Kraut J A, Mishler D R, Singer F R, Goodman W G
Kidney Int. 1986 Nov;30(5):694-700. doi: 10.1038/ki.1986.242.
Metabolic acidosis (MA) has been implicated in the pathogenesis of both osteomalacia and osteopenia. Alterations in the secretion of parathyroid hormone and in the metabolism of vitamin D may contribute to such skeletal changes. To minimize the influence of these factors, quantitative bone histology and measurements of bone formation using double tetracycline labeling were done in thyroparathyroidectomized (TPTX) rats with MA induced by ammonium chloride (TPTX-A), and in both non-acidotic TPTX (TPTX-C) and intact (C) controls. To evaluate the response of both cortical and trabecular bone to MA, histologic studies were done at three separate sites in the tibia, cortical bone from the mid-shaft, and trabecular bone from the epiphysis and from the metaphysis. Plasma pH was lower in TPTX-A, 7.24 +/- 0.10, than in either TPTX-C, 7.39 +/- 0.03, or C, 7.43 +/- 0.04, P less than 0.01, and urinary hydroxyproline excretion increased from 89.8 +/- 8.7 in TPTX-C to 150.2 +/- 25.9 micrograms/mg/creatinine in TPTX-A, P less than 0.01. Resorption surface at the epiphysis increased from 1.8 +/- 0.6% in TPTX-C to 4.0 +/- 1.6% in TPTX-A, P less than 0.05, values not different from those in C, 3.1 +/- 1.1%. Resorption surface was unchanged at other skeletal sites, but total bone volume at the metaphysis fell from 15.5 +/- 5.6% in TPTX-C to 9.0 +/- 4.3% in TPTX-A, P less than 0.05. Bone formation was reduced at each skeletal site in TPTX-A vs. TPTX-C, P less than 0.05 for all values, but histologic evidence of osteomalacia was not observed.(ABSTRACT TRUNCATED AT 250 WORDS)
代谢性酸中毒(MA)与骨软化症和骨质减少的发病机制均有关联。甲状旁腺激素分泌及维生素D代谢的改变可能导致此类骨骼变化。为尽量减少这些因素的影响,对氯化铵诱导产生MA的甲状旁腺切除(TPTX)大鼠(TPTX-A)、非酸中毒的TPTX大鼠(TPTX-C)以及完整对照大鼠(C)进行了定量骨组织学检查,并使用双四环素标记法测量骨形成。为评估皮质骨和小梁骨对MA的反应,在胫骨的三个不同部位进行了组织学研究,分别是骨干中部的皮质骨、骨骺和干骺端的小梁骨。TPTX-A组的血浆pH值为7.24±0.10,低于TPTX-C组的7.39±0.03和C组的7.43±0.04,P<0.01;TPTX-A组尿羟脯氨酸排泄量从TPTX-C组的89.8±8.7增加至150.2±25.9微克/毫克/肌酐,P<0.01。骨骺处的吸收表面从TPTX-C组的1.8±0.6%增加至TPTX-A组的4.0±1.6%,P<0.05,与C组的3.1±1.1%无差异。其他骨骼部位的吸收表面无变化,但干骺端的总骨体积从TPTX-C组的15.5±5.6%降至TPTX-A组的9.0±4.3%,P<0.05。与TPTX-C组相比,TPTX-A组各骨骼部位的骨形成均减少,所有数值P<0.05,但未观察到骨软化症的组织学证据。(摘要截选至250字)