Influence of PTH and 1,25(OH)2D on calcium homeostasis and bone mineral content after gastric surgery
Influence of PTH and 1,25(OH)2D on calcium homeostasis and bone mineral content after gastric surgery
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PTH和1,25(OH)2D对胃术后钙稳态和骨矿物质含量的影响
DOI：
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发表时间：
1985
影响因子：
4.2
通讯作者：
C. Christiansen
中科院分区：
文献类型：
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作者：
L. Nilas;C. Christiansen
在57例手术治疗的溃疡患者中，我们发现25 OHD浓度较低，1，25（OH）2D浓度升高（P<0.001），iPTH水平正常，单光子吸收法测定骨矿物质含量（BMC）无显著降低。经常服用维生素D的患者25 OHD浓度最高（P<0.05），而维生素D摄入量对1，25（OH）2D浓度和BMC值无影响。15例Billroth I手术患者的BMC为正常值的89.4±12.4%，其中钙代谢紊乱最严重。尽管钙和维生素D的膳食摄入量符合斯堪的纳维亚的建议，钙的吸收处于正常范围的较低部分，但一般营养状况似乎影响这些患者的骨量。骨吸收（r = 0.68，P <0.001）和骨形成（r= 0.42，P <0.001）的生化指标。我们认为，胃切除术后发现的高1，25（OH）2D浓度表达一个代偿过程，导致钙吸收的增加，在这个序列中的初始事件是一个趋势，低血清钙水平。随着对这种调节的需求增加或缺乏1，25（OH）2D合成的前体，骨量通过1，25（OH）2D和/或PTH的作用而下降。
SummaryIn 57 patients surgically treated for ulcer, we found low 25OHD concentrations, elevated 1,25(OH)2D concentrations, (P<0.001), a normal iPTH level, and a not significantly reduced bone mineral content (BMC) measured by single photon absorptiometry. The 25OHD concentrations were highest in patients regularly taking tablets containing vitamin D (P<0.05), whereas the 1,25 (OH)2D concentrations and the BMC values were not affected by vitamin D intake. The most severe calcium metabolic disturbances were seen in 15 Billroth I resected patients whose BMC was 89.4±12.4% of normal. Although the dietary intake of calcium and vitamin D complied with the Scandinavian recommendations and calcium absorption was in the lower part of the normal range, the general state of nutrition appears to influence the bone mass of such patients.In the patients as a group, the 1,25(OH)2D concentrations were significantly related to BMC (r=0.42,P<0.001) and biochemical signs of bone resorption (r=0.68,P<0.001) and formation (r=0.42,P<0.001) Conversely, no relationship could be detected between serum iPTH and bone mass or bone turnover. We suggest that the high 1,25(OH)2D concentrations found after gastric resections express a compensatory process leading to an increase in calcium absorption, and that the initial event in this sequence is a trend toward low serum calcium levels. With increased demands on this regulation or lack of precursor for 1,25(OH)2D synthesis, bone mass declines through the action of 1,25(OH)2D and/or PTH.
影响因子：
5.8
作者：
GALLAGHER, JC;RIGGS, BL;DELUCA, HF
通讯作者：
DELUCA, HF