Trydal T, Varhaug J E, Myking A, Aksnes L, Aakvaag A, Aarskog D
Department of Pediatrics, University of Bergen, Haukeland Hospital, Norway.
Acta Endocrinol (Copenh). 1992 Nov;127(5):407-12. doi: 10.1530/acta.0.1270407.
Vitamin D metabolites in serum and calcitriol receptor concentration in parathyroid tissue were examined in 52 patients operated on for primary hyperparathyroidism. The calcitriol receptor levels were not different in parathyroid adenomas (mean 224 fmol/mg of protein, range 29-509, N = 43), normal parathyroid tissue (mean 245, range 31-690, N = 20), and primary parathyroid hyperplasia (mean 172, range 46-477, N = 9). Preoperative serum levels of calcitriol concentration correlated inversely to the calcitriol receptor in normal parathyroid tissue in patients with adenoma (r = -0.57, N = 17, p = 0.017), but no such correlation was found in the corresponding adenomas (r = 0.14, p = 0.59). In 31 patients in whom both pre- and postoperative vitamin D metabolite analyses were carried out, 23 had lower calcitriol postoperative concentrations compared to preoperative values (p = 0.012, sign test). No change was found in the other vitamin D metabolites postoperatively. By multiple regression analysis calcitriol concentration in serum was inversely correlated to the serum concentration of urea and phosphate (p = 0.003). We conclude that calcitriol may influence calcitriol receptor expression in normal parathyroid tissue, but not in adenomatous parathyroid gland. Furthermore, serum calcitriol was correlated to the renal function, and phosphate level, and in most patients the calcitriol concentration was lower after the operation.
对52例因原发性甲状旁腺功能亢进接受手术的患者，检测了其血清维生素D代谢产物及甲状旁腺组织中骨化三醇受体浓度。甲状旁腺腺瘤（平均224 fmol/mg蛋白质，范围29 - 509，N = 43）、正常甲状旁腺组织（平均245，范围31 - 690，N = 20）和原发性甲状旁腺增生（平均172，范围46 - 477，N = 9）中的骨化三醇受体水平无差异。腺瘤患者正常甲状旁腺组织中，术前血清骨化三醇浓度与骨化三醇受体呈负相关（r = -0.57，N = 17，p = 0.017），但相应腺瘤中未发现这种相关性（r = 0.14，p = 0.59）。对31例术前和术后均进行维生素D代谢产物分析的患者，23例术后骨化三醇浓度低于术前值（p = 0.012，符号检验）。术后其他维生素D代谢产物无变化。通过多元回归分析，血清骨化三醇浓度与血清尿素和磷酸盐浓度呈负相关（p = 0.003）。我们得出结论，骨化三醇可能影响正常甲状旁腺组织中骨化三醇受体的表达，但不影响腺瘤性甲状旁腺组织。此外，血清骨化三醇与肾功能和磷酸盐水平相关，且大多数患者术后骨化三醇浓度降低。
