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Die intestinale Calcium-Resorption und ihre Störungen

Calcium absorption in health and disease part I. physiology of intestinal calcium absorption

I. Teil. Physiologie der intestinalen Calcium-Resorption

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Summary

Approximatively, half of the daily dietary Ca supplements of 0.6–1 g is absorbed. However, at low Ca intake an adaptation of Ca absorption with increased efficiency is compensating for the low Ca supplementation. Sufficient accuracy of measurements of Ca absorption is achieved by oral application of radioactive Ca and subsequent determination of the increase in serum radioactivity or measurement of total body or forearm radioactivity. With increasing age, Ca absorption and, frequently, dietary Ca uptake is decreasing. In the duodenum Ca is absorbed most efficiently but quantitatively the ileum plays a more important role due to the longer exposure of Ca to this part of the intestine. Ca is absorbed actively at low intraluminal concentrations while a passive component is overlapping the active absorption at high Ca concentrations. Vitamin D is hydroxylated in the liver and further in the kidney to a polar metabolite which is essential for normal Ca absorption. A protein of high avidity for Ca is formed in the small intestinal mucosa, the “calcium binding protein”. Its role in the physiology of Ca absorption is not yet completely understood.

Zusammenfassung

Die täglich mit der Nahrung zugeführte Ca-Menge von 0,6–1 g wird nur etwa zur Hälfte resorbiert. Bei niedrigeren Mengen erfolgt jedoch eine Adaptation mit gesteigerter Effektivität der Ca-Resorption. Für die Messung der intestinalen Ca-Resorption eignen sich für die Praxis die orale Verabreichung von radioaktivem Ca und die Messung des Aktivitätsanstieges im Serum („Belastungstest“) oder die Aktivitätsbestimmung im Ganzkörperzähler oder im Unterarm. Im Alter sind Resorption und häufig auch die Ca-Aufnahme mit der Nahrung herabgesetzt. Die größte Resorptionskapazität für Ca hat das Duodenum. Wegen der längeren Verweildauer wird jedoch quantitativ der größte Anteil im Jejunum resorbiert. Ca wird in niedrigen intraluminalen Konzentrationen aktiv resorbiert; bei hohen Konzentrationen überlagert eine passive Komponente die aktive. Vitamin D wird in der Leber und danach weiter in der Niere zu einem polaren Metaboliten metabolisiert, der Voraussetzung für eine normale Ca-Resorption ist. In der Dünndarmschleimhaut wird ein Protein mit besonderer Avidität für Ca gebildet, das Calcium-bindende Protein, dessen physiologische Bedeutung für die Ca-Resorption noch nicht vollständig geklärt ist.

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  1. I. Med. Klinik und Poliklinik der Johannes Gutenberg-Universität Mainz, Germany

    K. Ewe

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Ewe, K. Die intestinale Calcium-Resorption und ihre Störungen. Klin Wochenschr 52, 57–63 (1974). https://doi.org/10.1007/BF01468327

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