骨化三醇抑制试验在维生素D缺乏相关正常血钙甲状旁腺功能亢进症筛查中的应用OA

Objective To evaluate the application value of the calcitriol suppression test as a screening tool for primary hyperparathyroidism(NPHPT)and secondary hyperparathyroidism(SHPT)caused by vitamin D deficiency in patients with normal serum calcium levels.Methods From July 2023 to December 2024,43 patients with elevated para-thyroid hormone(PTH)levels,normal or mildly elevated serum calcium levels,and vitamin D deficiency were recruited from the outpatient department of the First Affiliated Hospital of Xinjiang Medical University.All patients underwent an oral calcitriol suppression test,receiving 0.25 μg of calcitriol three times daily for one week.Pre-and post-test levels of 25-hydroxyvitamin D[25(OH)D],PTH,and ultrasonographic findings of the parathyroid gland were recorded.The PTH suppression ratio was calculated.The diagnostic value of the calcitriol suppression test was assessed using receiver operat-ing characteristic(ROC)curve analysis.Results According to diagnostic criteria for primary hyperparathyroidism,par-ticipants were divided into two groups:normocalcemic primary hyperparathyroidism with vitamin D deficiency(NPHPT group,n=9)and SHPT caused by vitamin D deficiency(SHPT group,n=34).Compared to the SHPT group,the NPHPT group showed a significantly higher PTH-IR ratio[0.78(0.7,1.0)vs.1.20(0.9,1.5),P＜0.05].The ma-jority of patients in the NPHPT group had PTH-IR＞1(7/9),whereas most patients in the SHPT group had PTH-IR＜1(29/34).ROC curve analysis showed that the area under the curve(AUC)for PTH-IR in diagnosing NPHPT was 0.758(95%CI:0.557-0.960).The sensitivity,specificity,positive predictive value,and negative predictive value of PTH-IR for diagnosing NPHPT were 77.8%,85.3%,58.3%,and 93.5%,respectively.Conclusion The calcitriol suppression test is a simple and feasible diagnostic test for screening NPHPT,with good sen-sitivity and specificity.Further research in multicenter and large-sample studies is needed.