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A TEST OF 1,25‐DIHYDROXYVITAMIN D3 SECRETORY CAPACITY IN NORMAL SUBJECTS FOR APPLICATION IN METABOLIC BONE DISEASES

The circulating concentration of 1,25‐dihydroxyvitamin D3 [1,25‐(OH)2D3] varies in man in response to a variety of physiological stimuli. In pathological states, random plasma 1,25‐(OH)2D3 levels reflect the sum of the underlying pathological process and the homeostatic corrections to those perturbations. Hence random 1,25‐(OH)2D3 levels do not allow differentiation as to whether changes in 1,25‐(OH)2D3 production or metabolism are primary or secondary to other changes. Similarly random levels do not provide much insight into the reserve of 1,25‐(OH)2D3 secretory capacity. We have developed a single infusion of parathyroid extract (PTE) as a test of 1,25‐(OH)2D3 secretory capacity. Normal responses in twelve males and six females consisted of an increase in plasma 1,25‐(OH)2D3 levels of 78% over basal in the male and 77% over basal in the female subjects. The peak response occurred 18–22 h after the PTE was administered. This test of 1,25‐(OH)2D3 secretory capacity should prove useful in the evaluation of patients with metabolic bone disease. As part of this study, the diurnal plasma 1,25‐(OH)2D3 level was examined in six males and seven females. There was no significant diurnal rhythm between 8.00 and 22.00 h.