Renal Contributions to Age-Related Changes in Mineral Metabolism.
Renal Contributions to Age-Related Changes in Mineral Metabolism.
复制标题
肾脏代谢变化的肾脏贡献。
作者：
Irsik DL;Bollag WB;Isales CM
衰老会导致大多数系统的功能普遍下降。骨骼和肾脏系统尤其如此，影响矿物质动态平衡。钙和磷的调节需要肠道、骨骼、甲状旁腺和肾脏之间的紧密协调。肠道的作用是从饮食中吸收钙和磷。骨骼根据身体的需要储存或释放钙和磷。甲状旁腺产生甲状旁腺激素，调节骨骼的周转，以应对低的血浆离子钙浓度。肾脏重新吸收或排泄矿物质，并作为血浆浓度的最终调节器。除了甲状旁腺激素外，许多激素也参与了这一过程，包括骨骼产生的成纤维细胞生长因子23和肾脏合成的骨化三醇。硬化素、降钙素、护骨素和核因子受体激活剂-κB配体也参与组织特异性调节。由于衰老或疾病导致的器官功能变化会扰乱这种平衡。在衰老过程中，由于关键蛋白的表达减少，肠道不能有效地吸收钙。在骨骼中，在老年人中，骨形成和骨吸收之间的平衡倾向于后者。在生命的最后几十年，肾脏可能不会有效地过滤血液，矿物质稳态所需的某些蛋白质的表达随着年龄的增长而下降。这些变化往往会导致机体矿物质动态平衡失调。这篇综述将集中讨论衰老对矿物质动态平衡的影响，特别强调肾脏在这一过程中的作用。©2021作者。JBMR Plus由威利期刊有限责任公司代表美国骨骼和矿物研究学会出版。
Aging results in a general decline in function in most systems. This is particularly true with respect to the skeleton and renal systems, impacting mineral homeostasis. Calcium and phosphate regulation requires tight coordination among the intestine, bone, parathyroid gland, and kidney. The role of the intestine is to absorb calcium and phosphate from the diet. The bone stores or releases calcium and phosphate depending on the body's needs. In response to low plasma ionized calcium concentration, the parathyroid gland produces parathyroid hormone, which modulates bone turnover. The kidney reabsorbs or excretes the minerals and serves as the final regulator of plasma concentration. Many hormones are involved in this process in addition to parathyroid hormone, including fibroblast growth factor 23 produced by the bone and calcitriol synthesized by the kidney. Sclerostin, calcitonin, osteoprotegerin, and receptor activator of nuclear factor‐κB ligand also contribute to tissue‐specific regulation. Changes in the function of organs due to aging or disease can perturb this balance. During aging, the intestine cannot absorb calcium efficiently due to decreased expression of key proteins. In the bone, the balance between bone formation and bone resorption tends toward the latter in older individuals. The kidney may not filter blood as efficiently in the later decades of life, and the expression of certain proteins necessary for mineral homeostasis declines with age. These changes often lead to dysregulation of organismal mineral homeostasis. This review will focus on how mineral homeostasis is impacted by aging with a particular emphasis on the kidney's role in this process. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.