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Kalzium und Vitamin D in der Osteologie

Calcium and vitamin D in osteology

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Zusammenfassung

Die Kalziumhomöostase ist von zentraler, lebensnotwendiger physiologischer und pathophysiologischer Bedeutung. Dieser Beitrag fokussiert auf die skeletale Relevanz von Kalzium und Vitamin D in der täglichen klinischen Praxis. Vor dem Hintergrund eines in Deutschland bestehenden endemischen Vitamin-D-Mangels und einer zunehmenden Zahl von Patienten mit medikamentenbedingten enteralen Kalziumaufnahmestörungen ist es wichtig zu wissen, dass ein 25-OH-D3-Serumspiegel von > 30 µg/l Voraussetzung für die Sicherstellung einer intakten Skelettmineralisation ist und dass darüber hinaus eine physiologische Magensäureproduktion ebenfalls eine essenzielle Voraussetzung für die ungestörte enterale Kalziumaufnahme ist. Insofern ist ein leitliniengerechter Umgang mit der Vitamin-D- und Kalziumsubstitution eine Voraussetzung für jede osteologische Therapie nicht nur bei rheumatologischen Patienten.

Abstract

Calcium homeostasis is of paramount physiological and pathophysiological importance in health and disease. This article focuses on the skeletal relevance of calcium and vitamin D in daily clinical practice. Against the background of an endemic vitamin D deficiency in Germany and the increasing number of patients with drug-induced (proton pump inhibitor) enteral calcium uptake problems, it is of critical importance to understand that a vitamin D level of > 30 µg/l (> 75 nmol/l) is required for intact skeletal mineralization and that furthermore, a physiological gastric acid production is essential for a normal enteral uptake of calcium from foodstuffs. Therefore, a guideline-conform handling of vitamin D and calcium substitution is required not only for patients with rheumatoid diseases but also for any osteological therapy.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Amling und F. Barvencik geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Institut für Osteologie und Biomechanik (IOBM), Universitätsklinikum Hamburg Eppendorf, Lottestr. 59, 22529, Hamburg, Deutschland

    M. Amling & F. Barvencik

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  1. M. Amling
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  2. F. Barvencik
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Correspondence to M. Amling.

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Amling, M., Barvencik, F. Kalzium und Vitamin D in der Osteologie. Z Rheumatol 74, 421–434 (2015). https://doi.org/10.1007/s00393-014-1510-0

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  • DOI: https://doi.org/10.1007/s00393-014-1510-0

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