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題名 | Serum Parathyroid Hormone and Vitamin D Levels in Postmenopausal Diabetic Azotemics=停經後糖尿病腎病變合併氮血症患者血清副甲狀腺素與維生素D的狀況 |
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作者 | 林石化; 盧國城; 謝善德; 遲守華; 蔡大鈞; 李碧蓮; 戴良恭; 林裕峰; |
期刊 | 醫學研究 |
出版日期 | 19940500 |
卷期 | 14:6 1994.05[民83.05] |
頁次 | 頁371-378 |
分類號 | 415.668 |
語文 | eng |
關鍵詞 | 停經; 糖尿病; 氮血症; 副甲狀腺素; 維生素D; Postmenopause; Diabetics; Azotemics; PTH; Vitamin D; |
中文摘要 | 為瞭解停經後糖尿病腎病變合併氮血症患者血清副甲狀腺素與維生素D變化,55位停經後婦女分成三組接受評估。第一組有20位糖尿病合併腎功能不全但尚未接受血液透析治療及有理想之血糖控制,第二組有15位年紀相當,非糖尿病腎功能不全者,第三組有20位年紀相當,正常腎功能者。這三組病患皆未曾接受含鋁成份之磷結合劑。空腹12小時後,晨間抽血檢查血清中的LH, FSH, estradiol, progesterone, 25(OH) Vit-D, 1,25(OH)2 vit-D3及intact-PTH。結果顯示I-PTH、FSH、及LH在第一、二組比第三組有明顯增高,而1,25(OH)2 Vit-D3和estradiol值較第三組為低。在三組中1,25(OH)2 Vit-D值並無明顯差別。在第一、二組中,其PTH上昇程度並未與1,25(OH)2 Vit-D3下降成平行關係,我們的結論是:(1)雖然維生素D身體儲存減少及動情激素缺乏的狀態下,停經後糖尿病氮血症患者先前沒有暴露過鋁及有理想的血糖控制下可呈現副甲狀腺之功能增進及促進活性維生素D合成,(2)停經後糖尿病氮血症患者可能表現正常的下視丘-腦下垂體-性腺之回饋抑制系統,(3)腎衰竭為停經後糖尿病氮血症患者,血清副甲狀腺素及活性維生素D濃度的主要決定因子,而與糖尿病及停經後較無關聯。 |
英文摘要 | To clarify serum parathyroid hormone and vitamin D levels in postmenopausal diabetic azotemics, we deaigned the following study. Three different postmenopausal patient groups were evaluated. Group I consisted of 20 diabetic women with renal insufficiency who were not yet on dialytic therapy, but had a good glycemic control. Group II consisted of 15 aged matched nondiabetic women with comparable degree of renal insufficiency. Group III consistd of 20 age-matched women with normal renal function. None of three groups has received aluminum-containing phosphate binders. We investigated the overnight fasting serum estradiol, progesterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), 25(OH) vit-D, 1,25(OH)2 vit-D3, and intact parathyroid hormone (I-PTH) levels in these cases. Serum I-PTH, LH, and FSH levels were statistically significantly higher whereas estradiol and 1,25(OH)2, vit-D3 were significantly lower in Group I and Group II patients than in Group III patients. But there is no significant dirfference in serum 25(OH) vit-D among these three group of patients. The elevated I-PHT was not paralleld by reduction of 1,25(OH)2 vit-D3 conceentration in Group I and Group II patients. We conclude that (1) despite depletion of vit-D body store and estrogen deficiency, postmenopausal diabetic azotemics who had no prior exposure to aluminum and an optimal glycemic control may present enhanced parathyroid gland activity and preserve the function of synthesizing active vit-D (2) postmenopausal diabetic azotemics may exhibit operative hypothalamus-pituitary-gonadal feedback system (3) preterminal renal failure other than diabetics or menopause is the main factor in determining serum parathyroid hormone and active vit-D levels in postmenopausal azotemics with diabetes. |
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