Zamboni G, Soffiati M, Giavarina D, Tató L
Paediatric University Clinic, Verona, Italy.
Acta Paediatr Scand. 1988 Sep;77(5):741-6. doi: 10.1111/j.1651-2227.1988.tb10740.x.
Blood levels of glucose, insulin (IRI), Calcium (Ca), phosphorus (P), alkaline phosphatase (AP), osteocalcin (OC), parathyroid hormone (PTH), calcitonin (CT), 25-hydroxyvitamin D3 (25OHD3), 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) and urinary excretion of Ca (Ca/Cr), P (TmP/GFR), hydroxyproline (OH-P/Cr) and cyclic AMP (cAMP/GFR) were determined in 16 obese children, aged 8 to 11 years, on a diet rich in calories and carbohydrates and in 15 controls of the same age. Blood glucose, IRI, Ca, P, PTH and CT were also determined in both groups of subjects, during an oral glucose tolerance test (OGTT). In basal conditions glucose, IRI, AP, OC, PTH, CT and 1,25(OH)2D3 levels were significantly higher, and 25OHD3 levels lower, in obese children than in controls. Urinary Ca/Cr, TmP/GFR were lower in obese than in non obese children, while OH-P/Cr and cAMP/GFR were higher. Bone mineral content (BMC), measured by photon absorptiometry, and BMC/bone width ratio were lower in obese than in non obese children. During OGTT serum Ca and P decreased and serum PTH and CT increased less in obese than in non obese children. In obese children receiving a diet with high carbohydrate content, an alteration of mineral metabolism occurred, characterized by secondary increase of PTH and 1,25(OH)2D3. Ca decreased and PTH and CT increased less markedly during OGTT.
对16名8至11岁、摄入高热量和高碳水化合物饮食的肥胖儿童以及15名同龄对照儿童测定了血糖、胰岛素（IRI）、钙（Ca）、磷（P）、碱性磷酸酶（AP）、骨钙素（OC）、甲状旁腺激素（PTH）、降钙素（CT）、25-羟维生素D3（25OHD3）、1,25-二羟维生素D3（1,25(OH)2D3）的血药浓度，以及钙（Ca/Cr）、磷（TmP/GFR）、羟脯氨酸（OH-P/Cr）和环磷酸腺苷（cAMP/GFR）的尿排泄量。在两组受试者进行口服葡萄糖耐量试验（OGTT）期间，还测定了血糖、IRI、Ca、P、PTH和CT。在基础条件下，肥胖儿童的血糖、IRI、AP、OC、PTH、CT和1,25(OH)2D3水平显著高于对照组，而25OHD3水平则较低。肥胖儿童的尿Ca/Cr、TmP/GFR低于非肥胖儿童，而OH-P/Cr和cAMP/GFR则较高。通过光子吸收法测量的骨矿物质含量（BMC）以及BMC/骨宽度比，肥胖儿童低于非肥胖儿童。在OGTT期间，肥胖儿童的血清Ca和P下降，血清PTH和CT升高幅度小于非肥胖儿童。在摄入高碳水化合物饮食的肥胖儿童中，发生了矿物质代谢改变，其特征是PTH和1,25(OH)2D3继发性升高。在OGTT期间，Ca下降，PTH和CT升高幅度较小。
