Chan T Y
Department of Clinical Pharmacology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
Calcif Tissue Int. 1997 Jan;60(1):91-3. doi: 10.1007/s002239900192.
The prevalence of hypercalcemia in patients with untreated tuberculosis (TB) varies widely between countries. Since the vitamin D status and calcium intake are important determinants of hypercalcemia in TB, these two factors were compared among four populations (U.K., Hong Kong, Malaysia, Thailand) with a low prevalence (<3%) and two populations (Sweden, Australia) with a high prevalence (>25%). In the three Asian countries, the circulating vitamin D levels are abundant, but the calcium intakes are low. Subjects from the U.K. have the lowest circulating vitamin D level of all, although their calcium intake is high. In Sweden and Australia, both the circulating vitamin D levels and calcium intakes are high. Since serum 1,25(OH)2D concentration will only be raised if its substance for extrarenal conversion, 25(OH)D, is plentiful and the effect of a given serum 1,25 (OH)2D concentration on serum calcium is determined by the calcium intake, it is postulated that the regional variation in the prevalence of hypercalcemia in TB may be due to differences in the circulating vitamin D levels and calcium intakes in these populations.
未经治疗的结核病（TB）患者中高钙血症的患病率在不同国家之间差异很大。由于维生素D状态和钙摄入量是结核病中高钙血症的重要决定因素，因此在四个患病率较低（<3%）的人群（英国、中国香港、马来西亚、泰国）和两个患病率较高（>25%）的人群（瑞典、澳大利亚）中对这两个因素进行了比较。在这三个亚洲国家，循环维生素D水平充足，但钙摄入量较低。英国受试者的循环维生素D水平在所有人中最低，尽管他们的钙摄入量较高。在瑞典和澳大利亚，循环维生素D水平和钙摄入量都很高。由于只有当血清1,25(OH)2D的肾外转化物质25(OH)D充足时，血清1,25(OH)2D浓度才会升高，并且给定血清1,25(OH)2D浓度对血清钙的影响由钙摄入量决定，因此推测结核病中高钙血症患病率的区域差异可能是由于这些人群中循环维生素D水平和钙摄入量的差异。
