Reference range of serum calcitonin levels in humans: influence of calcitonin assays, sex, age, and cigarette smoking.
OBJECTIVE
The objective of this study was to re-evaluate the adult C(T) reference values determined by five different immunoassays and by introducing criteria for selecting control subjects.


METHODS
A prospective multicenter study.


METHODS
Three hundred and seventy-five clinically euthyroid subjects.


METHODS
We used five different C(T) immunoassays. Sera were assayed for the concentration of TSH, gastrin, procalcitonin, urea, calcium, and anti-thyroperoxidase antibodies.


RESULTS
Screening for the various potential causes of hypercalcitoninemia led to the exclusion of 23% of the sera. Our reference value analysis dealt with 287 subjects (142 men and 145 women). The proportion of samples in which no C(T) was detected varied from 56% (for assay D) to 88% (for assay C). We observed significant correlations (whose magnitude depended on the assay used) between C(T) levels and age or body mass index (BMI) (primarily in men). The distribution of C(T) levels showed that 4.7, 9.8, 2.5, 6.5, and 8.0% of the values were over 10 pg/ml respectively. These values corresponded essentially to samples from 11 male subjects (median age: 55 years), most of whom were smokers. The highest C(T) values were around twice as high in men than women, and were higher in smokers than non-smokers. Conclusion In clinical practice (and after having excluded the usual causes of raised C(T) levels), the interpretation of C(T) assay results must take into account i) the method used; ii) the patient's gender, age, and weight; and iii) the potential influence of cigarette smoking.
Department of Nuclear Medicine, Hôpital Salengro, CHRU, 59037 Lille Cedex, France. m-dherbomez@chru-lille.fr
Michèle
M
d'Herbomez
Philippe
P
Caron
Catherine
C
Bauters
Christine
C
Do Cao
Jean-Louis
JL
Schlienger
Rémy
R
Sapin
Line
L
Baldet
Bruno
B
Carnaille
Jean-Louis
JL
Wémeau
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002118:Calcium / Q000097:blood; D018276:Carcinoma, Medullary / Q000175:diagnosis; D005260:Female; D005755:Gastrins / Q000097:blood; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007453:Iodide Peroxidase / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D011933:Reagent Kits, Diagnostic; D012016:Reference Values; D012907:Smoking / Q000097:blood*; D013964:Thyroid Neoplasms / Q000175:diagnosis; D013972:Thyrotropin / Q000097:blood; D014508:Urea / Q000097:blood
D000906:Antibodies; D014408:Biomarkers, Tumor; C000606589:CALCA protein, human; D005755:Gastrins; D011498:Protein Precursors; D011933:Reagent Kits, Diagnostic; D014508:Urea; D013972:Thyrotropin; D002116:Calcitonin; D007453:Iodide Peroxidase; D015740:Calcitonin Gene-Related Peptide; D002118:Calcium