磷与糖尿病

介绍了补磷治疗低血磷糖尿病的结果及其可能的机制。     

动态监测不同钙浓度腹膜透析液对尿毒症患者钙磷代谢的影响

目的 动态监测使用不同钙浓度腹膜透析液行持续性不卧床腹膜透析（CAPD）对尿毒症患者钙磷代谢的影响。方法将加例初行CAPD的尿毒症患者随机分为标准钙组和低钙组，每组各20例，行正规CAPD治疗并配合碳酸钙口服，观察12个月。结果两组患者初行CAPD时，血清钙、磷、钙磷乘积及免疫反应性甲状旁腺素（iPTH）浓度比较差异均无统计学意义，普遍存在高磷血症及低iPTH血症。经过6个月的治疗，标准钙组患者的高钙、高磷血症进一步加重，而低钙组患者的血清钙[（2．29±0．27）mmol／L]、血清磷[（1．50±0．25）mmol／L]及钙磷乘积[（41．62±19．55）mg^2/dl^2]较治疗前显著降低，且均低于治疗后的同期标准钙组患者（P〈0．01），iPTH则显著上升（P〈0．01）。在随后的6个月中，低钙组患者血清钙、钙磷乘积保持稳定并维持在正常范围，血清磷进一步降至正常范围（0．8～1．5mmol／L），iPTH则维持在150ng/L左右，与标准钙组比较有显著改善（P〈0．01）。结论低钙浓度腹膜透析液有助于减轻尿毒症CAPD患者的钙磷代谢紊乱，延缓并发症的发生。     

32P-磷酸铬-聚 L-乳酸缓释粒子的制备及其放射性释出和生物分布

Objective The aim of this study was to prepare the 32P-chromic phosphate-poly(L-lac-tide) (32P-CP-PLLA) particles with different ratio of the materials and further examine their performance in-dex in vivo and in vitro and their intracorporeal distribution. Methods The erosion, degrading rates, de-layed release velocity and radioactivity self-absorption coefficient (RSAC) of 32P-CP-PLLA particles made from different materials were investigated and compared. After the implantation of 32P-CP-PLLA particles and the injection of 32P-CP colloids in the muscular tissues, the weight loss rate and the radioactivity release rate (RRR) of the particles were calculated. The intracorporeal distribution, radioactive half-life and bio-logical effect of 32P in the targeting sites were further studied. Statistical analysis was performed with SPSS 12.0, and one-way analysis of variance and t-test were used. Results 32P-CP-PLLA particles were of green cylinder, with regular shape and radionuclide distribution. The RSAC of the particles was of little re-lation with molecular weight of PLLA and proportional to the ratio of PLLA to CP. The extracorporeal release rate increased with the reduction of molecular weight of PLLA and with the increase of the ratio of PLLA to CP. The RRR reached peak when PLLA was 3 times of CP. The 32P-CP, released with the degradation and corrosion of the particle distributed mainly in the surrounding muscles of the particle. And the peak of per-centage activity of injection dose per gram of tissue (% ID/g) in liver, spleen and bone were 1. 7887, 1. 6401 and 1. 9470 respectively, much lower than that in the 32P-CP group (4.7523, 3.9712 and 4.3174 ; all t > 2.7, all P < 0.05). The % ID/g in other organs was much less. The radioactivity effective half-life in the targeting sites increased to about 13 d. There was widespread necrosis around the particles with no ex-istence of normal tissues among them. And no abnormality in spleen and liver was found. Conclusion As a better dosage form of pure β-particle emitter, 32P-CP-PLLA, which can increase the targeting radioactive dosage and effective half-life in the implanting sites, can be served as an potential implanting agent for onco-therapy with a better perspective.     

Electron probe microanalysis of calcium and phosphorus in dense bodies isolated from human platelets

Electron probe microanalysis has been used to examine the calcium and phosphorous content of human platelet dense bodies in intact cells and following isolation. In both preparations, differences in the net X-ray counts for phosphorus were not significant, although the isolated dense bodies produced an average of 31% higher net calcium counts than those in intact cells. In addition, the size of the dense-body core in each of the two preparations was not significantly different. Thus, human-platelet dense bodies can apparently undergo biochemical isolation without appreciable loss of their calcium or phosphorus content, and critical examination of storage and transport in the isolated organelles may produce conclusions relevant to similar processes in the intact platelet.     

32P-胶体灌注治疗慢性上颌窦炎动物模型的实验研究

目的 探讨^32P-胶体灌注治疗慢性上颌窦炎动物模型的作用机制及治疗效果。方法 选择雄性绵羊慢性上颌窦炎动物模型24只，采取上颌窦前外侧壁开窗术，按不同剂量分组将^32P-痰体注入动物模型上颌窦腔内，注药后定期观察窦内细菌变化和黏膜的组织学变化，以体征、细菌培养、病理检查等项指标判定治疗效果。结果 ^32P-胶体灌注治疗后，窦腔内菌种及慢性炎性细胞数量消失或明显减少，纤毛上皮结构基本完好。灌注治疗6个月后，治愈率达到83_3％，各组间比较具有非常显著性差异。结论实验证明了^32P-胶体的抑菌作用和促进慢性炎症消退的作用，并确定了^32P-胶体窦内用药的适宜剂量。放射生物学分布监测显示，对其他重要组织器官无任何影响。     

Time study of in vivo incorporation of32P orthophosphate into phospholipids of chicken epiphyseal tissues

Nine eight-week old chicks were given³²P orthophosphate, 1 mCi, intraperitoneally and killed 2, 14, 38, 86, and 169 hours after injection. Long bone epiphyses were dissected and separated into resting cartilage, proliferating cartilage, calcifying cartilages, and primary spongiosa. Lipids were extracted from each zone, each tissue was demineralized, and lipids were extracted again. The extracts were analyzed for total lipid and phospholipid content, types of phospholipids, and relative specific activity. Total lipid content of all epiphyseal tissues was 1.35 to 4.52% of the dry demineralized matrix weight. Phospholipid was about half the total. In the zones with higher calcium content more phospholipid was extracted after demineralization that before. Neutral phospholipids were 80 to 90% of the total phospholipids in predemineralization extracts and only 48 to 65% in extracts after demineralization. The amount of ethanolamine and serine phospholipids varied considerably in different epiphyseal zones. The amount and types of phospholipid and their relation to degree of calcification corroborated data reported for the calf. Relative specific activity curves revealed a sluggish metabolic pattern in resting cartilage and very active phospholipid turnover in the other three epiphyseal zones. The different types of phospholipids had markedly different metabolic patterns from each other. Special features of the turnover patterns of phosphatidyl ethanolamine, phosphatidyl serine, and phosphatidyl inositol in proliferating and calcifying cartilage suggest special roles of these lipids in the growth or calcification process.

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Zusammenfassung Neun achtwöchige Hühner erhielten intraperitoneal 1 mCi³²P-Orthophosphat und wurden 2, 14, 38, 86 und 169 Std nach der Injektion getötet. Die Epiphysen der Röhrenknochen wurden seziert und ruhende, proliferierende und verkalkende Knorpel, sowie primäre Spongiosa voneinander getrennt. Die Lipide jeder Zone wurden extrahiert, jedes Gewebe wurde demineralisiert und die Lipide erneut extrahiert. Der Gehalt der Extrakte an Gesamtlipden und Phospholipiden sowie die Art der Phospholipide wurden bestimmt und die relative spezifische Aktivität: gemessen.Der Gehalt an Gesamtlipiden aller epiphysischen Gewebe betrug 1,35–4,52% des Trockengewichtes der demineralisierten Matrix. Phospholipide machten ungefähr die Hälfte der Gesamtlipide aus. In den Zonen mit hohem Calciumgehalt konnten mehr Phospholipide nach der Demineralisation als vorher extrahiert werden. Die neutralen Phospholipide entsprachen in vor der Demineralisation erhaltenen Extrakten 80–90% und in jenen nach der Demineralisation nur 48–65% der gesamten Phospholipide. Die Aethanolamin- und Serinphospholipidmengen variierten bedeutend in den verschiedenen Zonen der Epiphyse. Die Menge und die Art der Phospholipide und ihr Verhältnis in bezug auf Verkalkungsgrad waren in Einklang mit den Werten, die für das Kalb angegeben werden. Die Kurven der relativen spezifischen Aktivität zeigten ein träges metabolisches Muster im ruhenden Knorpel und einen sehr aktiven Phospholipidumsatz in den drei anderen Zonen der Epiphyse. Die verschieden gearteten Phospholipide zeigten untereinander merklich verschiedene metabolische Muster. Die speziellen Eigenschaften der Umsatzsmuster von Phosphatidyläthanolamin, Phosphatidylserin und Phosphatidylinositol in proliferierendem und verkalkendem Knorpel lassen vermuten, daß diese Lipide spezielle Funktionen im Wachstums- oder Verkalkungsprozeß ausüben.

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Résumé Neuf polets, âgés de huit semaines, ont reçu 1 mCi de³²P orthophosphate par voi intrapéritonéale. Ils ont été sacrifiés 2, 14, 38, 86 et 169 heures asprès injection. Les épiphyses des os longs ont été prélevées et séparés en cartilage au repos, cartilage en voie de prolifération, cartilage en voie de calcification et os spongieux primitif. Les lipides sont extraits: chaque tissu est déminéralisé et les lipides sont extraits à nouveau. On détermine ainsi le contenu en lipides totaux et en phospholipides, ainsi que leurs divers types et l'activité spécifique relative: Le contenu lipidique total de tous les tissus épiphysaires est de 1,35 à 4,52% en poids sec de matrice déminéralisée. La fraction phospholipipidique constitue environ la moitié des lipides. Dans les régions à contenu élevé en calcium, plus de phospholipides sont extraits après déminéralisation qu'avant. Des phospholipides neutres constituten 80–90% des phospholipides totaux dans les extraits réalisés avant déminéralisation, et seulement 48–65% dans les extraits après déminéralisation. La quantité des phospholipides, éthanolamine et sérine, est variable dans les diverses zone épiphysaires. La quantité et les types de phospholipides et leur rapport avec le degré de calcification concordent avec les résultats publiés pour les tissus de veaux. Les courbes d'activité spécifique démontrent une activité réduite au niveau de cartilage au repos et des échange très actifs en phospholipides dans les trois autres zones épiphysaires. Les divers types de phospholipides ont des activités métaboliques nettement différentes les uns par rapport aux autres. Les modes d'échanges particuliers de la phosphatidyle ethanolamine, de la phosphatidyle sérine et de la phosphatidyle inositol, au niveau du cartilage en voie de prolifération et de calcification, suggérent un rôle spécial de ces lipides dans le mécanisme de las croissance et de la calcification.

     

Growth hormone and triiodothyronine permit an increase in plasma 1,25(OH)2D concentrations in response to dietary phosphate deprivation in hypophysectomized rats

Summary Hypophysectomy abolishes the four- to fivefold increase in plasma 1,25(OH)₂D levels that normally accompanies dietary phosphate deprivation in rats despite a smaller but significant decrease in plasma phosphate in these animals. This effect appears within 1 week of hypophysectomy and may be the result of a lack of GH, T₃, or some other pituitary hormone. In hypothyroid rats (2 weeks after TPTX) not given replacement T₃, plasma 1,25(OH)₂D levels rose threefold from 148±57 pmol/l to 402±96 pmol/l (mean±SD) after 4 days of dietary phosphate deprivation. However, in hypophysectomized animals given replacement T₃ alone, plasma 1,25(OH)₂D levels rose fourfold from 82±13 to 333±230 pmol/l after 4 days of phosphate deprivation. In addition, in hypophysectomized animals replaced with GH alone, plasma 1,25(OH)₂D levels rose from 243±86 to 525±85 pmol/l during phosphate deprivation. These results would suggest that both GH and T₃ must be absent to prevent enhanced renal 1,25(OH)₂D synthesis during phosphate deprivation. GH and T₃ appear to play a permissive role since plasma levels of these hormones do not increase when intact rats are deprived of phosphate. Furthermore, bioassayable somatomedin levels are also not increased in intact rats during phosphate deprivation as well as plasma levels of prolactin. As observed previously, plasma 1,25(OH)₂D levels were inversely correlated to plasma phosphate concentrations (r=0.46,P<0.025), despite the inclusion of data points for unreplaced hypophysectomized animals who were hypophosphatemic but showed no increase in plasma 1,25(OH)₂D. Thus the possibility remains that GH and T₃ may exert their effect by permitting the renal 25OHD-1α-hydroxylase to respond to a change in phosphate concentrations during dietary phosphate deprivation, that, in turn, may ultimately increase renal 1,25(OH)₂D synthesis and plasma levels of this hormone.     

Deficient energy metabolism is associated with low free magnesium in the brains of patients with migraine and cluster headache

We used phosphorus magnetic resonance spectroscopy to assess in vivo the brain cytosolic free magnesium concentration and the free energy released by the reaction of adenosine triphosphate (ATP) hydrolysis (DeltaG(ATPhyd)), the latter being an index of the cell's bioenergetics condition. We studied 78 patients with migraine in attack-free periods (7 with migraine stroke, 13 with migraine with prolonged aura, 37 with migraine with typical aura or basilar migraine, and 21 with migraine without aura), and 13 patients with cluster headache. In the occipital lobes of all subgroups of migraine and in cluster headache patients cytosolic free [Mg(2+)] as well as the free energy released by the reaction of ATP hydrolysis were significantly reduced. Among migraine patients, the level of free energy released by the reaction of ATP hydrolysis and the cytosolic free [Mg(2+)] showed a trend in keeping with the severity of clinical phenotype, both showing the lowest values in patients with migraine stroke and the highest in patients with migraine without aura. These results support our current hypothesis that the reduction in free [Mg(2+)] in tissues with mitochondrial dysfunction is secondary to the bioenergetics deficit, and are against a primary role of low brain cytosolic free [Mg(2+)] in causing the bioenergetics deficit in headache.     

Serum phosphate and chronic kidney and cardiovascular disease: Phosphorus potential implications in general population

It has already been established that in end-stage renal disease, hyperphosphatemia causes soft tissue calcification including vascular calcifications. It has also been supported that there is a connection between increased serum phosphate and morbidity in subjects, who suffer from renal disease. However, studies in these populations conferred mixed results. Several warnings are included in the role of serum phosphorus on cardiovascular disease in normal populations. Homeostasis of serum phosphate is obtained by the cooperation between regulatory hormones, cellular receptors and bone metabolic factors. There is the probability that one or more phosphate regulatory factors, rather than phosphate directly, may be responsible for observed associations with calcification and cardiovascular events in normal populations. Experimental studies have shown that the restriction of dietary phosphate prevents the progression of kidney dysfunction, although high dietary phosphate aggravates the renal function. In the current review, we discuss the role of serum phosphorus on progression of renal dysfunction and cardiovascular outcomes in chronic kidney disease patients and its involvement in important health risks in the general population.     

糖尿病肾病患者血清BMP2、BMP7水平与钙磷代谢的关系

目的探讨糖尿病肾病患者血清骨形态蛋白-2(BMP2)、骨形态蛋白-7(BMP7)水平与钙磷代谢的关系。方法选取2016年11月至2018年11月西电集团医院收治的126例糖尿病肾病患者作为研究组,采用系统性回顾性分析法分析研究组临床资料,根据不同分期阶段慢性肾脏病(CKD)将患者分为5组,分别为CKD 1组22例、CKD 2组21例、CKD 3组27例、CKD 4组31例、CKD 5组25例,另选取36例同期于西电集团医院门诊体检的健康人群作为对照组,测定患者血清BMP2、BMP7、血磷、血钙、肌酐(Scr)、甲状旁腺激素(iPTH),分析血清BMP2、BMP7与钙磷代谢的关系。结果①对照组与CKD 1~2期在血磷、血钙、Scr、iPTH、BMP2、BMP7水平之间差异无明显统计学意义(P>0.05);与对照组比较,CKD 4期以后血钙及血清BMP7水平明显降低(P<0.05);CKD 3期以后血清Scr、iPTH、BMP2水平明显开始升高、血清BMP7水平明显开始降低(P<0.05);CKD 4期以后血磷、Scr、iPTH、BMP2水平明显升高,血钙、BMP7水平明显降低;CKD 5期的变化情况同CKD 4期;②经Pearson积差相关分析,血清BMP2与血磷、Scr及iPTH呈正相关,与血钙呈负相关(P<0.05);BMP7与血钙呈正相关,与血磷、Scr及iPTH呈负相关(P<0.05);③经多因素多元逐步回归分析,血磷、血钙、Scr及iPTH均为影响糖尿病肾病患者血清BMP2、BMP7水平的相关因素(P<0.05)。结论CKD 3期以后血清BMP2开始升高、BMP7开始降低,且血清BMP2与血钙呈明显负相关,BMP7与血磷、Scr及iPTH呈明显负相关;钙磷代谢情况可能是糖尿病肾病患者血清BMP2升高、BMP7降低的重要相关因素。