Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate the clinical significance of measuring different fragments of parathyroid hormone (PTH) for assessment of bone turnover in maintenance hemodialysis (MHD) patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of 224 MHD patients were enrolled. Levels of serum intact parathyroidhormone (iPTH), whole parathyroid hormone which means (1-84) PTH, serum calcium (Ca), serum phosphorus (P), 25hydroxyvitamin D (25(OH) D), alkaline phosphatase (ALP), total type I procollagen amino terminal peptide (tPINP), osteocalcin (OC) and βType I collagen crosslinked carboxyl terminal peptide(βCTX) were evaluated. Serum (7-84) PTH is obtained by subtracting (1-84) PTH from iPTH. Analyze the clinical characteristics of different PTH and their interrelationship. According to the levels of iPTH, the patients are divided into five groups: group A (10~65 ng／ml), group B (66~199 ng／ml), group C (200~399 ng／ml), group D (400~799 ng／ml) and group E (≥800 ng／ml).
Ｒｅｓｕｌｔｓ：(1-84) PTH and (7-84) PTH increased with the increase of iPTH level, and the increase proportion of (7-84) PTH is greater than that of (1-84) PTH. iPTH can better predict the value of (1-84) PTH when iPTH <1 300 ng／ml. Correlation analysis showed a strong positive association among the three indicators of iPTH, (1-84) PTH and (7-84) PTH (P<005). iPTH, (1-84) PTH and (7-84) PTH are positively correlated with ALP, tPINP, OC and βCTX(P<005), and the correlation between (7-84) PTH and the above indexes is greater than that of iPTH and (1-84) PTH. (1-84) PTH／(7-84) PTH and (1-84) PTH／iPTH are negatively correlated with Ca, P, ALP, tPINP, OC and βCTX, while (7-84) PTH／iPTH is positively correlated with the above indexes(P<005).
Ｃｏｎｃｌｕｓｉｏｎ：In conclusion, (7-84) PTH fragment has the effect of antagonizing (1-84) PTH to promote bone turnover, and simultaneous detection of iPTH and (1-84) PTH fragment is helpful to better evaluate the bone turnover status of MHD patients.