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体内代谢性酸中毒对皮质中层骨离子组成的影响。

Effects of in vivo metabolic acidosis on midcortical bone ion composition.

作者信息

Bushinsky D A, Chabala J M, Gavrilov K L, Levi-Setti R

机构信息

Nephrology Unit, Department of Medicine, University of Rochester School of Medicine, Rochester, New York 14642, USA.

出版信息

Am J Physiol. 1999 Nov;277(5):F813-9. doi: 10.1152/ajprenal.1999.277.5.F813.

Abstract

Chronic metabolic acidosis increases urine calcium excretion without altering intestinal calcium absorption, suggesting that bone mineral is the source of the additional urinary calcium. During metabolic acidosis there appears to be an influx of protons into bone mineral, lessening the magnitude of the decrement in pH. Although in vitro studies strongly support a marked effect of metabolic acidosis on the ion composition of bone, there are few in vivo observations. We utilized a high-resolution scanning ion microprobe with secondary ion mass spectroscopy to determine whether in vivo metabolic acidosis would alter bone mineral in a manner consistent with its purported role in buffering the increased proton concentration. Postweanling mice were provided distilled drinking water with or without 1.5% NH(4)Cl for 7 days; arterial blood gas was then determined. The addition of NH(4)Cl led to a fall in blood pH and HCO(-)(3) concentration. The animals were killed on day 7, and the femurs were dissected and split longitudinally. The bulk cortical ratios Na/Ca, K/Ca, total phosphate/carbon-nitrogen bonds [(PO(2) + PO(3))/CN], and HCO(-)(3)/CN each fell after 1 wk of metabolic acidosis. Because metabolic acidosis induces bone Ca loss, the fall in Na/Ca and K/Ca indicates a greater efflux of bone Na and K than Ca, suggesting H substitution for Na and K on the mineral. The fall in (PO(2) + PO(3))/CN indicates release of mineral phosphates, and the fall in HCO(-)(3)/CN indicates release of mineral HCO(-)(3). Each of these mechanisms would result in buffering of the excess protons and returning the systemic pH toward normal.

摘要

慢性代谢性酸中毒会增加尿钙排泄,而不会改变肠道钙吸收,这表明骨矿物质是额外尿钙的来源。在代谢性酸中毒期间,质子似乎会流入骨矿物质,从而减小pH值下降的幅度。尽管体外研究有力地支持了代谢性酸中毒对骨离子组成有显著影响,但体内观察却很少。我们使用高分辨率扫描离子微探针结合二次离子质谱来确定体内代谢性酸中毒是否会以与其在缓冲增加的质子浓度中所声称的作用相一致的方式改变骨矿物质。给断奶后的小鼠提供含或不含1.5%氯化铵的蒸馏水,持续7天;然后测定动脉血气。添加氯化铵导致血液pH值和碳酸氢根离子浓度下降。在第7天处死动物,解剖股骨并纵向劈开。代谢性酸中毒1周后,皮质骨的钠/钙、钾/钙、总磷酸盐/碳 - 氮键[(PO₂ + PO₃)/CN]以及碳酸氢根离子/碳 - 氮键的比例均下降。由于代谢性酸中毒会导致骨钙流失,钠/钙和钾/钙的下降表明骨中钠和钾的流出比钙更多,这表明在矿物质上氢离子取代了钠和钾。(PO₂ + PO₃)/CN的下降表明矿物质磷酸盐的释放,而碳酸氢根离子/碳 - 氮键的下降表明矿物质碳酸氢根离子的释放。这些机制中的每一种都会导致对过量质子的缓冲,并使全身pH值恢复正常。

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