9 Citations (Scopus)

Abstract

In normal individuals, 1,25-dihydroxyvitamin D (1,25-D) levels regulate calcium (Ca) absorption according to Ca intake; its synthesis is stimulated by low Ca intake, probably via increased parathyroid hormone (PTH) secretion, to increase Ca absorption, and suppressed during high intake to reduce Ca absorption. The body also adapts Ca absorption in response to renal Ca excretion, and phosphate absorption in response to phosphate intake. These adaptations may fail or be impaired in certain diseases. In disorders of overadaptation, the intestinal tract absorbs excessive amounts of Ca due to overproduction of 1,25-D, as in absorptive hypercalciuria, sarcoidosis, primary hyperparathyroidism, and tumoral calcinosis. Intestinal hyperabsorption and hypercalciuria may occur on both low- and high-Ca diets. Primary hyperparathyroidism and hypoparathyroidism are bihormonal, related to over- and underproduction, respectively, of both 1,25-D and PTH. Underadaptation disorders are typically related to low 1,25-D synthesis or resistance to this metabolite; examples include postmenopausal osteoporosis, chronic renal failure, and osteomalacia. Many of these adaptational disorders can be relieved or improved by manipulating Ca, phosphate, sodium, or protein intake or by administering exogenous 1,25-D. Overabsorption of Ca and other substances, such as oxalate, may be responsible for Ca nephrolithiasis. Hypocitraturia (which may be a complication of certain diseases or the result of unbalanced diet or excessive exercise), diets high in readily metabolizable sugars and purine-rich proteins (meat, poultry, and fish), and low fluid intake can all contribute to stone formation. Various regimens may reduce the risk of Ca nephrolithiasis.

Original languageEnglish (US)
JournalJournal of the American College of Nutrition
Volume8 Suppl
StatePublished - 1989

Fingerprint

Calcium
calcium
metabolism
Hypercalciuria
Nephrolithiasis
renal calculi
hyperparathyroidism
Primary Hyperparathyroidism
parathyroid hormone
Diet
Parathyroid Hormone
hypoparathyroidism
osteomalacia
diet
calcinosis
Calcinosis
phosphates
Hypoparathyroidism
Osteomalacia
Postmenopausal Osteoporosis

ASJC Scopus subject areas

  • Food Science
  • Medicine (miscellaneous)

Cite this

Calcium metabolism. / Pak, C. Y.

In: Journal of the American College of Nutrition, Vol. 8 Suppl, 1989.

Research output: Contribution to journalArticle

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