Christiansen C, Christensen M S, Melsen F, Rødbro P, DeLuca H F
Clin Nephrol. 1981 Jan;15(1):18-22.
This study examines the interrelationship between serum levels of substances important in mineral metabolism including the 3 vitamin D metabolites 25OHD, 24.25(OH)2D and 1.25(OH)2D and static and dynamic histomorphometric measurements of bone remodelling in iliac crest biopsies in 17 patients with chronic renal failure. No correlation was found between the serum values of any of the vitamin D metabolites and the histomorphometric values. However, significant inverse correlations were found between serum calcium and both the osteoid surface extent (P less than 0.05) and osteoid volume (P less than 0.05) in trabecular bone. Serum immunoreactive parathyroid hormone (iPTH) was positively related to trabecular osteoclastic bone resorption. The serum level of 1.25(OH)2D was inversely related to endogenous creatinine clearance (P less than 0.01). These results support the hypothesis that the serum calcium concentration is more important than the serum concentration of vitamin D metabolites for bone remodelling in chronic renal failure.
本研究检测了17例慢性肾衰竭患者血清中矿物质代谢重要物质的水平，包括3种维生素D代谢产物25羟维生素D、24,25-二羟维生素D和1,25-二羟维生素D，并对其髂嵴活检标本进行了骨重塑的静态和动态组织形态计量学测量。未发现任何一种维生素D代谢产物的血清值与组织形态计量学值之间存在相关性。然而，血清钙与小梁骨类骨质表面范围（P<0.05）和类骨质体积（P<0.05）均呈显著负相关。血清免疫反应性甲状旁腺激素（iPTH）与小梁骨破骨细胞骨吸收呈正相关。1,25-二羟维生素D的血清水平与内生肌酐清除率呈负相关（P<0.01）。这些结果支持以下假设：在慢性肾衰竭中，血清钙浓度对骨重塑的重要性高于维生素D代谢产物的血清浓度。
