Abstract
The urinary excretion of total hydroxyproline was elevated above the upper limit of normal values in 8 out of 13 patients with surgically confirmed primary hyperparathyroidism. All patients with normal urinary total hydroxyproline excretion had normal plasma alkaline phosphatase levels and normal bone X-rays, whereas 3 of the 8 patients with increased total hydroxyproline excretion had increased plasma alkaline phosphatase levels, and 4 of these 8 patients showed evidence of bone involvement in X-rays. These results support the suggestion that the urinary excretion of total hydroxyproline may be a more sensitive index of bone involvement in hyperparathyroidism than plasma alkaline phosphatase or bone X-rays, but that even normal hydroxyproline excretion does not exclude bone involvement. After removal of the parathyroid adenoma, the urinary excretion of total hydroxyproline decreased in all 7 patients in whom this effect was studied, including 2 patients with initially normal urinary total hydroxyproline values.The ratio of free to total urinary hydroxyproline was determined in 9 patients with hyperparathyroidism, including 4 patients with normal urinary total hydroxyproline excretion. This ratio was found to be elevated in 8 out of 9 patients studied. The content of free serum hydroxyproline was normal in 3 of these 8 patients, suggesting that the increased ratio in the urine was probably due to renal effects of parathyroid hormone
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