Impaired vitamin D metabolism with aging in women. Possible role in pathogenesis of senile osteoporosis.
Impaired vitamin D metabolism with aging in women. Possible role in pathogenesis of senile osteoporosis.
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随着女性年龄的增长，维生素 D 代谢受损。
DOI：
10.1172/jci111373
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Riggs,BL
中科院分区：
文献类型：
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作者：
Tsai,KS;Heath3rd,H;Kumar,R;Riggs,BL
钙的吸收随着年龄的增长而减少，尤其是在70岁以后。我们通过研究10名正常绝经前妇女（A组）、8名绝经20年内正常绝经后妇女（B组）、10名正常老年妇女（C组）和8名髋部骨折的老年妇女（D组），研究了维生素D代谢异常的可能性，她们的年龄（平均+/- SD）分别为37 +/- 4岁、61 +/- 6岁、78 +/- 4岁和78 +/- 4岁。所有受试者血清25-羟维生素D [25(OH)D]不随年龄下降，但血清1,25-二羟维生素D [1,25(OH)2D]，生理活性维生素D代谢物，老年人（C组和D组，20 +/- 3 pg/ml）低于非老年人（A组和B组，35 +/- 4 pg/ml） （P = 0.01）。25(OH) d1 α -羟化酶的促生成剂牛甲状旁腺激素片段1-34输注24小时后血清1,25(OH)D的升高与年龄呈负相关（r = -0.58, P < 0.001），与肾小球滤过率直接相关（r = 0.64, P < 0.001）。老年髋部骨折患者的反应（13 +/- 3 pg/ml）比老年对照组（25 +/- 3 pg/ml）更迟钝（P = 0.01）。我们得出结论，衰老肾脏合成1,25(OH)2D的能力受损可能有助于老年性骨质疏松症的发病机制。
Calcium absorption decreases with aging, particularly after age 70 yr. We investigated the possibility that this was due to abnormal vitamin D metabolism by studying 10 normal premenopausal women (group A), 8 normal postmenopausal women within 20 yr of menopause (group B), 10 normal elderly women (group C), and 8 elderly women with hip fracture (group D) whose ages (mean +/- SD) were 37 +/- 4, 61 +/- 6, 78 +/- 4, and 78 +/- 4 yr, respectively. For all subjects, serum 25-hydroxyvitamin D [25(OH)D] did not decrease with age, but serum 1,25-dihydroxyvitamin D [1,25(OH)2D], the physiologically active vitamin D metabolite, was lower (P = 0.01) in the elderly (groups C and D; 20 +/- 3 pg/ml) than in the nonelderly (groups A and B; 35 +/- 4 pg/ml). The increase of serum 1,25(OH)D after a 24-h infusion of bovine parathyroid hormone fragment 1-34, a tropic agent for the enzyme 25(OH)D 1 alpha-hydroxylase, correlated inversely with age (r = -0.58; P less than 0.001) and directly with glomerular filtration rate (r = 0.64; P less than 0.001). The response was more blunted (P = 0.01) in elderly patients with hip fracture (13 +/- 3 pg/ml) than in elderly controls (25 +/- 3 pg/ml). We conclude that an impaired ability of the aging kidney to synthesize 1,25(OH)2D could contribute to the pathogenesis of senile osteoporosis.