Sjödén G, Rosenqvist M, Kriegholm E, Nordenström J, Björkhem I
Department of Orthopedic Surgery, Karolinska Institute, Huddinge University Hospital, Sweden.
J Intern Med. 1990 Oct;228(4):339-42. doi: 10.1111/j.1365-2796.1990.tb00242.x.
In rats, verapamil decreases intestinal absorption of calcium, increases serum parathyroid hormone (PTH), and induces osteopenia. In this prospective study, verapamil 80-120 mg three times daily was given for 2 months to 20 patients with hypertension, and the effects on calcium homeostasis were recorded. This dose of verapamil significantly reduced supine systolic and diastolic blood pressure (+/- SD) from 158/100 +/- 9/8 mmHg to 146/89 +/- 14/8 mmHg (P = 0.001). Serum alkaline phosphatase (ALP) increased significantly from 2.77 +/- 1.06 mu kat l-1 to 3.19 +/- 1.22 mu kat l-1 (P = 0.004), and isoenzymes of ALP of skeletal origin appeared after verapamil treatment. The excretion of sodium in the urine increased (Na/creatinine ratio 8.95 +/- 6.01 before and 13.16 +/- 8.26 after verapamil; P = 0.04), while the excretion of calcium, phosphate and potassium was not changed. PTH was slightly increased at the end of verapamil treatment (1.09 +/- 0.54 vs. 0.98 +/- 0.74 microgram l-1; P = 0.07), and s-1,25(OH)2D3 was also somewhat increased (22.3 +/- 14.4 vs. 17.6 +/- 4.9 ng l-1; P = 0.26). Serum Ca was not affected by verapamil (before verapamil 2.43 +/- 0.11 mmol l-1, after verapamil 2.40 +/- 0.12 mmol l-1; P = 0.28). The increase in serum ALP demonstrates that verapamil affects bone cell metabolism in man. This effect could be secondary to the enhancement of PTH secretion.
在大鼠中，维拉帕米可降低肠道对钙的吸收，增加血清甲状旁腺激素（PTH）水平，并诱发骨质减少。在这项前瞻性研究中，20例高血压患者每日3次服用80 - 120毫克维拉帕米，持续2个月，并记录其对钙稳态的影响。该剂量的维拉帕米可使仰卧位收缩压和舒张压（±标准差）从158/100±9/8毫米汞柱显著降至146/89±14/8毫米汞柱（P = 0.001）。血清碱性磷酸酶（ALP）从2.77±1.06微卡/升显著升高至3.19±1.22微卡/升（P = 0.004），且维拉帕米治疗后出现了骨骼来源的ALP同工酶。尿钠排泄增加（维拉帕米治疗前钠/肌酐比值为8.95±6.01，治疗后为13.16±8.26；P = 0.04），而钙、磷和钾的排泄未发生变化。维拉帕米治疗结束时PTH略有升高（1.09±0.54对0.98±0.74微克/升；P = 0.07），s-1,25(OH)2D3也有所升高（22.3±14.4对17.6±4.9纳克/升；P = 0.26）。血清钙不受维拉帕米影响（维拉帕米治疗前为2.43±0.11毫摩尔/升，治疗后为2.40±0.12毫摩尔/升；P = 0.28）。血清ALP的升高表明维拉帕米会影响人体骨细胞代谢。这种作用可能继发于PTH分泌的增强。
