Zaloga G P, Eil C, O'Brian J T
Am J Med. 1984 Dec;77(6):1101-4. doi: 10.1016/0002-9343(84)90195-5.
Hypothyroidism is known to affect calcium homeostasis by decreasing bone turnover and serum calcium level, and by increasing parathyroid hormone and 1,25-dihydroxyvitamin D concentrations. A 52-year-old hypothyroid woman is described who had hypercalcemia associated with elevated parathyroid hormone and 1,25-dihydroxyvitamin D levels, but decreased 24-hour urinary calcium excretion and ratio of calcium to creatinine clearance. These parameters normalized following thyroid hormone replacement therapy. Hypercalcemia appeared to result from a combination of reduced renal calcium excretion and a change in the "set point" for calcium feedback inhibition of the parathyroid glands. These data suggest that thyroid hormone has a direct effect on the parathyroid glands, regulating parathyroid hormone secretion, and on the kidney's ability to excrete calcium. It is recommended that parathyroid hormone, 1,25-dihydroxyvitamin D, and urinary calcium excretion values be interpreted in light of thyroid hormone status.
甲状腺功能减退症已知会通过降低骨转换和血清钙水平，以及增加甲状旁腺激素和1,25 - 二羟维生素D浓度来影响钙稳态。本文描述了一名52岁的甲状腺功能减退女性，她患有高钙血症，同时伴有甲状旁腺激素和1,25 - 二羟维生素D水平升高，但24小时尿钙排泄减少以及钙与肌酐清除率比值降低。甲状腺激素替代治疗后这些参数恢复正常。高钙血症似乎是由肾钙排泄减少和甲状旁腺钙反馈抑制“设定点”改变共同导致的。这些数据表明甲状腺激素对甲状旁腺有直接作用，调节甲状旁腺激素分泌，并且对肾脏排泄钙的能力也有影响。建议根据甲状腺激素状态来解读甲状旁腺激素、1,25 - 二羟维生素D和尿钙排泄值。
