期刊
YONSEI MEDICAL JOURNAL
卷 55, 期 5, 页码 1326-1332出版社
YONSEI UNIV COLL MEDICINE
DOI: 10.3349/ymj.2014.55.5.1326
关键词
1,25-dihydroxy-vitamin D-3; calcium; parathyroid hormone; urolithiasis
资金
- National Research Foundation of Korea (NRF) - Korea government (MEST) [2012-0000476]
- Next-Generation BioGreen 21 Program, Rural Development Administration, Republic of Korea [PJ.009621]
- Ministry of Health, Welfare and Family Affairs
Purpose: To find out the possible role of 1,25(OH)(2) vitamin D-3 [1,25(OH)(2)D-3] and parathyroid hormone (PTH) as intrinsic factors in urinary calcium stone formers (SFs), we investigated their relationship with serum and urinary biochemical parameters. Materials and Methods: A total of 326 calcium SFs (male: 204, female: 122) were enrolled and underwent outpatient metabolic evaluations including 1,25(OH)(2)D-3 and PTH as well as serum and 24-hour urinary biochemical parameters. As control, 163 age- and sex-matched (2:1) individuals (non-SFs) who have never urinary stone episode were included. Results: 1,25(OH)(2)D-3 level was positively correlated with urinary calcium excretion (r=0.347, p<0.001). The hypercalciuric group and recurrent SFs had higher serum 1,25(OH)(2)D-3 levels than the normocalciuric group (p<0:001) and first SFs (p=0.050). In the adjusted multiple linear regression analysis, serum 1,25(OH)(2)D-3 level (beta=0.259, p<0.001) and serum PTH level (beta=-0.160, p<0.001) were significantly correlated with urinary calcium excretion. The patients in highest tertile of 1,25(OH)(2)D-3 had a more than 3.1 fold risk of hypercalciuria than those in the lowest tertile (odds ratio=3.14, 95% confidence interval: 1.431-6.888, p=0.004). No correlation was observed between PTH and 1,25(OH)(2)D-3 (R=0.005, p=0.929) in calcium SFs, while a negative correlation was found in controls (R=-0.269, p=0.001). Conclusion: 1,25(OH)(2)D-3 was closely correlated with urinary calcium excretion, and high 1,25(OH)(2)D-3 levels were detected in the hypercalciuric group and in recurrent SFs. However, 1,25(OH)(2)D-3 was not correlated with PTH in calcium SFs. These findings suggest that 1,25(OH)(2)D-3 might be important intrinsic factor for altered calcium regulation in SFs.
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