Hendriks J T, Smeenk D
Acta Endocrinol (Copenh). 1979 May;91(1):77-88. doi: 10.1530/acta.0.0910077.
Seventeen normocalcaemic patients with severe hyperthyroidism were examined before therapy was initiated; 9 were re-examined about 1 year later. Studies with 47Ca under balance conditions and with calcitonin demonstrated a high rate of bone resorption in untreated patients. As a result of the increased bone turnover, the reaction to 6 MRC units of porcine calcitonin iv was more marked in the untreated than in the treated patients or the control group. In contrast to the normal diurnal pattern for PO4, it was found that during fasting the plasma PO4 level increases in the morning in patients with hyperthyroidism. This increase which was not suppressed by the administered dose of calcitonin developed in spite of an elevated urinary PO4 excretion. After treatment, the serum Ca concentration as well as the urinary and faecal Ca excretion was decreased. The Ca balance improved; the rapidly-exchangeable Ca pool returned to normal. The slowly-exchangeable and the total Ca pools, however, remained enlarged. The rate of bone resorption normalized. The accretion rate on the other hand remained elevated. This is atributed to continued enhancement of bone formation to compensate for the previous loss of bony tissue.
对17名重度甲状腺功能亢进的血钙正常患者在开始治疗前进行了检查；约1年后对其中9名患者进行了复查。在平衡条件下用47Ca及降钙素进行的研究表明，未经治疗的患者骨吸收速率很高。由于骨转换增加，静脉注射6 MRC单位猪降钙素后，未经治疗的患者比经治疗的患者及对照组的反应更明显。与正常的磷酸盐昼夜变化模式相反，发现甲状腺功能亢进患者在禁食期间血浆磷酸盐水平在早晨升高。尽管尿磷酸盐排泄增加，但这种升高并未被给予的降钙素剂量所抑制。治疗后，血清钙浓度以及尿钙和粪钙排泄减少。钙平衡得到改善；快速可交换钙池恢复正常。然而，缓慢可交换钙池和总钙池仍然增大。骨吸收速率恢复正常。另一方面，骨生长速率仍然升高。这归因于骨形成持续增强以补偿先前骨组织的丢失。
