Imanaka S, Morimoto S, Onishi T, Takamoto S, Fukuo K, Koh E, Itoh K, Hironaka T, Shiraishi T, Morita R
Department of Medicine and Geriatrics, Osaka University Medical School, Japan.
Endocrinol Jpn. 1988 Aug;35(4):593-9. doi: 10.1507/endocrj1954.35.593.
The effect of estrogens on the renal responsiveness to parathyroid hormone (PTH) was examined by PTH loading tests with synthetic human-PTH (1-34) in 8 normal elderly females (mean +/- SD age, 81.0 +/- 7.1 yr) before and after administration of estrogen (Premarin 1.25 mg/day for 4 weeks). Basal urinary adenosine cyclic 3', 5'-monophosphate (cAMP) excretion showed a tendency to increase after estrogen administration (5.47 +/- 1.68 vs 6.60 +/- 2.67 nmol/100 ml GFR) and the theoretical renal phosphorous threshold showed a tendency to decrease from 3.22 +/- 0.98 to 2.73 +/- 0.56 mg/dl. The blood ionized calcium concentration did not change after estrogen administration (4.44 +/- 0.16 vs 4.32 +/- 0.20 mg/dl) and serum phosphorous (P) decreased significantly (3.65 +/- 0.47 vs 3.01 +/- 0.42 mg/dl, p less than 0.05). There was no increase in mean serum immunoreactive PTH (0.34 +/- 0.10 vs 0.34 +/- 0.05 ngeq/ml). The urinary excretions of cAMP in response to PTH loading [100 U of human-PTH (1-34), intravenously] significantly (p less than 0.05) increased (94.8 +/- 57.0 vs 196.7 +/- 118.3 nmol/100 ml GFR/h) after estrogen administration. Moreover the changes in urinary excretion of cAMP (r = 0.698, p less than 0.01) and P (r = 0.555, p less than 0.05) induced by the PTH loading were positively correlated with serum estradiol in elderly females, assessed as groups before and after estrogen administration. These results suggest that estrogens may enhance the renal responsiveness to exogenous PTH administration.
通过给8名正常老年女性（平均年龄±标准差为81.0±7.1岁）在服用雌激素（普雷马林1.25毫克/天，共4周）前后进行合成人甲状旁腺激素（1-34）的甲状旁腺激素负荷试验，研究了雌激素对肾脏对甲状旁腺激素（PTH）反应性的影响。基础尿中环磷酸腺苷（cAMP）排泄量在服用雌激素后有增加趋势（5.47±1.68对6.60±2.67纳摩尔/100毫升肾小球滤过率），理论肾磷阈值有从3.22±0.98降至2.73±0.56毫克/分升的趋势。服用雌激素后血离子钙浓度未改变（4.44±0.16对4.32±0.20毫克/分升），血清磷（P）显著降低（3.65±0.47对3.01±0.42毫克/分升，p＜0.05）。血清免疫反应性甲状旁腺激素平均值无增加（0.34±0.10对0.34±0.05纳克当量/毫升）。服用雌激素后，静脉注射100单位人甲状旁腺激素（1-34）后尿cAMP排泄量显著增加（p＜0.05）（94.8±57.0对196.7±118.3纳摩尔/100毫升肾小球滤过率/小时）。此外，在老年女性中，甲状旁腺激素负荷诱导的尿cAMP排泄量变化（r = 0.698，p＜0.01）和磷排泄量变化（r = 0.555，p＜0.05）与血清雌二醇呈正相关，这是在服用雌激素前后作为分组进行评估的。这些结果表明，雌激素可能增强肾脏对外源性甲状旁腺激素给药的反应性。
