中国骨质疏松杂志

新疆某三甲医院维汉住院人群高PTH血症筛查

Spot check of Han and Uygur inpatients on high parathyroid hormone level in a three-A hospital of Xinjiang

DOI：10.3969/j.issn.1006.7108.2017.12.021

英文关键词:Parathyroid hormone 25-hydroxyvitamin D Uygur Han

基金项目:乌鲁木齐市科学技术局项目（G161310003）

作者	单位
郭艳英张凯迪王新玲* 张洁罗蕴之陈园赵红丽努荣古丽•买买提袁欣	新疆维吾尔自治区人民医院内分泌科，新疆乌鲁木齐 830001

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中文摘要:

目的初步探讨住院患者高PTH血症检出情况。方法调取2014年8月至2016年8月在新疆维吾尔自治区人民医院住院的患者1123例纳入本研究，年龄15~83岁，其中汉族612例[男/女：267/345，平均年龄（50.9±14.2）岁]，维吾尔族511例[男/女：244/267，平均年龄（52.4±13.4）岁]，采用化学发光法检测血清甲状旁腺激素（PTH）、25-羟维生素D[25(OH)D] ，检测血钙（Ca）、血磷（P）、血镁(Mg)、白蛋白、肌酐（Cr）、碱性磷酸酶（ALP）水平，按照血清25(OH)D水平分为维生素 D 缺乏组 ( ＜ 20 ng /mL) 、不足组 ( ≤ 20＜30 ng /mL) 和充足组 ( ≥30 ng /mL) ; 根据 PTH 水平分为＜ 65pg /mL组，≥ 65 pg /mL组，并对维汉两民族间代谢指标进行比较。结果维吾尔族高PTH血症（≥ 65 pg /mL组）检出率高于汉族（维/汉：18.79% vs 14.05%，c2=4.596， P =0.032），女性高于男性（男/女：17.03% vs 18.55%，c2=0.463，P=0.496）。维吾尔族维生素D充足、不足、缺乏分别为2.94%、5.09%、91.98%，汉族分别为4.08 %、9.48%、86.44%，维吾尔族25(OH)D缺乏的检出率明显高于汉族(c2=8.697，P =0.003 ）。在维生素D缺乏组，高PTH血症检出率明显升高，且维吾尔族高于汉族；偏相关分析提示血清PTH水平与25(OH)D呈负相关（P =0.002），与P、Mg呈正相关（P <0.001）。结论维汉两民族患者血清PTH水平无统计学差异，住院患者普遍存在维生素D缺乏，维吾尔族尤为严重；住院患者高PTH血症检出率存在民族差异可能原因是维生素D缺乏。

英文摘要:

Objective To investigate the prevalence of high parathyroid hormone (PTH) level in hospital inpatients. Methods From August 2014 to August 2016, in total 1123 patients treated in our hospital were involved in this study. The age range was 15 to 83 years, of which 612 cases of Han [male / female: 267/345, mean age 50.9 ±14.2 years], and 511 cases of Uygur [male / female: 244/267, mean age 52.4±13.4 years]. PTH, 25-hydroxyvitamin D [25(OH)D], calcium (Ca), phosphorus (P), magnesium (Mg), albumin, creatinine (Cr) and alkaline phosphatase (ALP) were examined using chemiluminescent immunoassay. Patients was classified into 3 groups according to serum D 25(OH)D levels, deficiency (25(OH)D < 20 ng/mL), insufficiency (20 ng/mL ≤ 25(OH)D < 30 ng/mL）, and sufficiency (25(OH)D > 30 ng/m1. Patients were also grouped into 2 groups according to PTH levels: PTH < 65 pg/mL and PTH≥ 65 pg/mL. Comparisons of relevant indicators were made between the two ethnic groups. Results The incidence of high PTH level (PTH≥ 65 pg/mL) in Uygur was significantly higher than in Han (18.79% vs 14.05%, c2 =4.596 P =0.032), and was significantly higher in females than in males (18.55% vs 17.03% vs, c2=0.463, P =0.496). The prevalence of vitamin D sufficiency, insufficiency and deficiency was 2.94%, 5.09% and 91.98% in Uygur, and 4.08 %, 9.48% and 86.44% in Han, respectively. The vitamin D deficiency rate of Uygur was significantly higher than that of Han (c2 =8.697 P =0.003). In individuals with vitamin D deficiency, the detection rate of high-level PTH increased significantly, especially in Uygur nationality. Partial correlation analysis showed that serum PTH levels were negatively correlated with 25 (OH)D (P = 0.002), and positively correlated with P and Mg (P <0.001).Conclusion There is an ethnic difference in the prevalence of high-level PTH in hospitalized patients, and 25(OH)D deficiency is common among these patients, especially in Uygur nationality. There were no significant differences between two groups in serum PTH level; patients generally have vitamin D deficiency, particularly in Uygur. The ethnic differences in the prevalence of high-level PTH might be due to vitamin D insufficiency.

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