カドミウム腎症におけるカルシウム・リン・ビタミンＤ代謝異常　富山県神通川流域カドミウム汚染地域に見いだされた近位尿細管障害３４例の検討

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タイトル別名
  • Abnormalities of Calcium, Phosphorus and Vitamin D Metabolism with Proximal Renal Tubular Dysfunction in Subjects Environmetally Exposed to Cadmium.
  • カドミウム ジンショウ ニ オケル カルシウム リン ビタミン D タイシャ
  • 富山県神通川流域カドミウム汚染地域に見いだされた近位尿細管障害34例の検討

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Calcium, phosphorus and vitamin D metabolism were examined in 21 male and 13 female subjects with renal tubular dysfunction in the cadmium-polluted Jinzu River basin in Toyama prefecture, Japan. Multiple proximal renal tubular dysfunction was detected in all subjects showing increased FEβ2-m and FEua, generalized aminoaciduria and renal glucosuria. Reduced ability of tubular reabsorption of phosphate resulted in hypophosphatemia in 31% of the women. Despite decreased tubular reabsorption of calcium, the level of serum calcium remained normal in all subjects. Serum 1, 25-dihydroxyvitamin-D[1, 25(OH)2D], which is produced in the proximal tubules through 1α-hydroxylation from 25-hydroxyvitamin-D[25OHD], was normal or increased to more than 60pg/ml. The serum level of 1, 25(OH)2D was inversely related to creatinine clearance in both the men (p<0.05) and women (p<0.01). Serum iPTH was slightly increased to more than 0.9ng/ml, whereas the levels of other hormones, including 25OHD, calcitonin, thyroxine (T4) and triiodothyronine (T3) were normal. The serum alkaline phosphatase activity and serum osteocalcin concentration were significantly increased compared to those of controls in both sexes. Bone loss detected by the measurement of bone density was prominent in female subjects. These results support the hypothesis that the serum phosphate concentration is more important than the serum concentration of 1, 25(OH)2D for abnormalities of bone metabolism in cadmium-induced renal tubular dysfunction.

収録刊行物

  • 日本衛生学雑誌

    日本衛生学雑誌 47 (6), 1009-1020, 1993

    一般社団法人日本衛生学会

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