Axelson J, Persson P, Gagnemo-Persson R, Håkanson R
Department of Surgery, University of Lund, Sweden.
Gut. 1991 Nov;32(11):1298-302. doi: 10.1136/gut.32.11.1298.
The stomach helps to maintain calcium homoeostasis by making dietary calcium accessible for uptake in the intestines, although the effect of the stomach on calcium homoeostasis is poorly understood. We examined the effect on blood calcium of gastric surgery in the rat. Within three weeks gastrectomy and fundectomy (excision of the acid producing part of the stomach) induced a slight lowering of the blood calcium concentration. When parathyroidectomy was combined with either gastrectomy or fundectomy the blood calcium concentrations promptly dropped to values lower than after parathyroidectomy alone. The mortality was close to 100% during the first three weeks after combined parathyroidectomy and gastric surgery. It was nil in rats subjected to parathyroidectomy alone. Gastrectomised rats absorbed Ca2+ better than unoperated control rats, possibly reflecting the fact that the serum 1,25-dihydroxyvitamin D concentration was raised. Gastrectomised rats had a food intake that was about 70% of that in intact rats, and the amount of dietary calcium absorbed (net absorption per kg body weight) by the gastrectomised rats was approximately 65% of that in intact control rats. We conclude that the acid producing part of the stomach is important for calcium homoeostasis, since its removal induced lethal hypocalcaemia in parathyroidectomised rats. One possible explanation for the hypocalcaemia induced by gastrectomy is a progressive calcium deficit. In addition, the loss of calciotrophic hormones originating in the stomach may contribute.
胃通过使膳食钙易于在肠道中吸收来帮助维持钙稳态,尽管胃对钙稳态的影响尚不清楚。我们研究了大鼠胃部手术对血钙的影响。在三周内,胃切除术和胃底切除术(切除胃的产酸部分)导致血钙浓度略有降低。当甲状旁腺切除术与胃切除术或胃底切除术联合进行时,血钙浓度迅速降至低于单独进行甲状旁腺切除术后的值。在甲状旁腺切除术和胃部手术联合后的前三周内,死亡率接近100%。单独接受甲状旁腺切除术的大鼠死亡率为零。胃切除的大鼠比未手术的对照大鼠吸收Ca2+更好,这可能反映出血清1,25 - 二羟基维生素D浓度升高这一事实。胃切除的大鼠食物摄入量约为完整大鼠的70%,胃切除的大鼠吸收的膳食钙量(每千克体重的净吸收量)约为完整对照大鼠的65%。我们得出结论,胃的产酸部分对钙稳态很重要,因为其切除在甲状旁腺切除的大鼠中诱发了致命的低钙血症。胃切除引起低钙血症的一个可能解释是逐渐出现的钙缺乏。此外,源自胃的钙营养激素的丧失可能也有作用。