Braun J J, Juttmann J R, Visser T J, Birkenhäger J C
Clin Endocrinol (Oxf). 1982 Jul 1;17(1):21-8. doi: 10.1111/j.1365-2265.1982.tb02630.x.
Oral administration of prednisone (30 mg/day for 9 days) to six normal individuals induced a significant rise in the concentration of serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] within 2 days. In four patients with primary hyperparathyroidism a larger increase of 1,25-(OH)-2D was observed within 3 days. In these patients the 1,25-(OH)-2D concentration remained elevated during the whole period of prednisone administration (10 days) whereas in the control group it had returned to basal levels or below after 9 days of prednisone administration. This response appeared dependent upon parathyroid hormone (PTH) as we found no change in the (basally low) 1,25-(OH)2D concentrations in five patients with hypoparathyroidism during 3-4 days of prednisone administration (30 mg/day). In these patients vitamin D medication had been interrupted 3-5 days before the administration of prednisone, whereafter serum calcium was kept between 2.10 and 2.30 mmol/1 by means of calcium infusion. The response of 1,25-(OH)2D to prednisone is best explained by a stimulatory action of glucocorticoids upon PTH secretion or by the induction of increased PTH sensitivity.
对6名正常个体口服泼尼松（30毫克/天，共9天），在2天内血清1,25 - 二羟维生素D [1,25 - (OH)₂D]浓度显著升高。在4名原发性甲状旁腺功能亢进患者中，3天内观察到1,25 - (OH)₂D有更大幅度的升高。在这些患者中，泼尼松给药整个期间（10天）1,25 - (OH)₂D浓度持续升高，而在对照组中，泼尼松给药9天后该浓度已恢复至基础水平或更低。这种反应似乎依赖于甲状旁腺激素（PTH），因为我们发现5名甲状旁腺功能减退患者在泼尼松给药3 - 4天（30毫克/天）期间，（原本就低的）1,25 - (OH)₂D浓度没有变化。在这些患者中，维生素D用药在泼尼松给药前3 - 5天中断，之后通过钙输注使血清钙维持在2.10至2.30毫摩尔/升之间。1,25 - (OH)₂D对泼尼松的反应，最好的解释是糖皮质激素对PTH分泌有刺激作用，或者是诱导了PTH敏感性增加。
