calcium homeostasis

钙稳态
  • 文章类型: Journal Article
    骨关节炎(OA)是一种以软骨退化为特征的退行性关节疾病,骨重塑,和痛苦。最近的证据表明,维生素D不足,甲状旁腺激素(PTH)水平的变化,血脂异常可能在OA的病理生理学中起作用,影响钙稳态和骨骼健康。我们调查了维生素D,PTH水平,血脂谱,OA患者的钙稳态。
    这项病例对照研究涉及200名参与者,分为OA组和对照组,2023年4月至5月在三级护理中心。血清25-羟维生素D水平,PTH,总胆固醇,HDL,LDL,甘油三酯,和钙被测量。进行统计分析以评估这些生物标志物与OA状态之间的相关性。
    与对照组相比,OA患者的维生素D水平明显降低,PTH和总胆固醇水平更高。维生素D不足很普遍,维生素D水平下降之间存在显著相关性,PTH升高,和血脂异常。这些发现表明潜在的代谢相互作用会影响OA的进展和症状学。
    该研究强调了维生素D不足,PTH水平改变,和OA患者的脂质失调,强调评估这些参数在OA临床管理中的重要性。需要进一步的研究来探索纠正OA中维生素D不足和脂质异常的治疗意义。
    UNASSIGNED: Osteoarthritis (OA) is a degenerative joint disease characterized by cartilage degradation, bone remodeling, and pain. Recent evidence suggests that Vitamin D insufficiency, alterations in parathyroid hormone (PTH) levels, and dyslipidemia may play roles in the pathophysiology of OA, affecting calcium homeostasis and bone health. We investigated the association between Vitamin D, PTH levels, lipid profile, and calcium homeostasis in OA patients.
    UNASSIGNED: This case-control study involved 200 participants, divided into OA and control groups, at a tertiary care center from April to May 2023. Serum levels of 25-hydroxyvitamin D, PTH, total cholesterol, HDL, LDL, triglycerides, and calcium were measured. Statistical analysis was conducted to assess correlations between these biomarkers and OA status.
    UNASSIGNED: OA patients demonstrated significantly lower Vitamin D levels and higher PTH and total cholesterol levels compared to controls. Vitamin D insufficiency was prevalent, with a notable correlation between decreased Vitamin D levels, elevated PTH, and dyslipidemia. These findings suggest a potential metabolic interplay affecting OA progression and symptomatology.
    UNASSIGNED: The study highlights a significant association between Vitamin D insufficiency, altered PTH levels, and lipid dysregulation in OA patients, underscoring the importance of assessing these parameters in the clinical management of OA. Further research is needed to explore the therapeutic implications of correcting Vitamin D insufficiency and lipid abnormalities in OA.
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  • 文章类型: Systematic Review
    目的:对孕妇的管理没有具体建议:本综述的目的,根据临床案例研究,是为了澄清它的发展,并发症,危险因素和治疗。
    方法:通过咨询Pubmed,科克伦图书馆,和科学直接数据库。
    结果:原发性甲状旁腺功能亢进定义为甲状旁腺激素的过量产生导致高钙血症。妊娠期原发性甲状旁腺功能亢进的患病率尚不清楚。的确,症状学,与高钙血症有关,不是很具体,容易与妊娠的临床表现混淆。特定于妊娠状态的生理变化经常导致轻微的低钙血症,这可能使原发性甲状旁腺功能亢进的诊断复杂化。在大多数情况下,原发性甲状旁腺功能亢进是由甲状旁腺腺瘤引起的,并且在怀孕期间通过超声检测到。妊娠期原发性甲状旁腺功能亢进会对母亲和胎儿造成重大风险。产妇并发症发生率为14-67%,然而,最严重的并发症是高血钙危象,这需要在产后加强监测。原发性甲状旁腺功能亢进也会引起产科并发症,如急性羊水过多,或宫内发育迟缓。以新生儿低钙血症为主要并发症的病例,胎儿并发症发生率可达45~80%。如果药物治疗是基于过度水合,只有手术治疗才有疗效。
    结论:对于有症状的患者或有高血钙水平的患者,应建议进行手术。在跨学科委员会进行讨论,并应在妊娠中期进行理想的组织,以避免孕产妇和胎儿并发症。
    OBJECTIVE: There is no specific recommendation for management in pregnant women: the aim of this review, based on a clinical case study, is to clarify its development, complications, risk factor and treatment.
    METHODS: A review of the literature was performed by consulting the Pubmed, Cochrane Library, and Science Direct databases.
    RESULTS: Primary hyperparathyroidism is defined as excessive production of parathyroid hormone resulting in hypercalcemia. The prevalence of primary hyperparathyroidism during pregnancy is not known. Indeed, the symptomatology, related to hypercalcemia, is not very specific and easily confused with the clinical manifestations of pregnancy. The physiological changes specific to the pregnant state frequently lead to a slight hypocalcemia which may complicate the diagnosis of primary hyperparathyroidism. Primary hyperparathyroidism results from a parathyroid adenoma in the majority of cases and is detected by ultrasound during pregnancy. Primary hyperparathyroidism in pregnancy causes significant risks to both mother and fetus. The maternal complication rate is 14-67%, however, the most serious complication is hypercalcemic crisis, which requires increased surveillance in the postpartum period. Obstetrical complications are also induced by primary hyperparathyroidism, such as acute polyhydramnios, or intrauterine growth retardation. The fetal complication rate can reach 45-80% of cases with neonatal hypocalcemia as the main complication. If medical treatment is based on hyperhydration, only surgical treatment is curative.
    CONCLUSIONS: Surgery should be proposed to symptomatic patients or those with high blood calcium levels, discussed in interdisciplinary committee and should be organized ideally in the second trimester to avoid maternal and fetal complications.
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  • 文章类型: Case Reports
    维生素D是钙稳态和骨骼健康所必需的脂溶性维生素。维生素D毒性或维生素D过多极为罕见。我们描述了一名73岁男子的病例,该男子因自我用药剂量的维生素D补充剂而出现危及生命的维生素D过多症和高钙血症。这个案子,与其他全球病例报告一样,强调了未经许可的维生素D替代的潜在危险。我们讨论了维生素D替代的证据,并提醒读者有关每日摄入和补充的当前指南。
    Vitamin D is a fat-soluble vitamin essential for calcium homeostasis and bone health. Vitamin D toxicity or hypervitaminosis D is extremely rare. We describe the case of a 73-year-old man who presented with life-threatening hypervitaminosis D and hypercalcaemia resulting from self-medicated doses of vitamin D supplements. This case, alongside other global case reports, highlights the potential dangers of unlicensed vitamin D replacement. We discuss the evidence for vitamin D replacement and remind readers of the current guidance on daily intake and supplementation.
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  • 文章类型: Case Reports
    Missense mutations in ATP2A1 gene, encoding SERCA1 protein, cause a muscle disorder designed as congenital pseudomyotonia (PMT) in Chianina and Romagnola cattle or congenital muscular dystonia1 (CMD1) in Belgian Blue cattle. Although PMT is not life-threatening, CMD1 affected calves usually die within a few weeks of age as a result of respiratory complication. We have recently described a muscular disorder in a double muscle Dutch Improved Red and White cross-breed calf. Mutation analysis revealed an ATP2A1 mutation identical to that described in CMD1, even though clinical phenotype was quite similar to that of PMT. Here, we provide evidence for a deficiency of mutated SERCA1 in PMT affected muscles of Dutch Improved Red and White calf, but not of its mRNA. The reduced expression of SERCA1 is selective and not compensated by the SERCA2 isoform. By contrast, pathological muscles are characterized by a broad distribution of mitochondrial markers in all fiber types, not related to intrinsic features of double muscle phenotype and by an increased expression of sarcolemmal calcium extrusion pump. Calcium removal mechanisms, operating in muscle fibers as compensatory response aimed at lowering excessive cytoplasmic calcium concentration caused by SERCA1 deficiency, could explain the difference in severity of clinical signs.
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