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Serum Gastrin Level Increased by Chronic Hypercalcemia-Reply

Lawrence E. Mallette, MD, PhD; Michelle Zaniewski, MD; Paul H. Jordan Jr, MD; Bianca Yip, MD, MS; John I. Thornby, PhD
Arch Intern Med. 1986;146(9):1854-1855. doi:10.1001/archinte.1986.00360210252043.
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—We thank Drs Brady and Utts for their comments. We are also concerned about the points they raise, but space limitation precluded a complete discussion. They fear that the serum samples may not have been obtained in the fasting state. At our hospitals, inpatient samples are routinely obtained fasting, while outpatient samples are usually drawn after the patient has waited for and completed his visit with the physician, ie, often two to three hours since the previous meal. Nevertheless, because we could not control sampling time, we were careful to select our control and disease group samples in identical fashion, so that nonfasting samples were equally likely in each group. The upper limit of a normal level for gastrin in our control group was 136 pg/mL, a value slightly higher than the one of 120 pg/mL found earlier with this assay system in fasting subjects,1 suggesting that a modest


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