哺乳期产妇钙磷代谢及骨密度变化  

Changes of calcium and phosphorus metabolism and bone mineral density in lactation

作　　者：陈莹莹 刘燕萍 王鸥 CHEN Ying-ying;LIU Yan-ping;WANG Ou(Department of Endocrinology,Key Laboratory of Endocrinology of National Health Commission,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Clinical Nutrition,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院内分泌科,国家卫生健康委员会内分泌重点实验室,北京100730 [2]中国医学科学院、北京协和医学院、北京协和医院临床营养科,北京100730

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2024年第3期259-265,共7页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：中央高水平医院临床科研业务费资助(2022-PUMCH-B-014);围孕期维生素D营养状态管理对妊娠结局改善的临床队列研究(ChiCTR 1900024080)。

摘　　要：哺乳期是机体钙磷代谢的一个特殊时期。在此阶段,母体钙磷和骨代谢状态在钙磷调节激素的作用下发生一系列变化,以期通过母乳为新生儿提供充足的钙质。本文就哺乳期产妇钙磷代谢及骨密度变化特点进行综述。研究表明,哺乳期间母体血钙水平保持正常,血磷水平轻度升高,同时,骨吸收和骨形成指标升高,并出现短暂性骨密度丢失,这些变化与升高的甲状旁腺激素相关蛋白(parathyroid hormone related protein,PTHrP)、泌乳素(prolactin,PRL)水平及低水平的雌二醇(estradiol,E2)有关。但随着停止哺乳、月经复潮,产妇骨代谢水平、骨密度逐渐恢复至孕前水平。Lactation is a special period of calcium and phosphorus metabolism in the body,in which a series of changes have happened in maternal bone metabolism and bone mineral density upon the function of calciotropic and phosphotropic hormones in order to provide adequate calcium to their neonate through breast milk.In this article the characteristics of calcium and phosphorus metabolism and bone mass change in lactation were reviewed.During lactation,it is reported that the serum calcium level remains normal,the level of serum phosphorus increases,maternal bone turnover markers increase,and women have a transient loss of bone mineral density.Above changes are related to an increasing parathyroid hormone related protein(PTHrP),prolactin(PRL)level and a decreasing estradiol(E2)level.However,the level of maternal bone metabolism and bone mineral density will gradually recover to the pre-pregnancy level after the cease of lactation and recovery of menstruation.

关 键 词：哺乳期 钙磷代谢 骨密度 

分 类 号：R58[医药卫生—内分泌]