Ⅱ型糖尿病肾病和非肾病患者甲状旁腺激素和钙磷代谢关系的初步探讨

测定４６例Ⅱ型糖尿病患者（肾病２５例，非肾病２１例）和２４例正常人血清甲状旁腺激素（ＰＴＨ）、钙（Ｃａ）、磷（Ｐ）、碱性磷酸酶（ＡＫＰ）、肌酐（Ｃｒ）和尿白蛋白（Ａｌｂ），发现糖尿病患者血ＰＴＨ、ＡＫＰ和尿Ｐ浓度较正常人增高，血Ｃａ、Ｐ浓度较正常人降低，其中肾病患者ＰＴＨ值又较非肾病组增高，差异有显著性。相关分析示糖尿病肾病的ＰＴＨ值与血Ｃｒ、ＡＫＰ和尿Ｐ有较好的相关性。作者认为糖尿病患者存在钙、磷代谢异常，体钙缺乏，这种代谢异常在糖尿病肾病患者尤为明显，血清ＰＴＨ值、ＡＫＰ和尿Ｐ浓度是反映糖尿病肾病钙、磷代谢异常的有意义指标。

RELATIONSHIP AMONG PARATHYROID HORMONE AND METABOLISM OF CALCIUM AND PHOSPHORUS IN NIDDM PATIENTS WITH AND WITHOUT DIABETIC NEPHROPATHY

The level of serum PTH and concentration of calcium and phosphorus in blood and urine were measured in 46 patients withMDDM(25 cases with diabetic nephropathy ,21 cases without diabetic nephropathy)and 24 normal subjects.The levels of serumPTH and AKP and urine phosphorus in NIDDM patients were significantly higher than those of the normal controls (P<0.05),and tha levels of serum PTH in diabetic nephropathic patients were significantly higher than those of the non-nephropathic patients(P<0.01).The levels of blood calcium and phosphorus in NIDDM patients were low. There were positive linear correlations a-mong the levels of PTH ahd serum Cr and AKP and urine phosphorus. We conclude that there are abnormal metabolism of calciumand phospbrus and insufficiency of body calcium in the patients with NIDDM,especially in those with diabetic nephropathy.ThePTH and AKP and urine phosphorus are meaningful signs that indicate the disturbed metabolism of calcium and phosphorus in dia-betic nephropathy.