Bushinsky David A, Smith Susan B, Gavrilov Konstantin L, Gavrilov Leonid F, Li Jianwei, Levi-Setti Riccardo
Department of Medicine, Univ. of Rochester School of Medicine, NY 14642, USA.
Am J Physiol Renal Physiol. 2003 Sep;285(3):F532-9. doi: 10.1152/ajprenal.00128.2003. Epub 2003 May 20.
Chronic metabolic acidosis increases urinary calcium excretion without altering intestinal calcium absorption, suggesting that bone mineral is the source of the additional urinary calcium. In vivo and in vitro studies have shown that metabolic acidosis causes a loss of mineral calcium while buffering the additional hydrogen ions. Previously, we studied changes in femoral, midcortical ion concentrations after 7 days of in vivo metabolic acidosis induced by oral ammonium chloride. We found that, compared with mice drinking only distilled water, ammonium chloride induced a loss of bone sodium and potassium and a depletion of mineral HCO3(-) and phosphate. There is more phosphate than carbonate in neonatal mouse bone. In the present in vitro study, we utilized a high-resolution scanning ion microprobe with secondary ion mass spectroscopy to test the hypothesis that chronic acidosis would decrease bulk (cross-sectional) bone phosphate to a greater extent than HCO3(-) by localizing and comparing changes in bone HCO3(-) and phosphate after chronic incubation of neonatal mouse calvariae in acidic medium. Calvariae were cultured for a total of 51 h in medium acidified by a reduction in HCO3(-) concentration ([HCO(-)]; pH approximately 7.14, [HCO3(-)] approximately 13) or in control medium (pH approximately 7.45, HCO3(-) approximately 26). Compared with incubation in control medium, incubation in acidic medium caused no change in surface total phosphate but a significant fall in cross-sectional phosphate, with respect to the carbon-carbon bond (C2) and the carbon-nitrogen bond (CN). Compared with incubation in control medium, incubation in acidic medium caused no change in surface HCO3(-) but a significant fall in cross-sectional HCO3(-) with respect to C2 and CN. The fall in cross-sectional phosphate was significantly greater than the fall in cross-sectional HCO3(-). The fall in phosphate indicates release of mineral phosphates, and the fall in HCO3(-) indicates release of mineral HCO3(-), both of which would be expected to buffer the additional protons and help restore the pH toward normal. Thus a model of chronic acidosis depletes bulk bone proton buffers, with phosphate depletion exceeding that of HCO3(-).
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。体内和体外研究均表明,代谢性酸中毒在缓冲额外氢离子的同时会导致矿物质钙流失。此前,我们研究了口服氯化铵诱导体内代谢性酸中毒7天后股骨中皮质离子浓度的变化。我们发现,与仅饮用蒸馏水的小鼠相比,氯化铵会导致骨钠和钾流失以及矿物质HCO3(-)和磷酸盐耗竭。新生小鼠骨骼中的磷酸盐比碳酸盐多。在本体外研究中,我们使用高分辨率扫描离子微探针和二次离子质谱来检验以下假设:通过将新生小鼠颅骨在酸性培养基中长时间孵育后定位并比较骨HCO3(-)和磷酸盐的变化,慢性酸中毒会使骨磷酸盐总量(横截面积)的减少幅度大于HCO3(-)。颅骨在通过降低HCO3(-)浓度酸化的培养基([HCO(-)];pH约为7.14,[HCO3(-)]约为13)或对照培养基(pH约为7.45,HCO3(-)约为26)中总共培养51小时。与在对照培养基中孵育相比,在酸性培养基中孵育导致表面总磷酸盐无变化,但相对于碳 - 碳键(C2)和碳 - 氮键(CN),横截面积磷酸盐显著下降。与在对照培养基中孵育相比,在酸性培养基中孵育导致表面HCO3(-)无变化,但相对于C2和CN,横截面积HCO3(-)显著下降。横截面积磷酸盐的下降幅度明显大于横截面积HCO3(-)的下降幅度。磷酸盐的下降表明矿物质磷酸盐的释放,而HCO3(-)的下降表明矿物质HCO3(-)的释放,预计两者都会缓冲额外的质子并有助于使pH值恢复正常。因此,慢性酸中毒模型会耗尽骨质子缓冲剂,磷酸盐的消耗超过HCO3(-)。