Calcium

Calcium metabolism or calcium homeostasis is the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcemia or hypocalcemia, which both can have important consequences for health. Calcium table image created for Wikipedia by Schnee on June 25, 2003, 9:51 UTC. Licensed under the terms of the GNU FDL. File links The following pages link to this file: Calcium User:Femto/elements e3 Categories: GFDL images ... Calcium table image created for Wikipedia by Schnee on June 25, 2003, 9:51 UTC. Licensed under the terms of the GNU FDL. File links The following pages link to this file: Calcium User:Femto/elements e3 Categories: GFDL images ... For other uses, see Calcium (disambiguation). ... For other uses, see Calcium (disambiguation). ... Hypercalcaemia is an elevated calcium level in the blood. ... In medicine, hypocalcaemia is the presence of less than a total calcium of 2. ...

Calcium location and quantity

Calcium is the most abundant mineral in the human body. The average adult body contains in total approximately 1 kg, 99% in the skeleton in the form of calcium phosphate salts. The extracellular fluid (ECF) contains approximately 22.5 mmol, of which about 9 mmol is in the serum. Approximately 500 mmol of calcium is exchanged between bone and the ECF over a period of twenty-four hours.^[1] Blood plasma is the liquid component of blood, in which the blood cells are suspended. ...

Normal ranges

The serum level of calcium is closely regulated with a normal total calcium of 2.2-2.6 mmol/L (9-10.5 mg/dL) and a normal ionized calcium of 1.1-1.4 mmol/L (4.5-5.6 mg/dL). The amount of total calcium varies with the level of serum albumin, a protein to which calcium is bound. The biologic effect of calcium is determined by the amount of ionized calcium, rather than the total calcium. Ionized calcium does not vary with the albumin level, and therefore it is useful to measure the ionized calcium level when the serum albumin is not within normal ranges, or when a calcium disorder is suspected despite a normal total calcium level. You may be looking for albumen, or egg white. ... ...

Corrected calcium level

One can derive a corrected calcium level when the albumin is abnormal. This is to correct for the change in total calcium due to the change in albumin-bound calcium, and gives an estimate of what the calcium level would be if the albumin were within normal ranges.

Corrected calcium (mg/dL) = measured total Ca (mg/dL) + 0.8 (4.0 - serum albumin [g/dL]), where 4.0 represents the average albumin level.

When there is hypoalbuminemia (a lower than normal albumin), the corrected calcium level is higher than the total calcium.

Effector organs

Sources

About 25 mmol of calcium enters the body in a normal diet. It can be lower if the diet is low in leafy green vegetables, legumes, or other calcium-containing substances. Of this, about 40% (10 mmol) is absorbed in gut, and 5 mmol leaves the body in feces, netting 5 mmol of calcium a day. Vitamin D is an important co-factor in the intestinal absorption of calcium, as it increases the number of calcium binding proteins, involved in calcium absorption through the apical membrane of enterocytes in small intestine. The mole (symbol: mol) is the SI base unit that measures an amount of substance. ... For the Physics term GUT, please refer to Grand unification theory The gastrointestinal or digestive tract, also referred to as the GI tract or the alimentary canal or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... Calbindin describes calcium binding proteins first described as the vitamin D-dependent calcium binding proteins in intestine and kidney. ... Alpha intercalated cell The apical membrane of a polarized cell is the part of the plasma membrane that forms its lumenal surface, distinct from the basolateral membrane. ... Enterocyte is a type of epithelial cell of the superficial layer of the small and large intestine tissue. ... In biology the small intestine is the part of the gastrointestinal tract (gut) between the stomach and the large intestine and includes the duodenum, jejunum, and ileum. ...

Excretion

The kidney excretes 250 mmol a day in pro-urine, and resorbs 245 mmol, leading to a net loss in the urine of 5 mmol/l. In addition to this, the kidney processes Vitamin D into calcitriol, the active form that is most effective in assisting intestinal absorption. Both processes are stimulated by parathyroid hormone. The kidneys are the organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... Parathyroid hormone (PTH) is secreted by the parathyroid glands as a polypeptide containing 84 amino acids. ...

The role of bone

Although calcium flow to and from the bone is neutral, about 5 mmol is turned over a day. Bone serves as an important storage point for calcium, as it contains 99% of the total body calcium. Calcium is released from bone by parathyroid hormone. Calcitonin stimulates incorporation of calcium in bone, although this process is largely independent of calcitonin. This article is about the skeletal organs. ... Parathyroid hormone (PTH) is secreted by the parathyroid glands as a polypeptide containing 84 amino acids. ... Calcitonin is a 32 amino acid polypeptide hormone that is produced in humans primarily by the parafollicular (also known as C) cells of the thyroid, and in many other animals in the ultimobranchial body. ...

Low calcium intake may also be a risk factor in the development of osteoporosis. In one meta-analyses, the authors found that only two out of the 52 studies that they reviewed showed that calcium intake did not promote better bone balance.^[2] With a better bone balance, the risk of osteoporosis is lowered.

Regulatory organs

Primarily calcium is regulated by the actions of Vitamin D, parathyroid hormone and calcitonin. The only real regulatory organ is the parathyroid gland. The parathyroid glands are located behind the thyroid, and produce parathyroid hormone in response to low calcium levels. The four human parathyroid glands are adjacent to the thyroid. ...

The parafollicular cells of the thyroid produce calcitonin in response to high calcium levels, but its significance is much smaller than that of PTH. Parafollicular cells (also called C cells) are cells in the thyroid which produce and secrete calcitonin. ... Parathyroid hormone (PTH) is secreted by the parathyroid glands as a polypeptide containing 84 amino acids. ...

Pathology

Hypocalcemia and hypercalcemia are both serious medical disorders. In medicine, hypocalcaemia is the presence of less than a total calcium of 2. ... Hypercalcaemia is an elevated calcium level in the blood. ...

Renal osteodystrophy is a consequence of chronic renal failure related to the calcium metabolism. Renal osteodystrophy is a bone pathology, characterized by defective mineralization, that results from renal disease. ...

Osteoporosis and osteomalacia have been linked to calcium metabolism disorders. Osteoporosis is a disease of bone - leading to an increased risk of fracture. ... Osteomalacia is a softening of the bones, resulting from defective bone mineralisation. ...

Research into cancer prevention

The role that calcium might have in reducing the rates of colorectal cancer has been the subject of many studies. However, given its modest efficacy, there is no current medical recommendation to use calcium for cancer reduction. Several epidemiological studies suggest that people with high calcium intake have a reduced risk of colorectal cancer. These observations have been confirmed by experimental studies in volunteers and in rodents. One large scale clinical trial shows that 1.2 g calcium each day reduces, modestly, intestinal polyps recurrence in volunteers.^[3] Data from the four published trials are available.^[4] Some forty carcinogenesis studies in rats or mice, reported in the Chemoprev.Database, also support that calcium could prevent intestinal cancer.^[5]

References

1. ^ Marshall, W. J. 1995. Clinical Chemistry, 3rd ed. Mosby, London.
2. ^ Heaney, R. P., et al. Calcium, dairy products and osteoporosis. J Am Coll Nutr. 2000 Apr;19(2 Suppl):83S-99S.
3. ^ Baron J, Beach M, Mandel J, van Stolk R, Haile R, Sandler R, Rothstein R, Summers R, Snover D, Beck G, Bond J, Greenberg E (1999). "Calcium supplements for the prevention of colorectal adenomas. Calcium Polyp Prevention Study Group". N Engl J Med 340 (2): 101-7. PMID 9887161. 
4. ^ http://www.inra.fr/reseau-nacre/sci-memb/corpet/Data/table.php?file=Potency-Man.txt
5. ^ http://www.inra.fr/reseau-nacre/sci-memb/corpet/MAcalcium.html

External links

• Physiology at MCG 5/5ch6/5ch6line