Kohri K, Takada M, Katoh Y, Kataoka K, Iguchi M, Kurita T, Yachiku S
Hinyokika Kiyo. 1985 Dec;31(12):2149-59.
Parathyroid hormone (PTH) is strongly concerned with the pathogenesis of urinary stones. PTH is mainly regulated by the serum calcium concentration and not by other hormones, as is usually the case. We studied whether PTH is also regulated by adrenocorticotrophic hormone (ACTH) or not. ACTH (0.25 mg) was injected intravenously to 17 patients with primary hyperparathyroidism PHP, 7 patients with urolithiasis, 7 patients with malignant hypercalcemia, and 6 control subjects. Serum calcium was significantly increased in only PHP. The serum calcium increase rate showed a significant positive correlation with serum alkaline phosphatase, and a negative correlation with the preinjected serum calcium. PTH was slightly increased in all four groups. Serum cortisol and ACTH concentrations were not significantly different among the groups. PTH concentration in a culture medium of parathyroid tissues increased after ACTH addition. Serum calcium was significantly increased after ACTH injection in an adrenalectomized rat, and decreased in a parathyroidectomized rat. From our data and those of others, it appears that ACTH acts on the adrenal glands to decrease the serum calcium concentration, and might act directly on the parathyroid gland or bones to increase it.
甲状旁腺激素（PTH）与尿路结石的发病机制密切相关。通常情况下，PTH主要受血清钙浓度调节，而非其他激素。我们研究了PTH是否也受促肾上腺皮质激素（ACTH）调节。对17例原发性甲状旁腺功能亢进症（PHP）患者、7例尿路结石患者、7例恶性高钙血症患者及6例对照受试者静脉注射ACTH（0.25mg）。仅在PHP患者中血清钙显著升高。血清钙升高率与血清碱性磷酸酶呈显著正相关，与注射前血清钙呈负相关。所有四组中PTH均略有升高。各组间血清皮质醇和ACTH浓度无显著差异。添加ACTH后，甲状旁腺组织培养基中的PTH浓度升高。ACTH注射后，肾上腺切除大鼠的血清钙显著升高，而甲状旁腺切除大鼠的血清钙降低。根据我们的数据以及其他研究数据，似乎ACTH作用于肾上腺以降低血清钙浓度，并且可能直接作用于甲状旁腺或骨骼以升高血清钙浓度。
