Sodium Bicarbonate Infusion Test: A New Method for Evaluating Parathyroid Function

Endocrine Journal

Yuji TANAKA⁴  Kunikazu KONDO²  Noriko MUTSUGA⁵  Etsuko YAMAMORI⁵  Nobuo NAKASHIMA³  Yutaka OISO⁵  Ayako KAKITA⁵  Yasumasa IWASAKI³  Hiroomi FUNAHASHI¹  Tsuneo IMAI¹ 

[1] Departments of Surgery, Nagoya University Graduate School of Medicine and Hospital;Department of Internal Medicine, Anjo Kosei Hospital;Departments of Clinical Pathophysiology, Nagoya University Graduate School of Medicine and Hospital;Department of Surgery I, Aichi Medical University;Departments of Internal Medicine, Nagoya University Graduate School of Medicine and Hospital

关键词: Parathyroid hormone;    Parathyroid gland;    Hyperparathyroidism;    Hypoparathyroidism;    Calcium;   

DOI  :  10.1507/endocrj.50.545

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(18)Cited-By(5)We have developed a new test for estimating the secretory capacity of parathyroid hormone (PTH) from the parathyroid gland. Sodium bicarbonate solution [8.4% (w/v); 35 ml/m2 body surface area] was infused for 2 min, and blood samples for the determination of plasma ionized calcium, plasma PTH (intact, midregion, carboxy-terminus) and related parameters were serially obtained. In 8 healthy volunteers, the mean (±SE) plasma ionized calcium fell promptly and significantly (from 1.21 ± 0.01 to 1.11 ± 0.01 mmol/L) after the sodium bicarbonate infusion. The mean (±SE) plasma intact PTH increased promptly and significantly, by more than four fold (42.3 ± 4.2 to 182.4 ± 34.7 pg/ml), and then gradually returned to basal levels. In patients with partial hypoparathyroidism who have detectable basal plasma levels of PTH, the absolute increment in PTH levels was much less, and in the plasma obtained from patients with complete hypoparathyroidism, absolutely no response was observed. Plasma obtained from patients diagnosed with primary hyperparathyroidism (parathyroid adenoma or hyperplasia) has high basal PTH levels. The response to the sodium bicarbonate infusion in these patients was markedly blunted (less than a two-fold increase in all cases examined). No significant adverse effects were observed during the procedure. Therefore, the sodium bicarbonate infusion test is a simple and sensitive method to stimulate PTH release, and is clinically useful for evaluating parathyroid gland function.

【 授权许可】

Unknown