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[正常孕期的钙代谢及钙调节激素]

[Calcium metabolism and calcium-regulating hormones during normal pregnancy].

作者信息

Ohara N, Morikawa H, Ueda Y, Mochizuki M

出版信息

Nihon Naibunpi Gakkai Zasshi. 1986 Jul 20;62(7):784-96. doi: 10.1507/endocrine1927.62.7_784.

Abstract

Dynamic changes in maternal and fetal calcium metabolism during pregnancy were investigated by simultaneously measuring serum or urinary concentrations of calcium and calcium regulating hormones. Serum concentrations of total calcium in maternal serum decreased significantly, but those of ionized calcium decreased slightly but not significantly late in pregnancy. Maternal serum levels of parathyroid hormone (PTH) were almost the same as non-pregnant values throughout pregnancy, but those of 1 alpha, 25-(OH)2 vitamin D3 increased as pregnancy progressed. Serum levels of calcitonin (CT) in maternal serum increased late in pregnancy but were statistically not significant. Calcium concentrations in maternal urine during pregnancy showed a slight decrease. It is suggested that calcium absorption in the maternal intestine might be increased by the action of increased serum 1 alpha, 25-(OH)2 vitamin D3, and the maternal bone during pregnancy might be kept at the same density as in non-pregnant women because increased CT protects the maternal skeleton by resisting the bone-resorbing activities of 1 alpha, 25-(OH)2 vitamin D3. The concentrations of ionized calcium and CT in umbilical cord blood were higher, but those of PTH and 1 alpha, 25-(OH)2 vitamin D3 were significantly lower than those of the maternal blood at term. It is considered that an active transport mechanism may be involved in the transplacental supply of calcium, and calcium transport from mother to fetus results in a decrease in the calcium concentrations of the maternal serum. Calcium transported into the fetus may be used as fetal body composition such as accumulation in the bone mainly by the action of serum CT.

摘要

通过同时测量血清或尿液中钙及钙调节激素的浓度,研究了孕期母婴钙代谢的动态变化。孕期母体血清总钙浓度显著下降,但离子钙浓度在孕晚期略有下降但不显著。孕期母体血清甲状旁腺激素(PTH)水平在整个孕期几乎与非孕期值相同,但随着孕期进展,1α,25-(OH)₂维生素D₃水平升高。孕期母体血清降钙素(CT)水平在孕晚期升高,但无统计学意义。孕期母体尿液中的钙浓度略有下降。提示血清1α,25-(OH)₂维生素D₃水平升高可能会增加母体肠道对钙的吸收,孕期母体骨骼密度可能与非孕期女性相同,因为升高的CT通过抵抗1α,25-(OH)₂维生素D₃的骨吸收活性来保护母体骨骼。足月时脐带血中离子钙和CT的浓度较高,但PTH和1α,25-(OH)₂维生素D₃的浓度显著低于母体血液中的浓度。认为钙的跨胎盘供应可能涉及一种主动转运机制,母体向胎儿的钙转运导致母体血清钙浓度降低。转运到胎儿体内的钙可能主要通过血清CT的作用用作胎儿身体组成成分,如在骨骼中蓄积。

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