery
December 1989

We obtained serial serum and urine samples from 14 patients with primary hyperparathyroidism both before and 3 to 9 months after excision of their parathyroid adenomas to (1) determine whether the circadian rhythms for calcium, phosphorus, and parathyroid hormone (PTH) previously described in normal human beings are disturbed in this disorder; (2) gauge the effect of surgical treatment on the patterns observed before intervention; and (3) ascertain whether time(s) of blood sampling can be defined for optimal biochemical detection of the disease. Significant rhythms for serum phosphorus, ionized calcium, PTH, urine phosphorus, and urine calcium were observed in many but not all patients before and after surgery. Nonetheless, collective analysis revealed the following: (1) diurnal patterns for serum ionized calcium, phosphorus, urine calcium, and urine phosphorus in patients with primary hyperparathyroidism both before and after surgery, whereas a rhythm for serum PTH was uniquely observed after surgical treatment; and (2) no significant correlation between preoperative serum ionized calcium and PTH but restoration of the expected reciprocal relationship between these variables after surgery. Although variability in individual expression of the rhythm for PTH precludes precise definition of a sampling "window" when hormone levels are likely to be highest, collection of data at points throughout the day helped establish the diagnosis of primary hyperparathyroidism in several patients with borderline serum biochemistries.

Duke Scholars

Published In

Surgery

ISSN

0039-6060

Publication Date

December 1989

Volume

106

Issue

6

Start / End Page

1009 / 1016

Location

United States

Related Subject Headings

  • Surgery
  • Phosphates
  • Parathyroid Neoplasms
  • Parathyroid Hormone
  • Middle Aged
  • Male
  • Hyperparathyroidism
  • Humans
  • Follow-Up Studies
  • Female
 

Citation

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Lobaugh, B., Neelon, F. A., Oyama, H., Buckley, N., Smith, S., Christy, M., & Leight, G. S. (1989). Circadian rhythms for calcium, inorganic phosphorus, and parathyroid hormone in primary hyperparathyroidism: functional and practical considerations. Surgery, 106(6), 1009–1016.
Lobaugh, B., F. A. Neelon, H. Oyama, N. Buckley, S. Smith, M. Christy, and G. S. Leight. “Circadian rhythms for calcium, inorganic phosphorus, and parathyroid hormone in primary hyperparathyroidism: functional and practical considerations.Surgery 106, no. 6 (December 1989): 1009–16.
Lobaugh B, Neelon FA, Oyama H, Buckley N, Smith S, Christy M, et al. Circadian rhythms for calcium, inorganic phosphorus, and parathyroid hormone in primary hyperparathyroidism: functional and practical considerations. Surgery. 1989 Dec;106(6):1009–16.
Lobaugh B, Neelon FA, Oyama H, Buckley N, Smith S, Christy M, Leight GS. Circadian rhythms for calcium, inorganic phosphorus, and parathyroid hormone in primary hyperparathyroidism: functional and practical considerations. Surgery. 1989 Dec;106(6):1009–1016.
Journal cover image

Published In

Surgery

ISSN

0039-6060

Publication Date

December 1989

Volume

106

Issue

6

Start / End Page

1009 / 1016

Location

United States

Related Subject Headings

  • Surgery
  • Phosphates
  • Parathyroid Neoplasms
  • Parathyroid Hormone
  • Middle Aged
  • Male
  • Hyperparathyroidism
  • Humans
  • Follow-Up Studies
  • Female