Ittner J, Dambacher M A, Muff R, Rüegsegger P, Trechsel U, Fischer J A
Miner Electrolyte Metab. 1986;12(3):199-203.
To determine whether PTH secretion can be stimulated in osteoporosis by peroral phosphate (1.5 g phosphorus), we have compared serum PTH and urinary cyclic AMP responses in 8 osteoporotic patients with vertebral compression fractures to those of 7 age-matched control subjects. While there was no statistically significant difference in the rise of serum phosphate and urinary phosphate excretion and in the fall of serumionized calcium concentrations, serum PTH and urinary cyclic AMP were increased in control subjects, but not in osteoporotic patients (osteoporotics vs. control group: PTH, p less than 0.01; cyclic AMP/glomerular filtrate, p less than 0.05). Moreover, plasma levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were the same in the 2 groups of subjects. Serum levels of the carboxyl-terminal flanking peptide (PDN-21) encoded by the calcitonin gene and cosecreted with calcitonin were similar in normal and osteoporotic subjects before and 3 min after 1-min intravenous calcium infusions (2 mg/kg body weight), and of calcitonin after the calcium infusions. We conclude that calcitonin and PDN-21 responses to intravenous calcium are the same in normal and osteoporotic subjects, whereas stimulation of PTH secretion by peroral phosphate is impaired in some osteoporotic patients.
为了确定口服磷酸盐（1.5克磷）能否刺激骨质疏松症患者的甲状旁腺激素（PTH）分泌，我们比较了8例患有椎体压缩性骨折的骨质疏松症患者与7例年龄匹配的对照者的血清PTH和尿环磷酸腺苷（cAMP）反应。虽然血清磷酸盐升高、尿磷酸盐排泄以及血清离子钙浓度下降方面，两组之间无统计学显著差异，但对照组的血清PTH和尿cAMP升高，而骨质疏松症患者则未升高（骨质疏松症患者与对照组比较：PTH，p<0.01；环磷酸腺苷/肾小球滤过率，p<0.05）。此外，两组受试者的血浆25-羟维生素D和1,25-二羟维生素D水平相同。在静脉注射钙剂（2毫克/千克体重）1分钟前及注射后3分钟，正常人和骨质疏松症患者血清中由降钙素基因编码并与降钙素共同分泌的羧基末端侧翼肽（PDN-21）水平以及钙剂注射后的降钙素水平相似。我们得出结论，正常人和骨质疏松症患者对静脉注射钙剂的降钙素和PDN-21反应相同，而一些骨质疏松症患者口服磷酸盐对PTH分泌的刺激受损。
