Serum ionized calcium, nephrogenous and total urinary cyclic AMP and urinary phosphate in normal subjects

Thode, J.; Sn, Holmegaard; Siggaard‐Andersen, Ole

doi:10.3109/00365518409161391

Cited by 8 publications

(2 citation statements)

References 17 publications

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“…This mean value is much higher than we have previously found in adults (95% confidence limits: 36K-372 pmolimol) [9], as also observed by other investigators [2, 4, 6, 71. This mean value is much higher than we have previously found in adults (95% confidence limits: 36K-372 pmolimol) [9], as also observed by other investigators [2, 4, 6, 71.…”

Section: Discussionsupporting

confidence: 85%

“…We and others have previously shown a significant difference in the excretion of creatinine between men and women [1,9,121 a fact which does not favour the expression of (UcAMPkrea)" in adults, where the preferable expression for the excretion of cAMP is the substance concentration in the glomerular filtrate of total urinary cAMP [UcAMP],,, or better of nephrogenous cAMP [NcAMPIGF, which also corrects for the filtrated load of plasma cAMP [l, 91. In contrast we did not find any significant difference between the results for (UcAMPkrea)" between girls and boys due to a non-significant difference in body mass [3,…”

Section: Discussionmentioning

confidence: 99%

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Urinary cyclic AMP in spot urine of healthy children

Thode

Jacobsen

Holmegaard

1985

Scandinavian Journal of Clinical and Laboratory Investigation

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We present reference values for the excretion of cAMP in spot urine collected between 09.00 and 12.00 hours in 143 healthy children aged 2-200 months. The excretion of cAMP was creatinine-corrected and expressed as a substance concentration ratio (UcAMP/crea)U due to a positive significant correlation between the excretion of cAMP and creatinine (r = 0.68, p less than 0.001). The mean value (95% significance limits) for (UcAMP/crea)U was 748 mumol/mol (254-2206 mumol/mol). A logarithmic transformation of the ratio was used, since preliminary analysis showed uneven distribution; when the logarithmic transformation was used, the data appeared evenly distributed. There was no significant difference between the results for girls and boys. The value of lg(UcAMP/crea)U was related to the age or body surface area with decreasing values at higher age or body surface area. (r = -0.55 and r = -0.57, p less than 0.001). Spot urine for measurement of urinary cAMP instead of a 24 h collection appears preferable due to the practicability of the test in children.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Urinary cyclic AMP in spot urine of healthy children

Thode

Jacobsen

Holmegaard

1985

Scandinavian Journal of Clinical and Laboratory Investigation

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Journal of Bone and Mineral Research

Ladenson

1991

Journal of Bone and Mineral Research

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Calcium is the most closely controlled substance in the blood. The biologic variation of total calcium is ~2 % and of the biologically active free (ionized, ionic) calcium only l070.('-~) Thus, the monitoring of calcium in blood requires analytic procedures of high precision and accuracy. For patients with asymptomatic primary hyperparathyroidism, calcium monitoring involves the measurement of total calcium and free calcium. This review first considers the measurement of total calcium and then free calcium. MEASUREMENT OF TOTAL CALCIUM Analytic approaches NUMBER OF ANALYTIC PROCEDURES have been utilizedA to measure total calcium over the last 50 years. Because of the small biologic variation, the need for methods of high precision and accuracy has long been apparent, and this analyte was one of the first to be addressed by professional organizations in laboratory medicine and clinical chemistry with interest in improving the performance of clinical laboratories. These efforts are now coordinated by the National Reference System for the Clinical Laboratory (NRSCL), formerly called the National Reference System in Clinical Chemistry. The NRSCL is a component of the National Committee for Clinical Laboratory Standards (NCCLS), which is a nonprofit organization that involves government, professional organizations, and industry and is the leading standards-setting organization for clinical laboratories in the United States.The components involved in the development and application of a standardization system are shown in Fig. 1. The key to the system are steps I1 through V. For calcium, a definitive method based on isotope dilution mass spectroscopy was developed by workers at the National Institute of Standards and Technology (NIST, formerly the National Bureau of Standards).(41 A primary reference material of calcium carbonate is available (standard reference material, SRM 915, available from NIST) and a reference method based on atomic absorption spectroscopy has been developed and validated.") In addition, a secondary reference material consisting of lyophilized sera with an assigned calcium value is available (SRM 909, NIST).These activities, along with the evolution of more automated procedures, have had a dramatic effect on the agreement among clinical laboratories for the measurement of total calcium. This improvement is readily apparent when comparing the interlaboratory precision 01' total calcium measurements with the survey samples of the College of American Pathologists quality control survey program ( Table 1). These data show that the interlaboratory precision of total calcium measurements decreased from =6Vo in the early 1970s to 3.3% in 1990. The precision in an individual laboratory can be even better ihan 3.3%. In the clinical chemistry laboratory at Barnes Hospital, the precision of total calcium measurements over the last year has been I .8-2.1 OJo for one type of analyzer and 2.3-3.1 Yo for another analyzer.It is my opinion that the current state of the art of total calcium measurement i...

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Demonstration of blood calcium-related parathyroid function in the diurnal variation of blood and urine calcium and phosphorus in healthy individuals

et al. 1991

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The circadian changes in blood and urine minerals and parathyroid function assessed by nephrogenous cyclic AMP (NcAMP) and a highly sensitive midregion specific parathyroid hormone (PTH) radioimmunoassay (RIA) were investigated for 26 hours in ten healthy 23 to 53-year-old males (group 1) with normal food intakes. Also, we studied another six male and four female adults between 600 and 1200 h as fasting controls (group 2). The blood calcium (Ca) levels were the highest at 630 h in both groups and decreased thereafter, and the diurnal variation of NcAMP reflected that of serum Ca, showing a low value in the morning. There were significant negative correlations between total Ca and NcAMP in both groups 1 and 2 (r=--0.323, n=130, p(0.01; r=-0.525, n=60, p(0.01), suggesting that the blood Ca level is the major determinant of parathyroid function and that NcAMP is a good indicator of blood Ca related PTH secretion in healthy individuals. This last relationship was not seen between Ca and midregion PTH levels presumably owing to slow clearance of PTH fragments from the circulation. However, midregion PTH perhaps because of its long half life, not NcAMP, shows a significant inverse relation to urinary Ca excretion (mg/dIGF) in the diurnal variation in healthy individuals (r--0.560, n=130, p(0.01). The circadian pattern (s) of serum phosphate (P) consisted of a minium level at 900-1100 h followed by two peaks, at 1400-1600 h and 2200-2400 h. Thus, this study conducted in healthy individuals under physiologic condition clearly demonstrated that the NcAMP level reflects blood Ca related PTH secretion and that urinary Ca excretion seems to be determined by the sum of PTH secretion.

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Serum ionized calcium, nephrogenous and total urinary cyclic AMP and urinary phosphate in normal subjects

Cited by 8 publications

References 17 publications

Urinary cyclic AMP in spot urine of healthy children

Urinary cyclic AMP in spot urine of healthy children

Journal of Bone and Mineral Research

Demonstration of blood calcium-related parathyroid function in the diurnal variation of blood and urine calcium and phosphorus in healthy individuals

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