Regulation des Calciumhaushaltes

Zusammenfassung

Ziel Der Calciummetabolismus wird in einem engen physiologischen Fenster gesteuert. Die beteiligten Organsysteme und die verschiedenen Regulationsmechanismen werden in dieser Arbeit vorgestellt.

Methoden Es handelt sich um eine Übersichtsarbeit aus der vorliegenden Literatur.

Ergebnisse Von den täglich aufgenommen 1000 mg Calcium kommt es zu einer Nettoaufnahme von ca. 200 mg pro Tag. Die Calciumregulation erfolgt über die Resorption im Darm, die Rückresorption oder Ausscheidung über die Nieren und die Freisetzung vom oder den Einbau in den Knochen. Veränderungen im Serumspiegel wirken über den Calcium-Sensing Rezeptor an der Nebenschilddrüsenzelle auf die Parathormonsekretion und an der Niere direkt über die Transportproteine auf die Rückresorption von Calcium. Parathormon reguliert die Freisetzung von Calcium auf den Knochen, die Calciumausscheidung in der Niere und die Stimulation der Vitamin D Synthese. Vitamin D wiederum erhöht die Calciumaufnahme aus dem Darm. Mit diesen komplexen Regulationsmechanismen gelingt es dem Körper den Calciumspiegel in dem engen Konzentrationsbereich zu halten

Schlußfolgerung Die Regulationsvorgänge für den Erhalt des Calciumspiegels sind komplex und viele hormonelle Veränderungen können beteiligt sein. Eine Störung des Calciummetabolismus kann deshalb nicht allein am Calciumwert diagnostiziert werden, da der Wert sich erst ganz spät ändert. Für die Diagnosestellung einer Calciumstoffwechselstörung kann deshalb die Bestimmung von Vitamin D, 1,25D, PTH und der Calciumausscheidung, sowie von Knochenumsatzparametern und der Knochendichte erforderlich sein.

Abstract

Aim Calcium metabolism is controlled within a narrow phyisological window. The organ systems involved and the different regulatory mechanisms are presented in this article.

Methods This is a review from the available literature.

Results Of the 1000 mg of calcium consumed daily, there is a net intake of about 200 mg per day. Calcium regulation takes place via absorption in the intestine, reabsorption or excretion via the kidneys and release from or incorporation into the bone. Changes in serum levels have an effect on parathyroid hormone secretion via the calcium-sensing receptor on the parathyroid cell and on the kidneys directly on the reabsorption of calcium via the transport proteins. Parathyroid hormone regulates the release of calcium of the bones, calcium excretion in the kidneys and the stimulation of vitamin D synthesis. Vitamin D, in turn, increases calcium absorption from the intestines. With these complex regulatory mechanisms, the body manages to keep the calcium level in the narrow concentration range.

Conclusion The regulatory processes for the maintenance of calcium levels are complex and many hormonal changes can be involved. A disturbance of the calcium metabolism can therefore not be diagnosed solely on the basis of the calcium value, since the value changes very late. For the diagnosis of a calcium metabolism disorder, the determination of vitamin D, 1,25D, PTH and calcium excretion, as well as bone turnover parameters and bone density may therefore be necessary.

Schlüsselwörter

Parathormon - Calcitonin - Vitamin D - Calciumresorption - Calciumausscheidung

Key words

parathyroid hormone - calcitonin - vitamin D - calcium excretion - calcium resorption

Publication History

Received: 27 July 2023

Accepted: 31 August 2023

Article published online:
05 October 2023

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