Martínez J, Olmos J M, Amado J A, Riancho J A, Freijanes J, González-Macías J
Departamento de Medicina Interna, Hospital Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
Bone Miner. 1993 Dec;23(3):207-12. doi: 10.1016/s0169-6009(08)80097-9.
A decrease in intestinal calcium absorption, in spite of normal serum calcitriol levels, has been reported in postmenopausal osteoporotic women, raising the possibility of an intestinal resistance to the hormone. The mechanism responsible for it could lie at the receptor or postreceptor level. Intestinal receptors are difficult to study on clinical settings, but calcitriol receptors have been found in peripheral blood mononuclear cells (PBMC). We have studied the PBMC calcitriol receptors by means of Scatchard analysis in 11 postmenopausal osteoporotic women without any treatment and in 12 normal postmenopausal women of similar age. No differences were found in the dissociation constant (Kd) or the concentration of binding sites (Nmax) (Kd in patients: 0.90 +/- 0.75 x 10(-10) M; Kd in controls: 0.85 +/- 0.40 x 10(-10) M; Nmax in patients: 2.4 +/- 1.2 fmol/10(7) cells; Nmax in controls: 2.1 +/- 0.6 fmol/10(7) cells), supporting the contention that the disorder responsible for the resistance to calcitriol in postmenopausal osteoporotic women is located at the postreceptor level. In addition, our study included five postmenopausal osteoporotic women treated with calcitriol (0.5 microgram/day). The number of calcitriol receptors was increased in this group (Nmax: 3.9 +/- 2.0 fmol/10(7) cells vs. 2.1 +/- 0.6 fmol/10(7) cells; P = 0.02).
据报道,尽管血清骨化三醇水平正常,但绝经后骨质疏松症女性的肠道钙吸收仍会减少,这增加了肠道对该激素产生抵抗的可能性。其负责机制可能存在于受体或受体后水平。在临床环境中研究肠道受体很困难,但已在外周血单核细胞(PBMC)中发现了骨化三醇受体。我们通过Scatchard分析研究了11名未经任何治疗的绝经后骨质疏松症女性和12名年龄相仿的正常绝经后女性的PBMC骨化三醇受体。在解离常数(Kd)或结合位点浓度(Nmax)方面未发现差异(患者的Kd:0.90 +/- 0.75 x 10(-10) M;对照组的Kd:0.85 +/- 0.40 x 10(-10) M;患者的Nmax:2.4 +/- 1.2 fmol/10(7) 细胞;对照组的Nmax:2.1 +/- 0.6 fmol/10(7) 细胞),这支持了绝经后骨质疏松症女性对骨化三醇抵抗的疾病位于受体后水平的观点。此外,我们的研究纳入了5名接受骨化三醇治疗(0.5微克/天)的绝经后骨质疏松症女性。该组骨化三醇受体数量增加(Nmax:3.9 +/- 2.0 fmol/10(7) 细胞对2.1 +/- 0.6 fmol/10(7) 细胞;P = 0.02)。