原创力文档evolution of the calcium paradigm the relation between vitamin d, serum calcium and calcium absorption维生素d钙进化范式之间的关系,血清钙和钙的吸收.pdfVIP
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Nutrients 2010, 2, 997-1004; doi:10.3390/nu2090997
OPEN ACCESS
nutrients
ISSN 2072-6643
/journal/nutrients
Review
Evolution of the Calcium Paradigm: The Relation between
Vitamin D, Serum Calcium and Calcium Absorption
Borje E. Christopher Nordin 1,2
1 Endocrine Metabolic Unit, Royal Adelaide Hospital, Adelaide 5000, South Australia, Australia;
E-Mail: christopher.nordin@.au
2 Discipline of Medicine, University of Adelaide, Adelaide 5000, South Australia, Australia
Received: 3 August 2010; in revised form: 18 August 2010 / Accepted: 24 August 2010 /
Published: 16 September 2010
Abstract: Osteoporosis is the index disease for calcium deficiency, just as
rickets/osteomalacia is the index disease for vitamin D deficiency, but there is considerable
overlap between them. The common explanation for this overlap is that hypovitaminosis D
causes malabsorption of calcium which then causes secondary hyperparathyroidism and is
effectively the same thing as calcium deficiency. This paradigm is incorrect.
Hypovitaminosis D causes secondary hyperparathyroidism at serum calcidiol levels lower
than 60 nmol/L long before it causes malabsorption of calcium because serum calcitriol
(which controls calcium absorption) is maintained until serum calcidiol falls below
20 nmol/L. This secondary hyperparathyroidism, probably due to loss of a ―calcaemic‖
action of vitamin D on bone first described in 1957,
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