Monnier L, Colette C, Aguirre L, Sany C, Mirourze J
Eur J Clin Invest. 1978 Aug;8(4):225-31. doi: 10.1111/j.1365-2362.1978.tb00857.x.
The intestinal absorption and the urinary excretion of calcium were compared in two groups of diabetic patients during periods of satisfactory and poor control. In a first group of ten patients, periods of isolated high glycosuria were obtained by giving an oral glucose load. The second group consisted of ten patients with a severe endogenous insulin deficiency. The subjects of this latter group were investigated before and after a few days of insulin therapy. In group I, the oral glucose load induced a significant increase in the intestinal calcium absorption and had a tendency to lower the urinary calcium excretion. Furthermore, an inverse relationship was found between the changes in the intestinal calcium absorption and the variations of the urinary calcium excretion. In group II, both intestinal absorption and urinary excretion of calcium fell significantly after recovery of satisfactory metabolic control by insulin therapy. From the results as obtained in group I one can conclude that glucose enhances the calcium transfer from the luminal to the serosal pole of both intestinal and renal tubular cells. During severe ketosis as observed in group II, calcium metabolism is considerably accelerated and the increase in the intestinal calcium absorption rate may be interpreted as compensatory mechanism for the high urinary loss of calcium.
在两组糖尿病患者病情控制良好和较差的时期，对钙的肠道吸收和尿排泄情况进行了比较。第一组10名患者，通过口服葡萄糖负荷获得单纯高糖尿期。第二组由10名严重内源性胰岛素缺乏的患者组成。后一组患者在胰岛素治疗数天前后接受了调查。在第一组中，口服葡萄糖负荷使肠道钙吸收显著增加，并倾向于降低尿钙排泄。此外，还发现肠道钙吸收的变化与尿钙排泄的变化呈负相关。在第二组中，通过胰岛素治疗恢复到良好的代谢控制后，钙的肠道吸收和尿排泄均显著下降。从第一组获得的结果可以得出结论，葡萄糖可增强钙从肠腔向肠和肾小管细胞浆膜侧的转运。在第二组观察到的严重酮症期间，钙代谢明显加快，肠道钙吸收率的增加可解释为对高尿钙丢失的一种代偿机制。
