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. 1971 Dec;12(12):978–983. doi: 10.1136/gut.12.12.978

47Calcium absorption in parenchymatous and biliary liver disease

Michael J Whelton, A K Kehayoglou, J E Agnew, L A Turnberg, Sheila Sherlock
PMCID: PMC1411990  PMID: 5171934

Abstract

As measured by whole body retention of isotopic calcium given in milk, absorption of calcium was impaired in 10 patients with chronic parenchymal non-biliary liver disease who were icteric. Mean absorption was normal in 15 patients with parenchymal liver disease who were anicteric although some individual patients absorbed less than any of the controls. Depressed absorption of calcium was seen in 10 patients with primary biliary cirrhosis and seven patients with intra- or extra-hepatic biliary obstructive disease. The most likely cause for this malabsorption is reduced bile salt secretion into the intestinal lumen which impairs vitamin D and fat absorption. The finding that parenteral vitamin D increased calcium absorption to normal levels in five patients with primary biliary cirrhosis suggests that deficiency of this vitamin is a major and correctable factor leading to calcium malabsorption in such patients. Precipitation of calcium salts by excess intraluminal fat appears to be a further possible factor reducing calcium absorption in these patients. These findings emphasize the importance of parenteral vitamin D therapy in patients with chronic obstructive biliary diseases. They also suggest that certain patients with chronic parenchymatous liver disease, particularly those who are icteric, may also occasionally require therapy with vitamin D.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ATKINSON M., NORDIN B. E., SHERLOCK S. Malabsorption and bone disease in prolonged obstructive jaundice. Q J Med. 1956 Jul;25(99):299–312. [PubMed] [Google Scholar]
  2. Agnew J. E., Kehayoglou A. K., Holdsworth C. D. Comparison of three isotopic methods for the study of calcium absorption. Gut. 1969 Jul;10(7):590–597. doi: 10.1136/gut.10.7.590. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Arman E., Nilsson L. H., Reizenstein P. Studies in the dumping syndrome. VI. Calcium deficiency after partial gastrectomy. Am J Dig Dis. 1970 May;15(5):455–462. doi: 10.1007/BF02283875. [DOI] [PubMed] [Google Scholar]
  4. Avioli L. V., McDonald J. E., Lee S. W. The influence of age on the intestinal absorption of 47-Ca absorption in post-menopausal osteoporosis. J Clin Invest. 1965 Dec;44(12):1960–1967. doi: 10.1172/JCI105302. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. BADENOCH J. Steatorrhoea in the adult. Br Med J. 1960 Sep 24;2(5203):879–887. doi: 10.1136/bmj.2.5203.879. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. BARON D. N., BELL J. L. Compleximetric determination of calcium in pathological and physiological specimens. J Clin Pathol. 1959 Mar;12(2):143–148. doi: 10.1136/jcp.12.2.143. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Badley B. W., Murphy G. M., Bouchier I. A. Intraluminal bile-salt deficiency in the pathogenesis of steatorrhoea. Lancet. 1969 Aug 23;2(7617):400–402. doi: 10.1016/s0140-6736(69)90111-1. [DOI] [PubMed] [Google Scholar]
  8. Bullamore J. R., Wilkinson R., Gallagher J. C., Nordin B. E., Marshall D. H. Effect of age on calcium absorption. Lancet. 1970 Sep 12;2(7672):535–537. doi: 10.1016/s0140-6736(70)91344-9. [DOI] [PubMed] [Google Scholar]
  9. DELLER D. J., EDWARDS R. G., ADDISON M. CALCIUM METABOLISM AND THE BONES AFTER PARTIAL GASTRECTOMY. II. THE NATURE AND CAUSE OF THE BONE DISORDER. Australas Ann Med. 1963 Nov;12:295–309. doi: 10.1111/imj.1963.12.4.295. [DOI] [PubMed] [Google Scholar]
  10. Deller D. J. Radiocalcium absorption after partial gastrectomy. Am J Dig Dis. 1966 Jan;11(1):10–19. doi: 10.1007/BF02237666. [DOI] [PubMed] [Google Scholar]
  11. Deller D. J., Worthley B. W., Martin H. Measurement of calcium-47 absorption by whole-body gamma spectrometry. Australas Ann Med. 1965 Aug;14(3):223–231. doi: 10.1111/imj.1965.14.3.223. [DOI] [PubMed] [Google Scholar]
  12. Kehayoglou A. K., Holdsworth C. D., Agnew J. E., Whelton M. J., Sherlock S. Bone disease and calcium absorption in primary biliary cirrhosis with special reference to vitamin-D therapy. Lancet. 1968 Apr 6;1(7545):715–718. doi: 10.1016/s0140-6736(68)92164-8. [DOI] [PubMed] [Google Scholar]
  13. LICHTWITZ A., CACHIN M., HIOCO D., TUTIN M., de SEZE [The phosphocalcium syndrome of cirrhosis]. Sem Hop. 1959 Aug 18;35:2399–2409. [PubMed] [Google Scholar]
  14. Paterson C. R., Losowsky M. S. The bones in chronic liver disease. Scand J Gastroenterol. 1967;2(4):293–300. doi: 10.3109/00365526709180085. [DOI] [PubMed] [Google Scholar]
  15. Ponchon G., DeLuca H. F. The role of the liver in the metabolism of vitamin D. J Clin Invest. 1969 Jul;48(7):1273–1279. doi: 10.1172/JCI106093. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. SCHACHTER D., FINKELSTEIN J. D., KOWARSKI S. METABOLISM OF VITAMIN D. I. PREPARATION OF RADIOACTIVE VITAMIN D AND ITS INTESTINAL ABSORPTION IN THE RAT. J Clin Invest. 1964 May;43:787–796. doi: 10.1172/JCI104965. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. SUMMERSKILL W. H., KELLY P. J. Osteoporosis with fractures in anicteric cirrhosis: observations supplemented by microradiographic evaluation of bone. Proc Staff Meet Mayo Clin. 1963 Apr 24;38:162–174. [PubMed] [Google Scholar]
  18. Southgate D. A., Widdowson E. M., Smits B. J., Cooke W. T., Walker C. H., Mathers N. P. Absorption and excretion of calcium and fat by young infants. Lancet. 1969 Mar 8;1(7593):487–489. doi: 10.1016/s0140-6736(69)91589-x. [DOI] [PubMed] [Google Scholar]
  19. Spencer H., Lewin I., Fowler J., Samachson J. Influence of dietary calcium intake on Ca47 absorption in man. Am J Med. 1969 Feb;46(2):197–205. doi: 10.1016/0002-9343(69)90004-7. [DOI] [PubMed] [Google Scholar]
  20. TENG C. T., DAESCHNER C. W., Jr, SINGLETON E. B., ROSENBERG H. S., COLE V. W., HILL L. L., BRENNAN J. C. Liver diseases and osteoporosis in children. I. Clinical observations. J Pediatr. 1961 Nov;59:684–702. doi: 10.1016/s0022-3476(61)80005-x. [DOI] [PubMed] [Google Scholar]

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