Venkataraman P S, Blick K E, Dasharathy G, Parker M K
Department of Pediatrics, University of Oklahoma Health Sciences Center.
J Pediatr Gastroenterol Nutr. 1987 Nov-Dec;6(6):931-5. doi: 10.1097/00005176-198711000-00019.
Oral glucose ingestion may lower serum Ca in infants of diabetic mothers (IDMs). Six metabolically stable IDMs were studied following ingestion of 1.7 +/- 0.1 g/kg (mean +/- SE) of glucose over 20 min and serum Ca, Mg, P, blood iCa, serum PTH, and CT were measured at 0, 1/2, 1, and 2 h. Data obtained in IDMs were compared with previously reported findings in 10 normal neonates. In IDMs as in normal neonates, serum Ca, Mg, P declined significantly after oral glucose ingestion. Blood Ca2+ was significantly lower at +1/2 h in IDMs versus normal neonates, and by analysis of covariance, trends in blood Ca2+ were significantly different in IDMs versus normal neonates, (p less than 0.05). Serum PTH concentrations were unaltered in IDMs versus a significant rise in serum PTH noted in normal neonates. The difference between the two groups was significant statistically (p less than 0.05). Baseline serum CT was elevated in both groups and did not change. Thus, in IDMs responses to oral glucose ingestion differs from that seen in normal neonates as follows: blood Ca2+ is lowered in IDMs versus normal neonates, and serum parathyroid hormone (PTH) does not respond to a decline in blood Ca2+ in IDMs, whereas in normal neonates serum PTH rises and blood Ca2+ is maintained. We speculate that relative parathyroid gland unresponsiveness occurs in IDMs, which may result in lowered blood Ca2+ after oral glucose ingestion in these infants.
口服葡萄糖可能会降低糖尿病母亲婴儿（IDMs）的血清钙水平。对6名代谢稳定的IDMs在20分钟内摄入1.7±0.1 g/kg（均值±标准误）葡萄糖后进行了研究，并在0、0.5、1和2小时测量了血清钙、镁、磷、血离子钙、血清甲状旁腺激素（PTH）和降钙素（CT）。将IDMs获得的数据与先前报道的10名正常新生儿的研究结果进行了比较。与正常新生儿一样，IDMs口服葡萄糖后血清钙、镁、磷显著下降。与正常新生儿相比，IDMs在0.5小时时血Ca2+显著降低，通过协方差分析，IDMs与正常新生儿血Ca2+的变化趋势存在显著差异（p<0.05）。与正常新生儿血清PTH显著升高不同，IDMs的血清PTH浓度未发生改变。两组之间的差异具有统计学意义（p<0.05）。两组的基线血清CT均升高且未发生变化。因此，IDMs对口服葡萄糖摄入的反应与正常新生儿不同，具体如下：与正常新生儿相比，IDMs的血Ca2+降低，且IDMs的血清甲状旁腺激素（PTH）对血Ca降低无反应，而正常新生儿血清PTH升高且血Ca2+维持稳定。我们推测IDMs中甲状旁腺相对无反应，这可能导致这些婴儿口服葡萄糖后血Ca2+降低。
