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CALCIUM HOMEOSTASIS AND HORMONAL REGULATION

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CALCIUM HOMEOSTASIS AND HORMONAL REGULATION
Clinical Chemistry 3 Lecture 5
CALCIUM HOMEOSTASIS AND HORMONAL REGULATION
Roles of Calcium
Signal transduction pathways àacts as a second messenger, in neurotransmitter release from neurons
Contraction of all muscle cell types
Fertilization
Enzyme cofactor àblood-clotting cascade
Proper bone formation

PRINCIPAL ORGANS INVOLVED IN CALCIUM
HOMEOSTASIS
Small Intestines
Bones (Skeletal System)
Kidneys
Normal Total Calcium: 2.2-2.6 mmol/L (9-10.5 mg/dL)
Normal Ionized Calcium: 1.1-1.4 mmol/L (4.5-5.6 mg/dL).
CALCIUM HOMEOSTASIS

HORMONAL CONTROL OF CALCIUM METABOLISM
Parathyroid Hormone
Vitamin D
A hormone
Structurally similar steroid hormones a metabolic product of the cholesterol synthetic pathway
Tissues involved in the synthesis:
Skin
Liver
Kidneys
Target Organs:
Gut
Bone
Parathyroids
VITAMIN D SYNTHESIS

Parathyroid Hormone àsecreted from four parathyroid glands in the region of the thyroid gland

Hormonal Control of Calcium Metabolism

HYPERCALCEMIA àthe state of blood calcium levels above the expected normal range in a healthy population àionized or free calcium—biologically active 50% àbound calcium àAlbumin àCitrate àPhosphate
Signs and Symptoms of Hypercalcemia
Central nervous system Altered central nervous system function
Lethargy
Decreased alertness
Depression
Confusion
Forgetfulness
Obtundation
Coma
GASTRO-INTESTINAL
Anorexia
Constipation
Nausea and vomiting
Renal
Calcium acts as a diuretic and impairs the kidneys’ ability to concentrate urine
Dehydration
hypercalciuria increases the risk of calcium-containing kidney stone
Skeletal
Patients with most causes of hypercalcemia have increased bone resorption increased bone demineralization, leading to increased fracture risk
Cardiovascular
Hypercalcemia may cause or exacerbate hypertension
ECG: shortened QT interval
Endocrine Causes of Hypercalcemia

Primary Hyperparathyroidism
àparathyroid
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