RELATIONSHIP BETWEEN THE CONCENTRATION AND RATE OF CHANGE OF CALCIUM AND SERUM INTACT PARATHYROID-HORMONE LEVELS IN NORMAL HUMANS
RELATIONSHIP BETWEEN THE CONCENTRATION AND RATE OF CHANGE OF CALCIUM AND SERUM INTACT PARATHYROID-HORMONE LEVELS IN NORMAL HUMANS
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DOI：
10.1210/jcem-67-5-944
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发表时间：
1988-11-01
影响因子：
5.8
通讯作者：
BROWN, EM
中科院分区：
文献类型：
--
作者：
BRENT, GA;LEBOFF, MS;BROWN, EM
我们采用不同速率的 EDTA 或葡萄糖酸钙输注来检查正常受试者血清总钙和血浆离子钙以及血清免疫反应性完整 PTH 浓度的浓度和变化率之间的关系。使用针对 PTH-(1-84) 的灵敏免疫放射测定法可以确定 PTH 对细胞外钙浓度扰动的全方位反应。通过在快速或缓慢输注过程中逐渐增加葡萄糖酸钙或 EDTA 的给药速率，八名男性的血清钙浓度实现了线性变化率。快速输注期间斜率增加了 2 倍。两种钙输注均使血清 PTH-(1-84) 水平从平均值 23.2 .+- 降低。 2.0 (.+-.SE) 至 6.4 .+-. 1.0 和 5.6.+-。快速和慢速输注分别为1.0 ng/L，没有明显的速率依赖性。快速或缓慢的 EDTA 输注将血清 PTH 水平增加到相同的最大程度（分别为 95.0.+-.20.2 和 99.9.+-.14.5 ng/L），也没有显着的速率依赖性。因此，钙的变化率对 PTH 反应没有影响，这反映在当分别汇集慢速和快速输注的数据时，PTH 与血清总钙和血浆离子钙之间类似的反 S 形关系。在正常女性中也发现了类似的 S 形曲线。这些数据表明，使用钙和 EDTa 输注结合完整的 PTH 测定来确定正常和紊乱的甲状旁腺生理学状态下 PTH-(1-84) 和钙的循环水平之间的关系是可行的。
We employed variable rates of infusion of EDTA or calcium gluconate to examine the relationships between the concentration and rate of change of serum total and plasma ionized calcium and serum immunoreactive intact PTH concentrations in normal subjects. Use of a sensitive immunoradiometric assay specific for PTH-(1-84) made it possible to determine the full range of PTH responses to perturbations in the extracellular calcium concentration. By progressively increasing the rate of administration of calcium gluconate or EDTA during rapid or slow infusions, linear rates of change in the serum calcium concentration were achieved in eight men. The slopes were 2-fold greater during the rapid infusions. Both the calcium infusions decreased serum PTH-(1-84) levels from a mean of 23.2 .+-. 2.0 (.+-. SE) to 6.4 .+-. 1.0 and 5.6 .+-. 1.0 ng/L for the rapid and slow infusions, respectively, with no obvious rate dependence. The rapid or slow EDTA infusions increased serum PTH levels to the same maximal extent (95.0 .+-. 20.2 and 99.9 .+-. 14.5 ng/L, respectively), also with no significant rate dependence. Thus, there was no effect of the rate of change of calcium on the PTH response, which was reflected in similar inverse sigmoidal relationships between PTH and serum total and plasma ionized calcium when the data for the slow and rapid infusions were pooled separately. Similar sigmoidal curves were found in normal women. These data suggest the feasibility of using calcium and EDTa infusions combined with an intact PTH assay to define the relationships between circulating levels of PTH-(1-84) and calcium in states of normal and deranged parathyroid physiology.