Stern P H, De Olazabal J, Bell N H
J Clin Invest. 1980 Oct;66(4):852-5. doi: 10.1172/JCI109924.
The effects of vitamin D, 2.5 mg (100,000 U)/d for 4 d, on serum calcium, serum 25-hydroxyvitamin D (25-OHD), and serum 1 alpha,25-dihydroxyvitamin D [1 alpha,25(OH)2D] were compared in 17 normal subjects and 6 patients with sarcoidosis who had normocalcemia and no history of hypercalcemia. The diagnosis was confirmed histologically in each of them. Vitamin D increased mean serum 25-PHD from 30 +/- 4 to 99 +/- 15 ng/ml (P < 0.001) and did not change mean serum 1 alpha,25(OH)2D (32 +/- 3 vs. 29 +/- 3 pg/ml) or mean serum calcium (9.5 +/- 0.1 vs. 9.6 +/- 0.1 mg/dl) in the normal subjects. In contrast, vitamin D increased mean serum 25-OHD from 19 +/- 3 to 65 +/- 19 ng/ml (p < 0.05), increased mean serum 1 alpha,25(OH)2D threefold from 40 +/- 7 to 120 +/- 24 pg/ml, and increased mean serum calcium from 9.4 +/- 0.2 to 9.8 +/- 0.2 mg/dl (P < 0.01). There was a significant positive correlation between the serum 1 alpha,25(OH)2D and serum calcium in these individuals (r = 0.663, P < 0.01) but not in the normal subjects. The results (a) provide further evidence for abnormal regulation of circulating 1 alpha,25(OH)2D in sarcoidosis and (b) indicate that the abnormality may exist in patients with normal calcium metabolism. Thus, the defect in vitamin D metabolism in sarcoid apparently is more common than was previously recognized.
在17名正常受试者和6名血钙正常且无高钙血症病史的结节病患者中，比较了连续4天每天服用2.5毫克（100,000单位）维生素D对血清钙、血清25-羟维生素D（25-OHD）和血清1α,25-二羟维生素D [1α,25(OH)₂D]的影响。他们每个人的诊断均经组织学证实。维生素D使正常受试者的平均血清25-OHD从30±4纳克/毫升升至99±15纳克/毫升（P<0.001），而平均血清1α,25(OH)₂D（32±3皮克/毫升对29±3皮克/毫升）或平均血清钙（9.5±0.1毫克/分升对9.6±0.1毫克/分升）未发生变化。相比之下，维生素D使结节病患者的平均血清25-OHD从19±3纳克/毫升升至65±19纳克/毫升（p<0.05），使平均血清1α,25(OH)₂D增至三倍，从40±7皮克/毫升升至120±24皮克/毫升，并使平均血清钙从9.4±0.2毫克/分升升至9.8±0.2毫克/分升（P<0.01）。这些个体的血清1α,25(OH)₂D与血清钙之间存在显著正相关（r = 0.663，P<0.01），而正常受试者中则无此相关性。结果（a）为结节病患者循环1α,25(OH)₂D的异常调节提供了进一步证据，（b）表明该异常可能存在于钙代谢正常的患者中。因此，结节病中维生素D代谢缺陷显然比之前认为的更为常见。
