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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
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Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Calcium and Bone Metabolism Indices.

Lu Song1

  • 1David Geffen School of Medicine, University of California, Los Angeles, CA, United States.

Advances in Clinical Chemistry
|September 24, 2017
PubMed
Summary

Maintaining calcium and phosphate balance is vital for bodily functions, regulated by hormones and organs. Laboratory tests and bone turnover markers aid in diagnosing and monitoring metabolic bone diseases, though standardization is needed.

Keywords:
1,25-Dihydroxyvitamin D25-Hydroxyvitamin DBone alkaline phosphataseBone formation markersBone resorption markersCTXCalcium homeostasisFGF23Hormones regulating calcium homeostasisHypercalcemiaHyperparathyroidismHyperphosphatemiaHypocalcemiaHypoparathyroidismHypophosphatemiaMeasurement of 25-hydroxyvitamin DMeasurement of PTHMeasurement of calciumMeasurement of free calciumMetabolic bone diseasesNTXOsteocalcinOsteomalaciaOsteoporosisP1NPPTHPaget diseasePhosphate homeostasisRegulation of phosphate homeostasisRenal osteodystrophyRickets

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Area of Science:

  • Endocrinology and Metabolism
  • Bone Biology
  • Clinical Diagnostics

Background:

  • Calcium and phosphate homeostasis are crucial for numerous physiological processes.
  • Parathyroid hormone (PTH), 1,25-dihydroxyvitamin D (1,25(OH)2D), and fibroblast growth factor 23 (FGF23) are key regulators.
  • Disruptions in these pathways lead to conditions like hypoparathyroidism, hyperparathyroidism, osteomalacia, and rickets.

Purpose of the Study:

  • To review the regulation of calcium and phosphate metabolism.
  • To highlight the role of laboratory diagnostics in identifying metabolic bone diseases.
  • To discuss the utility and standardization of bone turnover markers (BTMs).

Main Methods:

  • Review of existing literature on calcium and phosphate homeostasis.
  • Analysis of the diagnostic utility of laboratory tests (calcium, phosphate, PTH, vitamin D).
  • Discussion of bone turnover markers (serum P1NP, CTX) and standardization efforts.

Main Results:

  • Hormonal imbalances (PTH, vitamin D) significantly impact calcium and phosphate levels.
  • Laboratory tests are essential for diagnosing metabolic bone disorders.
  • Bone turnover markers show potential for fracture risk assessment and therapy monitoring, but require standardization.

Conclusions:

  • Accurate diagnosis and monitoring of metabolic bone diseases rely on understanding calcium and phosphate regulation.
  • Standardization of bone turnover marker assays and sample collection is critical for reliable clinical application.
  • Further research is needed to establish standardized reference intervals for BTMs across diverse populations.