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 a violation of 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 importance of hypovitaminosis D in the pattern of rickets formation is not ruled out. Such disorders are associated with fast growth and development of the bone skeleton, which, if the phosphorus-calcium metabolism is disturbed, leads to rickets-like conditions.
Reasons for the development of the disease
Among the most likely factors for the occurrence of the disease, the leading ones are the following:
- acceleration of the processes of growth and development, causing an increased need for minerals in the body;
- insufficient intake of calcium and phosphate from food;
- impaired absorption of calcium and phosphates in the intestine, as well as excessive excretion of minerals in the urine;
- a decrease in the concentration of calcium and phosphates in the body due to a violation of the acid-base balance, an imbalance of vitamins and minerals for several reasons;
- vitamin D deficiency due to exposure to external and internal (hereditary) factors;
- decrease in motor activity and body support load;
- violation of the hormonal background due to a violation of the optimal ratio of osteotropic hormones.
Metabolism Disorders
Phosphorus-calcium metabolism consists of the following sequential processes:
- Absorption of minerals through the intestinal wall.
- The mechanism of transfer of phosphorus and calcium from the blood to the bone skeleton tissue.
- Excretion of minerals through the organs of the excretory system.
The main reasons for the violation of phosphorus-calcium metabolism are associated with leaching of minerals from the bones of the skeleton into the blood. This leads to the development of pathologies such as osteoporosis and osteomalacia.
Calcium needs a growing body for fifty milligrams per kilogram of body weight per day. The main source of calcium throughout human life is dairy products. Moreover, the saturation of the body with minerals depends not only on the amount of consumed calcium-containing products, but also on a number of other reasons. For example, from the solubility of calcium, its percentage of phosphorus (two parts of calcium per one part of phosphorus are considered the ideal ratio), the pH level of blood and in tissues (the increased content of alkaline substances in the body impairs the absorption of minerals).
Mineral Metabolism Regulators
Vitamin D is recognized as the main regulator of phosphorus-calcium metabolism. Therefore, the order of the mineral metabolism depends on the level of its content in the body.
The main reserves of calcium and phosphorus are in bone tissue. About ninety percent of all calcium and seventy percent of phosphorus are concentrated in bones. Skeletal bones throughout human life are actively involved in metabolic processes, maintaining an optimal level of phosphorus and calcium in the blood. A decrease in the level of minerals causes a gradual destruction of bone tissue, and an increase in the limiting level leads to the deposition of salts.
The excretion of a certain part of mineral substances with urine is an indispensable mechanism of the metabolic process. Moreover, a deviation from the norm during the excretion of calcium and phosphorus has certain consequences, in particular:
- an increase in calcium in the urine causes hypercalcemia;
- a decrease in the content leads to hypocalcemia.
The vitamin itself is a set of about ten vitamins of group D, among which you can identify the most actively involved in the metabolic process. These are vitamins D2 and D3. The first is in small concentrations in vegetable oil and sprouted wheat, the second in fish oil, animal oil, eggs and milk.
In addition, a sufficient intake of vitamin D into the body is ensured by its formation in the skin under the influence of ultraviolet radiation (sunlight). The optimal concentration of this vitamin is achieved after a ten-minute exposure of the hands. If it is not possible to meet the body's need for vitamin D, its deficiency should be filled through food or by taking special preparations containing the necessary vitamins and minerals.
And if a newborn baby for some time after birth takes advantage of the reserves of this vitamin laid down during the gestation period, then as the body grows and grows up, the body needs regular intake of substances necessary for its normal functioning.
In addition to vitamin D, hormones are important regulators of mineral metabolism , namely: a hormone secreted by the parathyroid glands (parathyroid hormone), and a hormone secreted by thyroid C-cells (calcitonin).
It is noteworthy that with an increase in the production of parathyroid hormone in patients, manifestations of hypocalcemia are observed . This hormone is considered the main calcium-preserving hormone. It provides timely regulation of calcium metabolism, maintaining an 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. With an increase in the level of calcium in the blood, the production of this hormone increases. Accordingly, with a decrease in calcium concentration, the secretion of calcitonin decreases. The main function of this hormone is to protect the body from the state of hypercalcemia.
In addition to the listed regulators, the intensity of metabolic processes is affected by the content in the body of such microelements as magnesium, aluminum, lead, barium, strontium and silicon.
Symptomatology
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, the cause of rickets is hereditary renal pathology, diseases of the stomach and intestines, diseases that affect bone tissue, as well as deviations in the functioning of the parathyroid glands.
Among the common symptoms of a violation of calcium-phosphorus metabolism in adults and children, there are:
- decrease in body weight against a background of decreased appetite;
- nausea and vomiting, sometimes constipation in combination with pain in the epigastric region;
- fatigue, drowsiness, a feeling of weakness in the muscles;
- heart rhythm disturbances;
- kidney dysfunction.
Disorders of phosphorus-calcium metabolism according to ICD-10 are assigned respectively to classes E83.3 (impaired metabolism of phosphorus) and E 83.5 (impaired metabolism of calcium).
Stages of Rickets
The medical community distinguishes several stages of the development of rickets. They differ in the degree of damage to bone tissue and individual manifestations of disorders of mineral metabolism.
The first degree of rickets
The initial stage of the disease. According to most experts, it is accompanied exclusively by changes in the skeleton.
The second degree of rickets
Complicated by more pronounced changes. In particular, the bones of the chest and extremities, the bones of the skull are deformed (pronounced frontal and parietal tubercles appear).
The 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 with rickets in some patients, shortness of breath, rapid heartbeat, and an increase in liver size are observed.
Symptoms of Spasmophilia
Often in children, before reaching the age of two, they are diagnosed with specific rickets-like conditions called spasmophilia. Similar deviations have some symptoms of rickets. The cause of spasmophilia is a violation of phosphorus-calcium metabolism, hypofunction of the parathyroid glands. A concomitant symptom of spasmophilia is an increase in nervous and muscle excitability, accompanied by spasms and cramps caused by insufficient intake of calcium in the growing body. As factors complicating the clinical picture of the disease, a deficiency of important mineral substances is considered. These include sodium, magnesium and chlorine. In addition, the excess potassium content, as well as vitamin B1 deficiency, significantly increases the risk of seizures.
Manifestations of spasmophilia are more likely to occur in the spring season, but can also be observed in other periods. In addition to seasonal exacerbation, any other diseases that are accompanied by a significant increase in body temperature, digestive tract diseases, associated with frequent spontaneous eruption of the stomach contents, severe excitement, prolonged crying and even fright 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 mineral substances.
The main methods of treatment
Treatment of disorders of phosphorus-calcium metabolism 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 intake of sun and air baths (daily walks for two to three hours). As additional methods of treatment of disorders of phosphorus-calcium metabolism, the following are used:
- special diets;
- vitamin therapy, which consists in taking medications containing vitamins of group B, vitamin A, C, E;
- water treatments and massages.
In the absence of the proper effect of the undertaken treatment, the patient is subject to hospitalization for a deeper examination.
Pregnancy Prevention
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;
- a complete rejection of bad habits that cause intoxication of the body (alcohol, smoking, drugs);
- prevention of possible contact with toxic substances (chemicals, pesticides, dangerous medicines);
- sufficient physical activity, including daily walks in the air for several hours;
- compliance with the optimal regime of the day with a sufficient period of rest;
- prophylactic intake of vitamin D if indicated.
Preventive measures for children
Prevention of disorders of phosphorus-calcium metabolism in the first year of a child's life consists in observing the following measures:
- breastfeeding whenever possible;
- timely and correct introduction of complementary foods;
- sufficient walks in the fresh air, mandatory water procedures, gymnastics and massage;
- possible free swaddling of the child from the first days of life.
In addition, an additional intake of vitamin D is recommended as a measure of prevention and treatment of disorders of calcium-phosphorus metabolism.