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Radioimmunoassay represented a major methodological advance in endocrinology. However, the immunoheterogeneity of some hormones resulted in varying diagnostic sensitivities and specificities and limited their clinical utility. Parathyroid hormone (PTH) was one such hormone, being rapidly metabolized in liver and kidney [1] to yield aminoterminal (amino acid 1-34) and carboxyl terminal (aa 35-85) and other polypeptides. Armitage [2] in a recent review of parathyroid assay performance listed reported studies showing that C-terminal and mid-molecular assays provided clearer discrimination than N-terminal assays between normal and abnormal parathyroid function. The N-terminal assays reflect better acute changes in parathyroid function [2 and 3].

A comparison of the performance and clinical utility of mid-molecular and C-terminal parathyroid hormone assays