Saggese G, Federico G, Bertelloni S, Baroncelli G I, Calisti L
Department of Pediatrics, University of Pisa, Italy.
J Pediatr. 1991 Feb;118(2):220-5. doi: 10.1016/s0022-3476(05)80486-x.
Because insulin-dependent diabetes mellitus is associated with altered electrolyte metabolism and a derangement of the parathyroid hormone (PTH)-vitamin D endocrine system, we studied 23 children with diabetes (age 9.4 +/- 2.5 years) and found lower serum values for total and ionized calcium, magnesium, intact PTH, calcitriol, and osteocalcin than in age- and sex-matched control subjects. All patients were given magnesium orally (6 mg/kg daily of elemental magnesium) for up to 60 days. During treatment, serum magnesium, total and ionized calcium, intact PTH, calcitriol, and osteocalcin concentrations significantly increased, reaching control values. After a 3-day low-calcium diet, the patients had a significantly reduced delta-increment of PTH and calcitriol in comparison with values obtained during hypomagnesemia. After magnesium repletion, the delta-increments of both PTH and calcitriol, in response to the low-calcium diet, were not significantly different from control values. These data suggest that magnesium deficiency plays a pivotal role in altering mineral homeostasis in insulin-dependent diabetes mellitus.
由于胰岛素依赖型糖尿病与电解质代谢改变及甲状旁腺激素（PTH）-维生素D内分泌系统紊乱有关，我们对23名糖尿病患儿（年龄9.4±2.5岁）进行了研究，发现他们血清中的总钙、离子钙、镁、完整PTH、骨化三醇和骨钙素水平低于年龄及性别匹配的对照受试者。所有患者口服镁剂（每日6mg/kg元素镁），持续60天。治疗期间，血清镁、总钙、离子钙、完整PTH、骨化三醇和骨钙素浓度显著升高，达到对照值。在进行3天低钙饮食后，与低镁血症期间的值相比，患者的PTH和骨化三醇的增量显著降低。镁补充后，对低钙饮食反应的PTH和骨化三醇的增量与对照值无显著差异。这些数据表明，镁缺乏在胰岛素依赖型糖尿病的矿物质稳态改变中起关键作用。
