McElduff A, Lissner D, Wilkinson M, Posen S
Department of Endocrinology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.
J Clin Endocrinol Metab. 1990 May;70(5):1457-61. doi: 10.1210/jcem-70-5-1457.
We performed 6-h human PTH-(1-34) infusions in 8 control subjects, 10 subjects with primary hyperparathyroidism, and 7 men with idiopathic hypercalciuria. We measured serum calcium, serum 1,25-dihydroxyvitamin D, urinary calcium, and fractional phosphate excretion. The PTH-induced rise in serum 1,25-dihydroxyvitamin-D was significantly smaller in the hyperparathyroid patients than in either the controls or the hypercalciuric patients. The rise in serum calcium was similar in all 3 groups. The hyperparathyroid subjects had higher basal fractional phosphate excretion than the other two groups. PTH failed to increase fractional phosphate excretion in the hyperparathyroid individuals, whereas there was a statistically significant increase in the other two groups. PTH was without significant effect on urinary calcium excretion in any of the three groups. There were no discernible differences between the responses of the hypercalciuric patients and those of the normal subjects. These findings suggest that while responses to PTH are normal in hypercalciuria, some hyperparathyroid patients are resistant to exogenous PTH. This resistance is limited to specific arms of the PTH response pathway and may not involve PTH receptors.
我们对8名对照受试者、10名原发性甲状旁腺功能亢进患者和7名特发性高钙尿症男性进行了6小时的人甲状旁腺激素（1-34）输注。我们测量了血清钙、血清1,25-二羟维生素D、尿钙和磷排泄分数。甲状旁腺功能亢进患者中，甲状旁腺激素诱导的血清1,25-二羟维生素D升高显著小于对照组或高钙尿症患者。三组的血清钙升高情况相似。甲状旁腺功能亢进受试者的基础磷排泄分数高于其他两组。甲状旁腺激素未能增加甲状旁腺功能亢进个体的磷排泄分数，而其他两组有统计学意义的增加。甲状旁腺激素对三组中的任何一组尿钙排泄均无显著影响。高钙尿症患者与正常受试者的反应之间没有明显差异。这些发现表明，虽然高钙尿症患者对甲状旁腺激素的反应正常，但一些甲状旁腺功能亢进患者对外源性甲状旁腺激素有抵抗性。这种抵抗仅限于甲状旁腺激素反应途径的特定分支，可能不涉及甲状旁腺激素受体。
