Broadus A E, Horst R L, Lang R, Littledike E T, Rasmussen H
N Engl J Med. 1980 Feb 21;302(8):421-6. doi: 10.1056/NEJM198002213020801.
Fifty patients with primary hyperparathyroidism were studied with an oral calcium-tolerance test, measurements of plasma levels of vitamin D metabolites, and determination of calcium excretion on both a low-normal (400 mg) and high-normal (1000 mg) calcium intake. There were strong positive correlations between plasma levels of 1,25-dihydroxyvitamin D (1,25(OH)2D) and both the calciuric response to the calcium-tolerance test (r = +0.75, P less than 0.001) and calcium excretion on the 1000-mg calcium diet (r = +0.65, P less than 0.001). The patients were classified into two subpopulations: 30 patients showed hyperabsorption with the calcium-tolerance test, striking hypercalciuria, marked elevations in plasma 1,25(OH)2D, and a high incidence (19 of 30 patients) of renal stones; 20 patients had a normal response to the tolerance test, normocalciuria, normal or high-normal plasma 1,25(OH)2D, and a low incidence of stones (three of 20 patients). The findings emphasize the importance of circulating 1,25(OH)2D in the pathogenesis of hypercalciuria and stone formation in primary hyperparathyroidism.
对50例原发性甲状旁腺功能亢进患者进行了口服钙耐量试验、维生素D代谢产物血浆水平测定，并在低正常钙摄入量（400毫克）和高正常钙摄入量（1000毫克）情况下测定钙排泄量。1,25-二羟维生素D（1,25(OH)2D）血浆水平与钙耐量试验的尿钙反应（r = +0.75，P<0.001）以及1000毫克钙饮食时的钙排泄量（r = +0.65，P<0.001）之间均存在强正相关。患者被分为两个亚组：30例患者在钙耐量试验中表现为吸收亢进、显著高钙尿症、血浆1,25(OH)2D明显升高以及肾结石高发病率（30例患者中有19例）；20例患者对耐量试验反应正常、尿钙正常、血浆1,25(OH)2D正常或高正常，且结石发病率低（20例患者中有3例）。这些发现强调了循环中的1,25(OH)2D在原发性甲状旁腺功能亢进症高钙尿症和结石形成发病机制中的重要性。
