Altered diurnal regulation of blood ionized calcium and serum parathyroid hormone concentrations during parenteral nutrition

摘要: Background: Little is known about parathyroid gland function in patients receiving total parenteral nutrition (TPN). Objective: Our objective was to determine whether abnormal TPN recipients. Design: Six with a mean (± I SD) age of 45.5 ± 8.0 y who had been for 18.7 2.8 underwent bone biopsy, mass measurements dual-energy X-ray absorptiometry, and dynamic tests function. Diurnal variations blood ionized calcium (iCa 2+ ) serum hormone (PTH) concentrations were also assessed. Results compared those healthy volunteers. Results: Bone formation subnormal all patients. Basal PTH moderately higher the recipients than volunteers, values obtained every 30 min over 24 h significantly (P < 0.001) (5.0 0.9 pmol/L) volunteers (2.6 0.6 pmol/L). The percentage increase during citrate-induced hypocalcemia lower recipients, consistent secondary hyperparathyroidism. Evening infusions calcium-containing eliminated nocturnal rise PTH, increased amplitude change iCa h, orderliness as measured by approximate entropy (ApEn ), enhanced synchrony between PTH. Treatment 10 d calcium-free restored ApEn remained low, suggesting that component nutrient solutions, but not per se, enhances regularity release Conclusion: Parathyroid long-term which may contribute disturbances metabolism.