Prince R L, Schiff I, Neer R M
Department of Medicine, University of Western Australia, Perth.
J Clin Endocrinol Metab. 1990 Nov;71(5):1284-7. doi: 10.1210/jcem-71-5-1284.
The effect of transdermal 17 beta-estradiol replacement on ionized calcium and PTH levels was examined in 15 postmenopausal women. After baseline studies in the fasting state, the effect of a calcium infusion on PTH levels was studied. Estrogen replacement resulted in a fall in fasting resting ionized calcium and a rise in PTH levels. After calcium infusion there was no change in the shape of the relationship between plasma calcium and PTH. The level of nonsuppressible PTH secretion was not altered. Transdermal estrogen did not alter basal vitamin D-binding protein levels, 25-hydroxyvitamin D levels, or calcitriol levels. We conclude that the effect of transdermal estrogen replacement on PTH secretion is completely explained by the lowering of ionized calcium, causing a rise in PTH secretion. Thus, with this route of estrogen replacement, there is no necessity to postulate a direct effect of 17 beta-estradiol on the parathyroid gland.
在15名绝经后女性中研究了经皮17β-雌二醇替代治疗对离子钙和甲状旁腺激素（PTH）水平的影响。在禁食状态下进行基线研究后，研究了钙输注对PTH水平的影响。雌激素替代导致空腹静息离子钙水平下降，PTH水平升高。钙输注后，血浆钙与PTH之间关系的形状没有变化。不可抑制的PTH分泌水平未改变。经皮雌激素不改变基础维生素D结合蛋白水平、25-羟维生素D水平或骨化三醇水平。我们得出结论，经皮雌激素替代治疗对PTH分泌的影响完全可以通过离子钙降低来解释，离子钙降低导致PTH分泌增加。因此，通过这种雌激素替代途径，无需假定17β-雌二醇对甲状旁腺有直接作用。
