骨副甲状腺激素低响应:在慢性脏病中被忽视,但在临床上是重要的现实
Pieter Evenepoel1,2, Hanne Skou Jørgensen3,4
1Department of Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, KU Leuven, Belgium.
Current opinion in nephrology and hypertension
|April 23, 2024
概括
副甲状腺激素 (PTH) 在慢性病 (CKD) 中的低反应性是一个影响骨健康的复杂问题. 了解其原因是定制治疗二次性甲状腺功能增强症的关键.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 慢性病 (CKD) 与矿物质和骨疾病有关.
- 偏甲状腺激素 (PTH) 水平升高是常见的,但PTH低反应性也是一个重大问题.
- 在CKD中对PTH低响应性的临床认识有限.
研究的目的:
- 审查导致CKD中PTH低响应的因素和机制.
- 探索PTH低响应性对CKD患者骨结局的影响.
- 为提供个人化治疗方法的见解,用于CKD中的二次性副甲状腺功能障碍症.
主要方法:
- 对CKD中PTH低响应性研究的文献综述.
- 对影响骨对PTH反应的因素的分析.
- 检查矿物代谢和PTH响应性的队列研究.
主要成果:
- 酸盐代谢受损和感应受体信号受损会影响PTH的低反应性.
- 矿物代谢控制的变化驱动着不同人群对PTH反应的差异.
- 骨PTH低反应是多因素的,并显示出显著的个体间变异性.
结论:
- 在CKD中,PTH低反应性使PTH作为骨周转的生物标志物的使用变得复杂.
- 患者群体和治疗方法的异质性进一步挑战了PTH解释.
- 了解PTH低反应性对于个性化管理CKD中二次性副甲状腺功能障碍症至关重要.
相关概念视频
Skeleton and Calcium Homeostasis
4.5K
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.
4.5K
The Parathyroid Glands
2.1K
The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
2.1K
Hormones and Bone Tissue
2.7K
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.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
2.7K
Bone Remodeling
38.3K
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
38.3K
Antihypertensive Drugs: Potassium-Sparing Diuretics
527
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
527
Osteoclasts in Bone Remodeling
2.9K
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
2.9K


