Riggs B L, Gallagher J C, DeLuca H F, Edis A J, Lambert P W, Arnaud C D
Mayo Clin Proc. 1978 Nov;53(11):701-6.
Although most patients with postmenopausal osteoporosis have normal or low values for serum immunoreactive parathyroid hormone (iPTH), we have reported previously that a small subset (about 10% of the total group) have increased values. We studied three patients representative of this latter group. Serum iPTH was two to three times higher than the age-adjusted normal mean, serum ionized calcium and total calcium were in the lower half of the normal range, and serum 1,25-dihydroxyvitamin D [1,25(OH)2D] was in the low-normal range. Six months of treatment of one patient with 0.5 microgram/day of synthetic 1,25(OH)2D improved calcium absorption and balance; however, serum iPTH remained high. After surgical removal of 1,010 mg of hyperplastic parathyroid tissue, serum iPTH decreased to normal. These and other data suggest that increased serum iPTH in these patients was caused by secondary hyperparathyroidism, possibly because of inadequate conversion of 25-OH-D to 1,25(OH)2D.
尽管大多数绝经后骨质疏松症患者的血清免疫反应性甲状旁腺激素（iPTH）值正常或偏低，但我们之前报告过一小部分患者（约占总群体的10%）的iPTH值升高。我们研究了代表后一组的三名患者。血清iPTH比年龄校正后的正常平均值高两到三倍，血清离子钙和总钙处于正常范围的下半部分，血清1,25-二羟维生素D [1,25(OH)₂D]处于低正常范围。一名患者每天服用0.5微克合成1,25(OH)₂D治疗六个月，改善了钙吸收和钙平衡；然而，血清iPTH仍保持较高水平。手术切除1010毫克增生的甲状旁腺组织后，血清iPTH降至正常。这些以及其他数据表明，这些患者血清iPTH升高是由继发性甲状旁腺功能亢进引起的，可能是由于25-OH-D向1,25(OH)₂D的转化不足。
