1,25—（OH）2D3对人垂体GH瘤细胞GH分泌的影响

在15例体外培养的人垂体生长激素(GH)分泌瘤细胞上研究1,25-(OH)_2D_3对GH分泌的调节作用,发现14例瘤细胞的GH分泌对血清生理范围(40～80pg/ml)的1,25-(OH)_2D_3有兴奋和抑制两种反应,其中9例出现GH分泌明显的抑制反应,2例呈明显兴奋反应,3例在培养不同天分别出现兴奋和抑制不同形式的反应。1,25-(OH)_2D_3使垂体GH瘤GH分泌的抑制平均为对照的63.1±3.3％,GH分泌的增加达对照值的164.0±6.2％.本研究结果表明,血清生理范围的1,25-(OH)_2D_3对大多数体外培养的人垂体GH瘤的GH分泌有直接调节作用,这种作用包括抑制与兴奋两种,其中抑制作用更为常见。     

肺心病急性加重期患者1,25-(OH)2D3改变及其原因的研究

目的探讨肺心病急性加重期1,25-(0H)2D3改变及其改变的原因.方法测定了48例患者血1,25-(OH)2D3、25-(OH)D3、甲状旁腺素(PTH)和血钙磷镁(SCa、SP、SMg).结果与对照组相比,病人组l,25-(OH)2D3、25-(OH)D3、PTH、SCa和SMg显著降低(P均＜0.01).25-(OH)D3低于均值组的1,25-(OH)2D3值显著低于25-(OH)D3高于均值组者(P＜0.05);PTH低于均值组的1,25-(OH)2D3值显著低于PTH高于均值组者(P＜0.01).结论肺心病急性加重期时1,25-(OH)2D3显著降低;25-(OH)D3和PTH的降低是1,25-(OH)2D3降低的原因.应予该病患者适量补充药物性维生素D.     

绝经后妇女骨丢失与1,25-二羟维生素D的相关性研究

目的研究随增龄和绝经发生的骨化三醇1,25(OH)2D活性和/或数量降低与骨量丢失的相关性及其影响因素,以阐明绝经后骨质疏松症的病因机理以用于指导临床防治.方法应用放免法测定了绝经后骨质疏松症妇女57例和绝经后非骨质疏松症妇女37例的血清1,25-二羟维生素D(1,25(OH)2D)、25-羟维生素D(25(OH)D)、甲旁腺素(PTH)、雌激素(E2)水平,ELISA法测定尿脱氧吡啶酚与肌酐比值等骨代谢相关指标,并进行病例对照分析.结果绝经后骨质疏松妇女血清1,25(OH)2D和25(OH)D含量分别为18 pg/ml±6pg/ml和32 ng/ml±9 ng/ml,非骨质疏松组分别为31 pg/ml±14 pg/ml和46 pg/ml±17 ng/ml, 骨质疏松妇女的血清1,25(OH)2D和25(OH)D含量明显低于非骨质疏松妇女,雌激素水平也明显降低,但PTH和Dpd/Cr水平则明显升高(P<0.01).对于绝经后妇女,L2～4的骨密度值(BMD)与血清1,25(OH)2D含量存在高度相关(r=0.693,P<0.001), BMD值的变异中有48%可以用血清1,25(OH)2D水平的变化来解释.此外,血清1,25(OH)2D与25(OH)D的相关关系密切(r=0.511, P<0.001),两者存在底物依赖合成关系.结论血清1,25(OH)2D水平与骨量值明显相关.年龄的增长,绝经年限的延长和绝经引起雌激素水平的下降,导致了血清1,25(OH)2D 水平下降,并伴有继发性PTH升高,是绝经后妇女骨量丢失加速的重要病理生理之一.     

哮喘儿血清1，25-二羟维生素D3与IL-10水平及肺功能的相关性研究

目的通过探讨哮喘患儿血清1,25-二羟维生素D3[1,25-dihydroxyvitamin D3,1,25（OH）2D2]与白细胞介素-10浓度（interleukin-10,IL-10）及肺功能的关系,为治疗哮喘患儿提供临床理论依据。方法设36例健康体检儿童为对照组,92例确诊为哮喘的患儿为哮喘组,根据病情程度分为间歇状态（12例）、轻度持续（18例）、中度持续（33例）、重度持续（29例）4个级别;用酶联免疫分析（ELIsA）法检测两组血清中1,25（OH）2D2和IL-10的含量;哮喘组肺功能的评价指标为呼气峰流速（PEF）和第1秒用力呼气容积（FEV1）。结果哮喘组血清中1,25（0H）2D2和IL-10的含量均显著低于对照组（均P〈O．05）;除间歇状态级与轻度持续级患儿在1,25（0H）2D3、IL-10和PEF指标比较差异无统计学意义外,1,25（0H）2D3、IL-IO和PEF、FEV-在不同程度的哮喘（轻度持续、中度持续、重度持续）之间两两比较差异均有统计学意义（P〈0．05）;1,25（OH）2D3与IL-10、PEF和FEV1均呈正相关（P〈0．05）。结论哮喘患儿血清1,25（0H）2D3和IL-10水平较健康儿童低,1,25（OH）2D3可以促进IL-10水平提高,改善肺功能。     

Suppression of secondary hyperparathyroidism in uraemia: acute and chronic studies

A study was conducted evaluating the response of serum parathyroid hormone to acute hypercalcaemia and long term administration of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in patients receiving maintenance haemodialysis. During infusion of elemental calcium 4 mg/kg/h over four hours in 12 patients not receiving vitamin D the concentration of serum amino terminal parathyroid hormone fell by 31-96% (mean 74.8 (SD 17.6)%) while that of carboxy terminal parathyroid hormone changed little. There was a strong inverse correlation between baseline serum calcium concentration and percentage fall in amino terminal parathyroid hormone during infusion (r = 0.88; p less than 0.001). In seven patients who received prolonged treatment with 1,25(OH)2D3 after calcium infusion there was a positive correlation between maximum percentage fall in amino terminal parathyroid hormone during infusion and the percentage fall in amino terminal parathyroid hormone after 1,25(OH)2D3 treatment (r = 0.79; p less than 0.05). The responsiveness of the parathyroid glands to changes in calcium in acute studies may be used to predict the efficacy of long term treatment with 1,25(OH)2D3. Patients in whom calcium infusion does not suppress parathyroid hormone may have true parathyroid autonomy and require early parathyroidectomy.     

纠正继发性甲状旁腺功能亢进对维持性血液透析患者心脏结构和功能的影响

目的探讨应用活性维生素D3纠正继发性甲状旁腺功能亢进（SHPT）对维持性血液透析（MHD）患者心脏结构和功能的影响。方法56例MHD患者均符合SHPT诊断标准,采用低钙透析液稳定透析3个月以上,随机分为A组（29例）和B组（27例）,测定血钙（Ca）、磷（P）、甲状旁腺素（iPTH）。A组每日午饭中嚼服碳酸钙600mg,B组在此基础上服用活性维生素D3,2～3μg／周,分2～3次于透析后当晚口服,二组连续用药12个月,当Ca〉10．2mg／dl或Ca×P≥55mg2／dl2调节药物剂量。分别于实验开始前及6个月、12个月行心脏多普勒超声检查。结果于实验6个月、12个月后,B组iPTH平均值较A组下降明显（P〈0．05,P〈0．01）。心脏结构和功能比较,治疗前左室肥厚（LVH）、射血分数（EF）,舒张早期和舒张晚期二尖瓣口最大血流速度之比（E／A）等指标二组之间羔异无统计学意义（P〉0．05）,治疗6个月、12个月后,A组上速各指标无明显变化（P〉0．05,P〉0．05）,B组随治疗时间的延长上述指标明显好转,差异有统计学意义（P〈0．05和P〈0．01）。结论活性维生素D3不仅可以减轻MHD患者SHPT,而且有助于改善SHPT患者的心脏结构和功能。     

1,25-二羟维生素D_3对大鼠肾间质纤维化的作用研究

目的：研究1,25-二羟维生素D3〔1,25-（OH）2D3〕对单侧输尿管梗阻（UUO）大鼠肾间质纤维化的影响。方法：45只大鼠随机分为假手术组（n=15）、UUO组（n=15）和1,25-（OH）2D3干预组（n=15）,建立UUO大鼠肾间质纤维化模型,干预组于术后第1天起每天腹腔注射1,25-（OH）2D3,假手术组及UUO组腹腔注射等量生理盐水。分别于术后第3天、第7天和第14天处死大鼠,每次5只,取梗阻侧肾脏行HE、Masson染色及α-平滑肌肌动蛋白（α-SMA）免疫组化标记,观察肾损伤程度和肾间质纤维化程度;取血测定肌酐和尿素氮水平观察肾功能;处死前1天收集24 h尿液,检测尿中蛋白含量。结果：与假手术组相比,UUO组和干预组各时间点HE、Masson染色和α-SMA表达变化明显,呈逐渐加重趋势,差异有统计学意义（P〈0.05）;肌酐、尿素氮及24 h尿蛋白含量术后第3和第7天时表现为升高,术后第14天时出现下降,差异有统计学意义（P〈0.05）。与UUO组相比,干预组各时间点各项指标变化明显改善,差异有统计学意义（P〈0.05）。结论：1,25-（OH）2D3可抑制UUO大鼠肾间质纤维化进程,改善肾功能。     

早期糖尿病肾病患者1,25-(OH)_2D_3及炎性因子的变化及骨化三醇胶丸的干预作用

目的观察维生素D代谢物1,25-二羟维生素D_3[1,25-(OH)_2D_3]对早期糖尿病肾病(DN)患者炎性因子TGF-β、TNF-α、IL-6、hs-CRP水平的影响。方法2型糖尿病患者150例,其中单纯糖尿病患者60例为DM组,早期DN 90例为DN组。DN组再随机分为治疗亚组和对照亚组各45例。对照亚组常规治疗,治疗亚组常规治疗+骨化三醇胶丸,疗程均3个月,比较各组1,25-(OH)_2D_3、24 h尿蛋白定量及相关炎性因子的变化。结果治疗前,DN组1,25-(OH)_2D_3水平低于DM组(P<0.05);TGF-β、TNF-α、IL-6、hs-CRP,24 h尿蛋白定量、SCr水平均高于DM组(P<0.05);治疗亚组治疗后TGF-β、TNF-α、IL-6、hs-CRP水平及24 h尿蛋白定量均较治疗前降低(P<0.05),1,25-(OH)_2D_3水平较前升高(P<0.05)。对照亚组与治疗亚组不良反应发生率比较差异无统计学意义(11.1】%vs.11.11%,P>0.05)。结论早期DN患者1,25-(OH)_2D_3缺乏,炎性因子水平增高,补充骨化三醇胶丸可以改善炎性反应状态。     

老年骨质疏松症患者血清1，25-二羟维生素D3与骨骼肌减少症的相关性研究

目的 探讨老年骨质疏松症（osteoporosis,OP）患者血清1,25-二羟维生素D3〔1,25-（OH）2D3〕与骨骼肌减少症（sarcopenia,SAR）的相关性。 方法 选取2013年10月—2015年4月到云南省第一人民医院就诊的老年OP患者390例。根据是否合并SAR,将纳入患者分为合并SAR组（n=286）和未合并SAR组（n=104）。患者均进行体格检查、骨密度和身体组织成分检测及实验室检查,并分析血清1,25-（OH）2D3与SAR评价指标和影响因素的相关性。 结果 两组患者性别、年龄及BMI比较,差异无统计学意义（P＞0.05）。未合并SAR组患者血清1,25-（OH）2D3高于合并SAR组,差异有统计学意义（P＜0.05）。Spearman秩相关分析结果显示,男性/女性OP患者血清1,25-（OH）2D3与步速、握力呈正相关（P＜0.05）,而与四肢骨骼肌量指数（ASMI）不相关（P＞0.05）;血清1,25-（OH）2D3与雌二醇（E2）、睾酮（T）、胰岛素样生长因子-1（IGF-1）、白介素10（IL-10）呈正相关（P＜0.05）,与活性氧（ROS）、全段甲状旁腺激素（iPTH）、肿瘤坏死因子α（TNF-α）、白介素6（IL-6）呈负相关（P＜0.05）,而与BMI、胰岛素抵抗指数（HOMA-IR）、超敏C反应蛋白（hs-CRP）不相关（P＞0.05）。 结论 OP患者血清1,25-（OH)2D3水平与部分SAR评价指标和影响因素相关,可能是早期预测和评估SAR的指标之一。     

1,25双羟维生素D3及转化生长因子β1对人胚成骨细胞增殖和分化的影响

目的　研究 1,2 5双羟维生素D3 [1,2 5 (OH) 2 VD3 ]及人转化生长因子 β1(hTGF β1)对人胚成骨细胞增殖和分化的影响。方法　体外培养人胚成骨细胞 ,经 1,2 5 (OH) 2 VD3 及hTGF β1作用后 ,通过四唑盐 (MTT)比色法观察细胞增殖 ;检测细胞培养液中碱性磷酸酶 (ALP)活性及骨钙素 (OC)含量 ;逆转录 聚合酶链反应 (RT PCR)方法观察细胞中TGF β信号传导关键蛋白 SMAD蛋白mRNA水平的变化。结果　MTT比色发现 1,2 5 (OH) 2 VD3 组的吸光度值 (OD值 )较对照组下降 30 6 % (0 0 86±0 0 2 2比 0 12 4± 0 0 31,P <0 0 5 )。细胞培养液中ALP活性在 1,2 5 (OH) 2 VD3 组、hTGF β1组以及二者联合应用组均有显著增高 ,为对照组的 1 3～ 2 0倍 (P <0 0 5 )。其中 ,当hTGF β1浓度为 1× 10 -6g/L时 ,1,2 5 (OH) 2 VD3 及hTGF β1对人胚成骨细胞ALP的分泌存在协同刺激作用。 1,2 5 (OH) 2 VD3 与 1×10 -6g/L和 1× 10 -5g/L浓度的hTGF β1合用使得细胞培养液中OC水平增加 (P <0 0 5 ) ,但未发现二者的协同作用。当 1,2 5 (OH) 2 VD3 与 1× 10 -6g/L的hTGF β1合用时SMAD3mRNA水平达高峰 ,约为对照组的 6倍。结论　 1,2 5 (OH) 2 VD3 抑制人胚成骨细胞增殖 ,促进其分化。 1,2 5 (OH) 2 VD3 及hTGF β1     

急性淋巴细胞白血病患者血清乳酸脱氢酶和维生素D水平与其预后的关系

目的 探讨急性淋巴细胞白血病(ALL)患者血清乳酸脱氢酶(LDH)和维生素D水平与其预后的关系.方法 选取成人初治ALL患者63例为ALL组,行大剂量甲氨蝶呤治疗并随访至少1年.并以同期健康查体志愿者30例为对照组.检测比较两组血清LDH和25-羟维生素D[25(OH)D]水平及同期急性生理和慢性健康评分(APACHEⅡ评分).统计ALL组随访1年的生存预后.分析ALL患者血清LDH和25(OH)D水平与其A-PACHEⅡ评分及1年生存率的关系及其预测1年生存预后的价值.结果 与对照组比较,ALL组治疗前血清LDH水平和APACHEⅡ评分升高而血清25 (OH)D水平则降低(P＜0.05).与治疗前比较,ALL组治疗后3d和治疗后1个月的血清LDH水平和APACHEⅡ评分降低而血清25(OH)D水平则升高(P＜0.05).ALL组1年生存率为80.95％.与ALL组存活患者比较,AL组死亡患者治疗前后的血清LDH水平和APACHEⅡ评分升高而血清25(OH)D水平则降低(P＜0.05).Spearman无条件相关分析结果显示,ALL患者血清LDH水平与APACHEⅡ评分呈正相关(r =0.868,P＜0.05)而与1年生存率呈负相关(r=-0.892,P＜0.05),其血清25(OH)D水平与A-PACHEⅡ评分呈负相关(r=-0.705,P＜0.05)而与1年生存率呈正相关(r=0.826,P＜0.05).ROC曲线分析结果显示,ALL患者治疗前、治疗后3d和治疗后1个月的血清LDH和25 (OH)D水平联合预测其1年生存预后的准确性分别为88.89％、95.24％和98.41％.结论 ALL患者血清LDH和25(OH)D水平与病情相关且联合预测患者预后的价值良好,可能作为ALL患者病情和预后评估的参考指标.     

脑皮质星形细胞在1,25-(OH)2D3限定培养中表达NGF

目的：研究原代中枢神经胶质细胞在1,25-二羟维生素D₃［1,25-(OH)₂D₃］化学限定培养中神经生长因子（NGF）基因转录及表达。方法：用新生乳鼠脑皮质制备星形胶质细胞,采用浓度0、10_-7、10^-8、10^-9、10^-10、10^-11及10^-12 mol•L^-1 1,25-(OH)₂D₃化学限定无血清培养液培养后,RT-PCR法检测NGF mRNA转录,双向夹心-ELISA检测NGF。 结果：1,25-(OH)₂D₃化学限定无血清原代培养的神经胶质细胞在1,25-(OH)₂D₃作用下可分泌NGF,实验中1,25-(OH)₂D₃有效浓度范围10^-11~10_-7mol•L^-1;1,25-(OH)₂D₃培养6 h后开始检测到mRNA的表达,12 h时表达最高,36 h后检测不到NGF mRNA的表达;而NGF蛋白的ELISA反应持续时间大于48 h。结论：星形神经胶质细胞的NGF基因可被甾体激素1,25-(OH)₂D₃激活并转录表达。     

2型糖尿病患者血清1,25-二羟基维生素D3的变化及意义

目的:比较2型糖尿病患者与正常人之间血清1,25-二羟基维生素D3[1,25(OH)2D3]水平的差异,分析维生素D与2型糖尿病的关系?方法:选择2型糖尿病患者110例为病例组,同期本院健康体检者105例为对照组?用ELISA法测定血清1,25(OH)2D3水平,同时进行问卷调查并检测相关临床及生化指标,统计分析?结果:血清1,25(OH)2D3在病例组和对照组中的差异明显(P < 0.01),血清1,25(OH)2D3与空腹血糖呈显著负相关(rs=-0.696,P < 0.01)?结论:血清1,25(OH)2D3在2型糖尿患者中明显低于正常人?空腹血糖越高,血清1,25(OH)2D3越低?     

Clinical trial with somatonorm in idiopathic growth hormone deficiency in children.

This article reports the efficacy and safety of treatment with Somatonorm in 9 children with idiopathic growth hormone (GH) deficiency in China. The growth velocity increased from 2.6 +/- 0.2 cm/year before treatment to 10.7 +/- 0.5 cm/year at the end of 1-year treatment. The increment of human growth hormone (hGH) level and area under the response curve above the baseline level were larger after one injection of Somatonorm at the dose of 0.1 IU/kg sc than that of 0.17 IU/kg im. Increments of delayed bone age were not significant. There was no correlation between the increase of height growth velocities and the serum Somatomedin-C (SMC) levels during hGH therapy (r = -0.055). Blood sugar levels and blood alkaline phosphatase concentrations increased significantly after therapy. There were no significant side effects. Serum T4 levels of 3 patients dropped below normal after treatment. Serum anti-hGH antibody appeared at 3-12 month in 2 patients, but it did not attenuate the growth velocity.

     

泼尼松联合阿法骨化醇治疗原发性肾病综合征的临床观察

目的观察泼尼松联合阿法骨化醇治疗原发性肾病综合征的临床疗效。方法选择2008年1月—2009年10月住院及门诊治疗的原发性肾病综合征患者56例,随机分为2组:C组28例常规泼尼松治疗,T组28例常规泼尼松联合阿法骨化醇(0.5μg/d)治疗,比较2组治疗前后临床症状的改善,血清钙、磷、甲状旁腺激素(PTH)、25-(OH)_2D_3以及1,25-(OH)_2D_3水平以及尿蛋白定量变化。结果治疗3、6及12个月后,T组缓解率均明显高于C组(P<0.05)。治疗6个月,C组患者24 h尿蛋白下降(P<0.05),血钙、血磷、血25-(OH)_2D_3及1,25-(OH)_2D_3、PTH水平稍有改善,但差异无统计学意义(P>0.05);T组血钙、25-(OH)_2D_3及1,25-(OH)_2D_3水平上升(P<0.05),24 h尿蛋白、PTH水平下降(P<0.05),且与C组治疗后相比,差异具有统计学意义(P<0.05),而血磷水平无明显变化(P>0.05)。结论泼尼松联合阿法骨化醇治疗原发性肾病综合征疗效明显。     

南京汉族人群维生素D结合蛋白受体基因多态性与2型糖尿病的相关性研究

目的 探讨南京汉族人群中维生素D结合蛋白(DBP)受体基因Asp416Glu与Thr420Lys多态性与2型糖尿病及血清1,25-二羟基维生素D3[1,25(OH)2D3]的相关性.方法 采用聚合酶链反应限制性片段长度多态性( PCR-RFLP)技术,检测105例2型糖尿病患者和105例正常者的DBP基因型,用酶联免疫吸附( Elisa)法测定血清1,25( OH)2D3水平,并检测相关临床及生化指标,比较DBP基因型和等位基因频率的分布差异及不同基因型血清1,25( OH )2D3等相关指标的差异.结果 维生素D结合蛋白受体基因Asp416Glu与Thr420Lys多态性位点基因型和等位基因频率在两组中的分布无显著性差异(P＞0.05).血清l,25(OH)2D3在不同基因型间无有意义的差别(P＞(0.05).结论 DBP受体基因Asp416Glu与Thr420Lys多态性与2型糖尿病及血清1,25(OH)2D3无关.     

1,25-Dihydroxyvitamin D3 pretreatment enhances the efficacy of allergen immunotherapy in a mouse allergic asthma model

Background  Allergen-specific immunotherapy can induce immune tolerance to specific allergens by regulating immune status of individuals. However, its clinical application is limited due to individual differences in efficacy among patients and un-confirmed safety. 1,25 Dihydroxyvitamin D₃ (1,25(OH)₂D₃) has been shown to be involved in a variety of physiological processes, including immune response regulation. In the present study we explored the role of 1,25(OH)₂D₃ pretreatment for immunotherapy.

Methods  Seventy-five BALB/c mice were randomly divided into five groups (15 mice per group). The mouse allergic asthma model was established by intra-peritoneal injection of ovalbumin (OVA, 10 μg) and aluminium hydroxide (2 mg) as an adjuvant. Intra-peritoneal injection of 50 ng of 1,25(OH)₂D₃ served as a pretreatment, subcutaneous injection of OVA (100 μg) as an immunotherapy, and 1% OVA inhalation as a challenge. Histopathological analysis was performed on four mice per group. The number of cells and their classification in bronchoalvolar lavage (BAL) fluid were assayed. Levels of serum OVA-specific immunoglobulin E (sIgE) and IFN-γ, IL-4, IL-5 and IL-10 in BAL fluid were measured by ELISA.

Results  After 1,25(OH)₂D₃ pretreatment, immunotherapy could significantly inhibit the infiltration of inflammatory cells into lung tissues and BAL fluid of mice with allergic asthma when compared with un-treated animals (eosinophils: (7.46±1.34)×10⁴/ml vs. (13.41±1.67)×10⁴/ml, P <0.05). In addition, levels of IL-4 ((36.91±7.87) pg/ml vs. (43.70±6.42) pg/ml, P >0.05) and IL-5 ((41.97±7.93) pg/ml vs. (60.14±8.35) pg/ml, P <0.05) in BAL fluid and serum sIgE ((0.42±0.05) vs. (0.75±0.06) OD units, P <0.05) were profoundly reduced. However, the IL-10 level in BAL fluid was significantly increased ((67.74±6.57) pg/ml vs. (44.62±8.81) pg/ml, P <0.05).

Conclusions  These results indicated that 1,25(OH)₂D₃ pretreatment enhanced the inhibitory effects of immunotherapy on allergic airway inflammation. In the treatment of allergic diseases, 1,25(OH)₂D₃ pretreatment may be beneficial for improving the efficacy of immunotherapy. 

     

Insulin resistance, renal injury, renal 1-alpha hydroxylase, and bone homeostasis in aged obese rats

BACKGROUND: This study aimed to explore the relationship among insulin resistance (IR), renal injury, renal 1-alpha hydroxylase activity (RHA), and bone homeostasis in the presence of obesity. METHODS: Obesity, obesity treated with vitamin D, and obesity treated with 1-alpha hydroxyvitamin D [1-alpha(OH)D] were studied in animal models using aged Wistar rats. Glucose infusion rates (GIR), levels of urinary albumin (UA), serum 25-hydroxyvitamin D [25-(OH)D], serum 1,25-dihydroxyvitamin D [1,25(OH)(2)D], and bone mineral density (BMD) in lumbar vertebrae and femoral bone were measured. RESULTS: GIR in obese rats decreased. A negative correlation existed between UA level and GIR in the aged obese rats, which did not exist in the normal control rats. Levels of serum 25(OH)D in all models were similar. Obese rats had lower levels of serum 1,25(OH)(2)D and BMD than normal control rats. Treating obese rats with vitamin D had no effect on levels of serum 25-(OH)D, serum 1,25(OH)(2)D, and BMD. Administration of 1alpha-(OH)D to obese rats significantly increased serum 1,25(OH)(2)D to above-normal levels and BMD to normal level. In obese rats, levels of serum 1,25(OH)(2)D and BMD in lumbar vertebrae and femoral bone were positively correlated with GIR, and the level of serum 1,25(OH)(2)D was negatively correlated with the UA level. CONCLUSIONS: In the presence of obesity, IR, renal injury, decrease in RHA and bone loss exist. IR-injured kidney accounts for a decrease in RHA, which is a precipitating factor for bone loss.     

Relation of serum growth hormone and estradiol levels and osteoporosis in postmenopausal women

Serum GH, E2, FSH, LH levels, bone mass, serum alkaline phosphatase (AKP), calcium levels and urinary calcium/creatine ratio in 42 postmenopausal women were compared with those in 30 women of fertile age. In thirteen out of the postmenopausal women we also observed these parameters before and after treatment with diethylstilbestrol (DES). The postmenopausal women had significantly reduced serum GH (P less than 0.01) and E2 levels (P less than 0.001) and increased serum FSH(P less than 0.001), LH levels (P less than 0.001), and had lower bone mass (P less than 0.01). They also had increased serum AKP levels (P less than 0.05) and urinary calcium/creatine ratio(P less than 0.01). There were positive correlations between serum E2 and GH levels, between postmenopausal bone loss and serum E2, GH decline. The postmenopausal bone loss began early as menopause commenced. After treatment with DES in 13 postmenopausal women, we observed that GH significantly increased (P less than 0.01) and FSH, LH decreased (P less than 0.001), AKP decreased by 27.58% and urinary calcium/creatine ratio decreased by 43.94% (compared with that before treatment). Our results indicate that bone turnover increased after menopause and resorption exceeded formation. There is bone loss in early postmenopause. The postmenopausal bone loss is related to serum GH, E2 levels. Estrogen replacement therapy is necessary in postmenopausal women and it should be given as early as possible. After treatment with DES, increased serum GH levels, decreased AKP values (27.58%) and urinary calcium/creatine ratio (43.94%) suggest that estrogen may play a definite role in bone metabolism through increased GH.