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With a deficiency of both enzymes, similar changes in other clinical and laboratory markers (testosterone, DEA-SO4 and 17-ketosteroids) are observed. Laboratory and some clinical signs of frequent and rare forms of CAH are summarized in the table. Vitamin D is fat-soluble and enters the digestive canal with food, and is also formed in stages from 7-dihydrocholesterol whensun exposure of the skin.
Vitamin D is found in many foods, including milk. It is absorbed in the intestines along with fats, so malabsorption of frumil products can cause a lack of vitamin D. In the liver, under the influence of the enzyme 25-hydroxylase, 25-hydroxycholecalciferol is formed, which in the kidneys, thanks to the enzyme Ι-α-hydroxylase, is converted into its active form - 1,25-dihydroxycholecalciferol, or calcitriol. Activation of the enzyme Ια-hydroxylase occurs in the kidneys under the influence of HPT (Fig. 6.38).
The synthesis of calcitriol is accelerated by a decrease in the concentration of calcium in the blood plasma, but its direct effect was. However, its formation significantly increases under the influence of PTH, which activates the 1α-hydroxylase enzyme in the kidneys. Stimulates the secretion of calcitriol, a decrease in the concentration of phosphates in the blood - hypophosphatemia. The concentration of calcitriol increases and breastfeeding, due to prolactin, enhances the activity of 1α-hydroxylase.
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Calcitriol is a steroid hormone that crosses the target cell membrane and binds to a receptor protein in the cytoplasm. The hormone-receptor complex affects the DNA-binding site in the nucleus, which leads to the synthesis of proteins in the cell. Effect of 1,25-dihydroxycholecalciferol on calcium absorption. Foods containing significant amounts of calcium are dairy products, sardines, dark green vegetables, and chocolate.
Calcium absorption occurs from the small intestine due to calcium-binding proteins in the membrane of the intestinal epithelium. Under the influence of calcitriol, the formation of calcium-binding proteins related to calbindins increases within 2 days. This leads to buy frumil online of more Ca 2+ into the cytoplasm of the intestinal epithelium, from where it enters the bloodstream due to facilitated diffusion. This process lasts several weeks after the removal of 1,25-dihydroxycholecalciferol from the body.
- Laboratory diagnosis of congenital adrenal hyperplasia, CAH.
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