Kolb E
Z Gesamte Inn Med. 1981 Sep 1;36(17):597-602.
Animal-experimental examinations show that the peroral or intramuscular application of a high dose of vitamin D2 or of D3 leads to a toxic effect of these compounds on the osteocytes and that the hypercalcaemia evoked by this is mainly to be traced back to an increased deliberation of calcium from the bones. After application of a larger dose of vitamin D the activation mechanism in the liver and in the kidneys is much inhibited for several weeks so that no formation of 1,25-hydroxy-vitamin-D takes place; consequently, no furthering effect on the mineralisation of the bones is performed. Therefore, it is recommended to use physiological doses in the prevention of rachitis (500-1,000 IU a day). During the pregnancy the activity of the enzymes which participate in the activation of the D-vitamins increases in the liver and the kidneys. The kidneys of the fetuses are able to form 1,25-hydroxy-vitamin-D. Vitamin D and 25-hydroxy-vitamin-D transgress through the placenta into the fetuses. Due to the adaptation mentioned and the increased formation of 1,25-hydroxy-vitamin-D the absorption of calcium and phosphate increases during pregnancy. Recent pathobiochemical knowledge concerning the metabolism of the D-vitamins in several diseases are described.
动物实验检查表明,经口或肌肉注射高剂量的维生素D2或D3会导致这些化合物对骨细胞产生毒性作用,由此引起的高钙血症主要可追溯到骨骼中钙的释放增加。应用较大剂量的维生素D后,肝脏和肾脏中的激活机制会被抑制数周,从而无法形成1,25-二羟维生素D;因此,对骨骼矿化没有促进作用。所以,建议在预防佝偻病时使用生理剂量(每天500-1000国际单位)。在怀孕期间,肝脏和肾脏中参与维生素D激活的酶的活性会增加。胎儿的肾脏能够形成1,25-二羟维生素D。维生素D和25-羟维生素D可通过胎盘进入胎儿体内。由于上述适应性变化以及1,25-二羟维生素D形成增加,怀孕期间钙和磷的吸收会增加。本文描述了有关几种疾病中维生素D代谢的最新病理生化知识。