Bone remodelling as a whole is highly dependent on serum calcium levels, which, in turn, are kept in the normal range by a balance between parathyroid hormone, or PTH, calcitonin and vitamin D.

整个骨重建进程高度依赖于血清中的含量，将血清中的含量维持在正常值范围内是由甲状旁腺激素、降血素与维生素D间的制约平衡所控制的。

Now, that calcium's still in the lumen, but parathyroid hormone also affects the distal convoluted tubule and increases calcium reabsorption.

这时，仍然在腔内，但甲状旁腺激素也会影响远曲小管，增的再吸收。

Related to this is pseudohyporparathyroidism, which is where the kidneys simply don't respond to parathyroid hormone because of a genetic defect in the parathyroid hormone receptor.

与此相关的是伪甲状旁腺功能减退症，也就是由于甲状旁腺激素受体的基缺陷，肾脏不甲状旁腺激素作出反应。

Additionally, parathyroid hormone can boost 1-alpha-hydroxylase activity, which forms more active vitamin D, increasing gut absorption of calcium.

此外，甲状旁腺激素可以增1-α-羟化酶的活性，从更多有活性的维生素D，增肠道的吸收。

So when the dust settles, as a result of parathyroid hormone, phosphate is lost in the urine while ionized calcium is kept in the blood, so ionized calcium levels rise and phosphate levels fall!

所以最终导致的结果是磷酸盐在尿液中丢失，游离被保存在血液中，此游离含量上升，磷酸盐含量下降！

Now, the levels of calcium and phosphate in the bone, but also in the blood, are regulated by vitamin D and parathyroid hormone, or PTH.

和磷不仅存在于骨中，也存在于血液中，磷含量的调节受维生素D和甲状旁腺激素（PTH）调控。

If osteoporosis is really advanced, teriparatide, a recombinant parathyroid hormone can be used.

如果骨质疏松十分严重，可以使用特立帕肽这种重组甲状旁腺激素治疗。

This affects the amount of parathyroid hormone that gets released by the parathyroid gland.

这从会影响甲状旁腺释放甲状旁腺激素的量。

Ok, now let's have a quick look at parathyroid hormone.

好，来看甲状旁腺的功能。

Less calcium entering the blood is the most common cause and can be due to hypoparathyroidism, or lower levels or lower activity of parathyroid hormone.

离子进入血液的量减少是最常见的原，可能是由于甲状旁腺功能减退或者甲状旁腺激素的量或者活性降低。

The parathyroid hormone gets the bones to release calcium, and gets the kidneys to reabsorb more calcium so it's not lost in the urine as well as synthesize calcitriol also known as 1,25-dihydroxycholecalciferol also known as active vitamin D.

甲状旁腺激素作用于骨骼使其释放离子，也作用于肾脏增的重吸收，这样就不会随尿液排出；以及用于合骨化三醇，也称为1，25-二羟基胆化固醇，又叫活性维生素D。

Lastly, parathyroid hormone increases calcium reabsorption and reduces the reabsorption of phosphate from the kidneys, so more phosphate is excreted through the urine.

最后，甲状旁腺激素可以促进肾脏的重吸收，减少磷酸盐的重吸收，此导致尿磷升高。

Now, even though parathyroid hormone stimulates bone resorption, it's been found that intermittent injections with teriparatide activates osteoblasts more than osteoclasts, therefore increasing bone formation.

其实，即使甲状旁腺激素刺激骨吸收，研究发现间歇性注射特立帕肽激活了更多造骨细胞非破骨细胞，从增强骨生长。

As calcium levels in the blood fall, parathyroid hormone is released, causing the bones to lose calcium.

随着血降低，甲状旁腺激素释放，导致溶骨作用。

Since parathyroid hormone tells the kidneys to save calcium and get rid of phosphate, calcium again gets lost and phosphate builds up in the blood, following the same pattern as kidney disease, including the thinning of the bones.

为甲状旁腺激素可以促使肾脏储存和去除磷酸盐，再次流失磷酸盐在血液中累积，这和肾病的机理一致，包括骨质变薄。

All right, so since, again, parathyroid hormone causes excretion of phosphate and reabsorption of calcium, then another cause of hyperphosphatemia is hypoparathyroidism, when the parathyroid glands don't produce enough parathyroid hormone in the first place.

为甲状旁腺激素会导致磷酸盐的排泄以及的再吸收，那引发高磷血症的另一原就是甲状旁腺功能减退，也就是当甲状旁腺首先不能产生足够的甲状旁腺激素时。

It turns out, though, that parathyroid hormone also shuts this down.

不过，事实证明甲状旁腺激素也会阻止这种反应。

To identify the cause, lab tests are typically done, which includes tests for parathyroid hormone, vitamin D, albumin, phosphorus, and magnesium.

为了确定病，通常要做实验室检查，其中包括甲状旁腺激素、维生素D、白蛋白、磷和镁的检测。

We have teriparatide, which is a parathyroid hormone analogue that also reduces fracture risk and increases bone mineral density in patients with osteoporosis.

我们还有特立帕肽，这是一种甲状旁腺激素类似物，能够降低骨质疏松症患者的骨折风险，并增骨密度。

If calcium levels fall, the four parathyroid glands buried within the thyroid gland release parathyroid hormone which frees up both calcium and phosphate ions from the bones.

如果水平下降，那么在甲状腺内的四个甲状旁腺释放甲状旁腺激素，导致骨骼中释放和磷酸盐离子。