Fujita Takuo
Kobe University, Katsuragi Hospital.
Clin Calcium. 2006 Jun;16(6):898-903.
Classical clinical calcium endocrinology was built on measurements of serum Ca, P and alkaline phosphatase as well as urinary Ca. Serum Ca, the most strictly maintained biological constant, occupies the central role among them, controlling PTH secretion and bone metabolism. Ca is strongly bound to proteins especially albumin, so that total serum Ca values are sometimes misleading, necessitating the use of corrected or ionized Ca. Serum Pi rises early in renal insufficiency, playing an important role in vascular calcification. Growth hormone and thyroid hormone functions are also reflected on serum P. Serum alkaline phosphatase especially the bone-specific type is also important for the evaluation of bone dynamics such as growth and tumor metastasis. These classical datasets should be reevaluated in the light of actions of new compounds such as calcimimetics, P-binders, bisphosphonates, vitamin D derivatives, cytokines, etc.
经典的临床钙内分泌学建立在血清钙、磷、碱性磷酸酶以及尿钙的测量基础之上。血清钙作为最严格维持的生物学常数，在其中占据核心地位，控制着甲状旁腺激素的分泌和骨代谢。钙与蛋白质尤其是白蛋白紧密结合，因此总血清钙值有时会产生误导，需要使用校正钙或离子钙。血清磷在肾功能不全早期升高，在血管钙化中起重要作用。生长激素和甲状腺激素的功能也反映在血清磷上。血清碱性磷酸酶尤其是骨特异性类型对于评估骨动态如生长和肿瘤转移也很重要。这些经典数据集应根据拟钙剂、磷结合剂、双膦酸盐、维生素D衍生物、细胞因子等新化合物的作用重新评估。
