EFFECT OF ESTROGEN ON CALCIUM-ABSORPTION AND SERUM VITAMIN-D METABOLITES IN POST-MENOPAUSAL OSTEOPOROSIS
EFFECT OF ESTROGEN ON CALCIUM-ABSORPTION AND SERUM VITAMIN-D METABOLITES IN POST-MENOPAUSAL OSTEOPOROSIS
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DOI：
10.1210/jcem-51-6-1359
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发表时间：
1980-01-01
影响因子：
5.8
通讯作者：
DELUCA, HF
中科院分区：
文献类型：
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作者：
GALLAGHER, JC;RIGGS, BL;DELUCA, HF
骨质疏松症妇女钙吸收减少，血清1，25-二羟维生素D [1，25-（OH）2D]降低，通常处于负钙平衡。雌激素治疗改善绝经后骨质疏松症患者的钙平衡。在鸟类中，雌激素给药增加25-羟基维生素D（25 OHD）转化为1，25-（OH）2D。为了确定雌激素治疗是否会影响人体维生素D代谢，对21名绝经后妇女进行了6个月前后的研究。的治疗。比较了安慰剂组（9例患者）或结合型马雌激素组（1.2-2.5 mg/天; 12例患者）。钙吸收分数（平均值±. SE）在用安慰剂治疗后没有变化（0.51 . ±. 0.03至0.52 ±。0.01），但用雌激素治疗后增加（0.53 ± 0.01）。0.02至0.65 ±。0.04; P < 0.005）。雌激素治疗后的增加与另外10名接受6个月治疗的乳腺癌妇女的增加相似。用0.5 μ g/天的小剂量1，25-（OH）2D（0.54 ± 0.05 μ g/天），0.03至0.68 . ±. 0.04; P < 0.005）。血清1，25-（OH）2D在安慰剂治疗后无变化（27.5 ± 0.01）。1.3至27.6 .+-。1.7 pg/ml），但在用雌激素处理后增加（23.6 ± 0.001 μ g/ml）。2.7至33.2 .+-。3.7 pg/ml; P < 0.005）。血清免疫反应性甲状旁腺激素（PTH）增加（23.0 ± 0.01）。4.2至32.7 .+-。4.6μ eq/ml; P < 0.05）雌激素治疗后，但安慰剂治疗后则不然。雌激素治疗后，血清免疫反应性PTH升高与血清1，25-（OH）2D升高相关（r = 0.68; P < 0.05），血清1，25-（OH）2D升高与钙吸收升高高度相关（r = 0.89; P < 0.001）。雌激素治疗通过增加血清1，25-（OH）2D而明显增加绝经后骨质疏松症患者的钙吸收。这种作用似乎是通过刺激肾1 α-β受体而间接介导的。羟化酶升高。
Osteoporotic women have decreased Ca absorption and decreased serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] and are usually in negative Ca balance. Estrogen therapy improves Ca balance in patients with postmenopausal osteoporosis. In birds, estrogen administration increases the conversion of 25-hydroxyvitamin D (25OHD) to 1,25-(OH)2D. To determine if estrogen therapy affects vitamin D metabolism in human subjects, 21 osteoporotic women were studied before and after 6 mo. of treatment. Groups treated with either placebo (9 patients) or conjugated equine estrogen (1.2-2.5 mg/day; 12 patients) were compared. Fractional Ca absorption (mean .+-. SE) was unchanged after treatment with placebo (0.51 .+-. 0.03 to 0.52 .+-. 0.01) but increased after treatment with estrogen (0.53 .+-. 0.02 to 0.65 .+-. 0.04; P < 0.005). The increase after estrogen was similar to the increase observed in 10 additional osteoporotic women treated for 6 mo. with a small dose of 0.5 .mu.g/day 1,25-(OH)2D (0.54 .+-. 0.03 to 0.68 .+-. 0.04; P < 0.005). Serum 1,25-(OH)2D was unchanged after treatment with placebo (27.5 .+-. 1.3 to 27.6 .+-. 1.7 pg/ml) but increased after treatment with estrogen (23.6 .+-. 2.7 to 33.2 .+-. 3.7 pg/ml; P < 0.005). Serum immunoreactive parathyroid hormone (PTH) increased (23.0 .+-. 4.2 to 32.7 .+-. 4.6 .mu.eq/ml; P < 0.05) after estrogen but not after placebo treatment. After estrogen treatment the increases in serum immunoreactive PTH and serum 1,25-(OH)2D were correlated (r = 0.68; P < 0.05), and the increases in serum 1,25-(OH)2D and Ca absorption were highly correlated (r = 0.89; P < 0.001). Estrogen treatment evidently increases Ca absorption in postmenopausal osteoporosis by increasing serum 1,25-(OH)2D. This effect appears to be mediated indirectly through stimulation of renal 1.alpha.-hydroxylase by increased serum PTH.