筋緊張性ジストロフィー症におけるカルシウム代謝異常に関する研究

書誌事項

タイトル別名
  • Abnormal Calcium Metabolism in Myotonic Dystrophy
  • (II) : Increased Level of Nephrogenous Cyclic AMP and Serum Immunoreactive Parathyroid Hormone
  • (第II報) 腎原性cyclic AMP及び血清副甲状腺ホルモン免疫活性について

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抄録

Myotonic dystrophy (MyD) is a multisystemic disorder characterized by muscle atrophy, myotonia and cataract. Although a number of reports have been accumulated showing the presence of bone changes in MyD patients, there are few published papers in which calcium metabolism was precisely examined. In the preveious paper, we reported that intestinal calcium absorption was increased in MyD patients due to the elevation of plasma 1, 25 (OH) 2D level. The present study was designed to elucidate the mechanism of increased level of serum 1, 25 (OH) 2 D concentration in MyD patients. <BR>Calcium tolerance tests were performed in 13 patients with MyD, 13 patients with other neuromuscular disorders (non-MyD) and 12 healthy control subjects according to the method of Broadus et al. Immunoreactive PTH (iPTH) levels and cyclic AMP (cAMP) levels were measured using commercially available RIA kits. <BR>The basal plasma calcium levels in MyD were slightly higher than those in the other two groups, but the difference was not statistically significant. The plasma 1, 25 (OH) 2 D levels, calcemic responses and calciuric responses in MyD were significantly higher than those in the other two groups. Serum iPTH levels in MyD (0.462±0.320ng/ml, Mean±SD) were significantly higher than those in the other two groups (normal subjects 0.175±0.092, non-MyD 0.200±0.111; p<0.02). Nephrogenous cyclic AMP (NcAMP) levels in MyD (2.094 ±3.244nmol/100mlGF) were also higher than those in normal subjects (0.907±0.212, p< 0.05) and in non-MyD (0.929±0.335, p<0.05). There was a significant correlation between serum iPTH levels and NcAMP levels, and therefore it might be possible to accept that these two measurements reflect the level of parathyroid funciton. There were also significant correlations between NcAMP and plasma 1, 25 (OH) 2D levels, calcemic responses and calciuric responses (p<0.01). <BR>The present study shows that parathyroid hormone function was augmented in MyD patients. Hence, increased levels of palsma 1, 25 (OH) 2 D shown in MyD is considered to be the result of hyperparathyroid state in these patients.

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