The Ca∗Cl/P Ratio: A Novel and More Appropriate Screening Tool for Normocalcaemic or Overt Primary Hyperparathyroidism
Authors' conclusion
The Ca∗Cl/P ratio provides excellent diagnostic power for diagnosis of PHPT, especially NPHPT.
Study context
- Population
- 230 primary hyperparathyroidism (PHPT) patients, including 65 with normocalcaemic PHPT (NPHPT), and 230 sex- and age-matched controls, January 1, 2013, to March 31, 2023230 PHPT, 230 matched controls
- Comparison
- Ca∗Cl/P ratio vs albumin-corrected calcium, Ca/P ratio and Cl/P ratio for diagnosis of PHPT
- Outcome
- Diagnostic performance of the Ca∗Cl/P ratio for PHPT, especially NPHPT (ROC-AUC)
Methodological detailsretrospective, sex- and age-matched controls
- Retrospective
- Sex- and age-matched controls
Performance
As reported in the abstract
ROC-AUC for diagnosis of PHPT, overall cohort
Ca∗Cl/P ratio
0.964
AUC · 95% CI 0.943–0.979
Albumin-corrected calcium
0.959
AUC · 95% CI 0.934–0.973
Ca/P ratio
0.956
AUC · 95% CI 0.934–0.973
Cl/P ratio
0.923
AUC · 95% CI 0.895–0.946
Further findings
| Outcome | Ca∗Cl/P ratio |
|---|---|
| Ca∗Cl/P ratio cut-off above 239.17 mmol/L: PHPT vs healthy individuals | |
| Sensitivity | 0.952 |
| Specificity | 0.922 |
| PPV | 0.924 |
| NPV | 0.951 |
| Accuracy | 0.937 |
| Ca∗Cl/P ratio performance for NPHPT | |
| Sensitivity | 0.831 |
| Specificity | 0.938 |
| PPV | 0.931 |
| NPV | 0.847 |
| Accuracy | 0.885 |
Ca∗Cl/P ratio vs corresponding controls (NPHPT; HPHPT)
- NPHPT vs controls
- 271.64 ± 51.74 vs 192.71 ± 26
- HPHPT vs controls
- 419.91 ± 139.11 vs 199.14 ± 36.75
- Significantly higher in NPHPT and HPHPT than controls
- P < 0.001
Original publication
The Ca∗Cl/P Ratio: A Novel and More Appropriate Screening Tool for Normocalcaemic or Overt Primary Hyperparathyroidism. Endocr Pract. Published 10 December 2023. doi:10.
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