Aubia J, Bosch J, Lloveras J, Mariñoso L, Masramon J, Serrano S, Cuevas X, Orfelia A, Llorach I, Llorach M
Proc Eur Dial Transplant Assoc Eur Ren Assoc. 1985;21:902-8.
The first study compared two groups on dialysis: 25 patients with diabetes mellitus and 25 matched non-diabetic patients, in relation to the presence of signs of hyperparathyroidism, to assess the reported low incidence of hyperparathyroidism in these patients. The diabetic group showed significantly lower values of PTH, Alk phosphatase, percentage of patients requiring vitamin D treatment, and less evidence of hyperparathyroidism on X-ray and in bone histomorphometry. In the second study 16 patients with chronic renal failure due to diabetic nephropathy were compared to 27 patients with the same degree of renal failure of other origin, the diabetic nephropathy group showed no increase in PTH, with falling creatinine clearance. Despite this low PTH, the phosphaturia was higher in the diabetic nephropathy group (Tm PO4/C Cr: 1.94 +/- 0.43 vs 2.5 +/- 0.68). In conclusion, patients with diabetes mellitus are less prone to develop hyperparathyroidism in progressive renal failure. This could be due to a relative increase in phosphaturia during declining function.
25例糖尿病患者和25例匹配的非糖尿病患者，就甲状旁腺功能亢进体征的存在情况进行比较，以评估这些患者中报道的甲状旁腺功能亢进低发病率。糖尿病组的甲状旁腺激素（PTH）、碱性磷酸酶、需要维生素D治疗的患者百分比的值显著较低，并且在X线和骨组织形态计量学方面甲状旁腺功能亢进的证据较少。在第二项研究中，将16例因糖尿病肾病导致慢性肾衰竭的患者与27例具有相同程度其他病因肾衰竭的患者进行比较，糖尿病肾病组的PTH没有随着肌酐清除率下降而升高。尽管PTH水平较低，但糖尿病肾病组的磷尿更高（肾小管最大磷酸盐重吸收率/肌酐清除率：1.94±0.43 vs 2.5±0.68）。总之，糖尿病患者在进行性肾衰竭时发生甲状旁腺功能亢进的倾向较小。这可能是由于功能下降期间磷尿相对增加所致。
