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治疗。

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

这从而会甲状旁释放甲状旁的量。

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

好，来看甲状旁的功能。

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

不过，事实证明甲状旁也会阻止这种反应。

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

随着血钙降低，甲状旁释放，导致溶骨作用。

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

此外，甲状旁可以增加1-α-羟化酶的活性，从而形成更多有活性的维生D，增加肠道对钙的吸收。

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

这时，钙仍然在腔内，但甲状旁也会曲小管，增加对钙的再吸收。

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

现在，钙仍然在腔内，但是甲状旁也会曲小管增加钙的再吸收。

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功能减退症，也就是由于甲状旁受体的基因缺陷，肾脏不对甲状旁作出反应。

Also, people with the genetic disease DiGeorge syndrome, often born with parathyroid glands that are too small and can't produce enough parathyroid hormone.

或是由于患有DiGeorge综合症，生来甲状旁就太小，不能产生足够的甲状旁。

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，甲状旁可以促进肾脏对钙的重吸收，而减少对磷酸盐的重吸收，因此导致尿磷升高。

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，即使甲状旁刺骨吸收，研究发现间歇性注射特立帕肽活了更多造骨细胞而非破骨细胞，从而增强骨生长。

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

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

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.

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

This can result in conditions like primary hyperparathyroidism which result in too much parathyroid hormone, which leads to excess phosphate being excreted in the urine.

这可能引发原发性甲状旁功能亢进，会造成甲状旁过多，导致过多的磷酸盐从尿液中排出。

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.

如果钙水平下降，那么在甲状内的四个甲状旁释放甲状旁，导致骨骼中释放钙和磷酸盐离子。

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.

钙离子进入血液的量减少是最常见的原因，可能是由于甲状旁功能减退或者甲状旁的量或者活性降低。

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.

因为甲状旁会导致磷酸盐的排泄以及钙的再吸收，那引发高磷血症的另一原因就是甲状旁功能减退，也就是当甲状旁首先不能产生足够的甲状旁时。

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钙的含量，而将血清中钙的含量维持在正常值范围内是由甲状旁、降血钙与维生D间的制约平衡所控制的。

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，而游离钙被保存在血液中，因此游离钙含量上升，而磷酸盐含量下降！