Phosphorus-calcium metabolism is one of the most important metabolic processes in the body, violations of which lead to serious consequences. It can be in both children and adults. The most common disease associated with impaired phosphorus-calcium metabolism is rickets.
In the context of the international classification, rickets is considered as a disease of the endocrine system, as well as a complication arising from metabolic disorders. In addition, the significance of hypovitaminosis D in the formation of rickets is not excluded. Associate such violations with the rapid growth and development of the bone skeleton, which, if phosphorus-calcium metabolism is disturbed, leads to rickets-like conditions.
Causes contributing to the development of the disease
Among the most likely factors for the onset of the disease, the leading ones are the following:
- acceleration of growth and development processes, causing an increased need for minerals;
- insufficient intake of calcium and phosphate from food;
- violationabsorption of calcium and phosphate in the intestines, as well as excessive excretion of minerals in the urine;
- decrease in the concentration of calcium and phosphates in the body due to acid-base imbalance, imbalance of vitamins and minerals for a number of reasons;
- vitamin D deficiency due to external and internal (hereditary) factors;
- decrease in motor activity and body support load;
- hormonal imbalance due to violation of the optimal ratio of osteotropic hormones.
Conditions for the occurrence of metabolic disorders
Phosphorus-calcium metabolism consists of the following sequential processes:
- Absorption of minerals through the intestinal walls.
- The mechanism of transfer of phosphorus and calcium from the blood to the tissues of the bone skeleton.
- Excretion of minerals through the organs of the excretory system.
The main causes of phosphorus-calcium metabolism disorders are associated with the leaching of minerals from the bones of the skeleton into the blood. This leads to the development of pathologies such as osteoporosis and osteomalacia.
The need of a growing body for calcium is fifty milligrams per kilogram of body weight per day. Dairy products remain the main source of calcium throughout a person's life. Moreover, the saturation of the body with minerals depends not only on the amount of calcium-containing products consumed, but also on a number of other reasons. For example, on the solubility of calcium, its percentageratio to phosphorus (the ideal ratio is two parts of calcium to one part of phosphorus), the pH level of the blood and tissues (an increased content of alkaline substances in the body impairs the absorption of minerals).
Regulators of mineral metabolism
The main regulating phosphorus-calcium metabolism vitamin D is recognized, therefore, the order of the process of mineral metabolism largely depends on the level of its content in the body.
The main reserves of calcium and phosphorus are in the bone tissue. It is in the bones that about ninety percent of all calcium and seventy percent of phosphorus are concentrated. The bones of the skeleton throughout a person's life are actively involved in metabolic processes, maintaining the optimal level of phosphorus and calcium in the blood. A decrease in the level of minerals causes the gradual destruction of bone tissue, and an increase in the limit level leads to the deposition of s alts.
Isolation of some of the minerals in the urine is an essential mechanism of the metabolic process. Moreover, the deviation from the norm during the excretion of calcium and phosphorus has certain consequences, in particular:
- increased urinary calcium causes hypercalcemia;
- decrease leads to hypocalcemia.
The vitamin itself is a set of about ten vitamins of group D, among which we can identify the most actively involved in the metabolic process. These are vitamins D2 and D3. The first in a small concentration is found in vegetable oiland germinated wheat, the second - in fish oil, animal oil, eggs and milk.
In addition, sufficient intake of vitamin D is ensured by its formation in the skin under the influence of ultraviolet (sunlight). The optimal concentration of this vitamin is achieved after a ten-minute irradiation of the hands. If it is impossible to meet the body's need for vitamin D, its deficiency should be replenished through food or by taking special preparations containing the necessary vitamins and trace elements.
And if a newborn baby uses the reserves of this vitamin for some time after birth, laid down during the gestation period, then as the body grows and matures, the body needs a regular supply of the substances necessary for its normal functioning.
In addition to vitamin D, hormones are important regulators of mineral metabolism, namely the hormone produced by the parathyroid glands (parathormone) and the hormone produced by the C-cells of the thyroid gland (calcitonin).
It is noteworthy that with an increase in the production of parathyroid hormone, patients experience manifestations of hypocalcemia. This hormone is considered the main calcium-sparing hormone. It provides timely regulation of calcium metabolism, maintaining the optimal concentration of minerals in the blood.
The production of calcitonin is directly related to the concentration of calcium in the blood. Its action is directly opposite to the action of parathyroid hormone. When you level upthe level of calcium in the blood increases the production of this hormone. Accordingly, with a decrease in calcium concentration, the secretion of calcitonin decreases. The main function of this hormone is to protect the body from a state of hypercalcemia.
In addition to the listed regulators, the intensity of metabolic processes is affected by the content in the body of such trace elements as magnesium, aluminum, lead, barium, strontium and silicon.
Symptomatics
In children, a violation of phosphorus-calcium metabolism is most often accompanied by hypocalcemia in its various manifestations. As a rule, the consequence of such changes is the development of rickets, provoked by a lack of vitamin D, or problems with metabolic processes. In rare cases, rickets-like conditions are caused by hereditary kidney pathologies, diseases of the stomach and intestines, diseases that affect bone tissue, as well as abnormalities in the functioning of the parathyroid glands.
Among the common symptoms of impaired calcium-phosphorus metabolism in adults and children are:
- weight loss due to decreased appetite;
- nausea and vomiting, sometimes constipation in combination with pain in the epigastric region;
- fatigue, drowsiness, feeling of weakness in the muscles;
- heart rhythm disturbances;
- kidney dysfunction.
Disorders of phosphorus-calcium metabolism according to ICD-10 are classified respectively in classes E83.3 (disorders of phosphorus metabolism) and E 83.5 (disorders of calcium metabolism).
Stages of rickets
The medical community distinguishesseveral stages of development of rickets. They differ in the degree of damage to the bone tissue and individual manifestations of mineral metabolism disorders.
First degree rickets
The initial stage of the disease. According to most experts, it is accompanied exclusively by changes in the bone skeleton.
Second degree of rickets
Complicated by more pronounced changes. In particular, the bones of the chest and limbs, the bones of the skull are deformed (pronounced frontal and parietal tubercles appear).
Third degree of rickets
Among the characteristic manifestations of the disease in the third degree of the course, the following are distinguished: gross deformation of the bones of the skull, chest and lower extremities, as well as deviations of a neurological nature. In addition, in violation of phosphorus-calcium metabolism in rickets, some patients experience shortness of breath, palpitations, and an increase in the size of the liver.
Symptoms of Spasmophilia
It is not uncommon for children under two years of age to be diagnosed with specific rickets-like conditions called spasmophilia. Such deviations have some symptoms of rickets. The cause of spasmophilia is a violation of phosphorus-calcium metabolism, hypofunction of the parathyroid glands. An accompanying symptom of spasmophilia is an increase in nervous and muscle excitability, accompanied by spasms and convulsions caused by insufficient intake of calcium in a growing organism. Deficiency is considered as factors complicating the clinical picture of the disease.important minerals. These include sodium, magnesium and chlorine. In addition, an excess of potassium, as well as a deficiency of vitamin B1, significantly increases the risk of seizures.
Manifestations of spasmophilia often occur in the spring season, but can also be observed in other periods. In addition to seasonal exacerbation, any other diseases accompanied by a significant increase in body temperature, diseases of the digestive tract associated with frequent spontaneous eruption of stomach contents, severe arousal, prolonged crying and even fear can provoke an attack of spasmophilia. It is believed that such conditions lead to a violation of the acid-base balance, as a result of which the body begins to experience a deficiency of certain minerals.
Basic treatments
Treatment of phosphorus-calcium metabolism disorders is reduced to the correction of metabolic processes, replenishment of vitamin D deficiency, relief of pronounced manifestations of rickets and restoration of impaired functions of the internal organs of the body. Among the mandatory therapeutic measures include the use of preparations containing vitamin D, as well as regular sun and air baths (daily walks for two to three hours). The following are used as additional methods for treating disorders of phosphorus-calcium metabolism:
- special diets;
- vitamin therapy, which consists in taking preparations containing vitamins of group B, vitamin A, C, E;
- water treatmentsand massage.
In the absence of the desired effect of the treatment taken, the patient is subject to hospitalization for a deeper examination.
Preventive measures during pregnancy
Prevention of disorders of phosphorus-calcium metabolism is carried out at the stage of gestation and is as follows:
- selection of the right diet, eliminating the deficiency of the most important vitamins and minerals;
- complete rejection of bad habits that cause intoxication of the body (alcohol, smoking, drugs);
- preventing possible contact with toxic substances (chemicals, pesticides, hazardous drugs);
- sufficient physical activity, including daily walks in the air for several hours;
- observance of the optimal regime of the day with a sufficient period of rest;
- Vitamin D prophylaxis when indicated.
Prevention activities for children
Prevention of violations of phosphorus-calcium metabolism in the first year of a child's life consists in observing the following measures:
- breastfeed whenever possible;
- timely and correct introduction of complementary foods;
- sufficient outdoor walks, mandatory water treatments, gymnastics and massages;
- if possible free swaddling of the baby from the first days of life.
In addition, supplementation with vitamin D is recommended as a measure to prevent and treat calcium-phosphorus metabolism disorders.
