Plasma insulin and C-peptide in classified subgroups of calcium stone formers — influence of a test meal and relationship to urinary calcium and phosphate

  • G. Rümenapf
  • Paul Otto Schwille
Conference paper
Part of the Fortschritte der Urologie und Nephrologie book series (2824, volume 23)


Gastrintestinal (GI) and pancreatic hormones may alter the composition of urine and thus influence the risk of stone formation (1–4). Special interest has been focused on insulin, a hormone long known to increase urinary calcium (Ca) excretion (4, 5). In unclassified recurrent calcium urolithiasis (RCU) patients, exaggerated and sustained plasma insulin levels were observed after oral administration of carbohydrate-rich test meals (2, 6) or pure carbohydrate loads (6), giving rise to speculations on a possible role of insulin in stone pathophysiology.


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  1. 1.
    Schwüle PO, Thun R, Samberger NM (1976) Calcium stone disease: pilot study of hormonal response to meal and hypoglycemia. In: Fleisch H, Robertson WG et al (eds) Urolithiasis Research. Plenum Press, New York London, pp 513–516CrossRefGoogle Scholar
  2. 2.
    Scholz D, Schwüle PO, Sigel A (1981) Response of gastrointestinal hormones and intestinal calcium absorption during an oral carbohydrate meal. In: Smith et al (eds) Urolithiasis, Basic and Clinical Research. Plenum Press, New York London, pp 795–800Google Scholar
  3. 3.
    Schwüle PO, Scholz D, Engelhardt W (1981) Is increased intestinal calcium absorption in human calcium urolithiasis a feature of hormonal imbalance? Hepato-gastroenterol 28: 131–134Google Scholar
  4. 4.
    De Fronzo RA, Cooke CR, Andres R, Faloona GR, Davis PJ (1975) The effect of insulin on renal handling of sodium, potassium, calcium and phosphate in man. J Clin Invest 55: 845–855CrossRefGoogle Scholar
  5. 5.
    Lindemann RD, Adler S, Yiengst MJ, Beard ES (1967) Influence of various nutrients on urinary divalent cation excretion. J Lab & Clin Med 70: 236–245Google Scholar
  6. 6.
    Rao PN, Gordon C, Davies D, Blacklock NJ (1982) Are stone formers maladapted to refined carbohydrates? Br J Urol 54: 575–577PubMedCrossRefGoogle Scholar
  7. 7.
    Scholz D, Schwüle PO, Sigel A (1980) Zur metabolischen Klassifikation und Metaphylaxe der häufigsten Lithiasisformen. Urologe A 19: 202–206PubMedGoogle Scholar
  8. 8.
    Herbert V, Lau L, Gottlieb WC, Bleicher SJ (1965) Coated charcoal immunoassay of insulin. J Clin Endocrinol Metabol 25: 1375–1384CrossRefGoogle Scholar
  9. 9.
    Sachs L (1972) Statistische Auswertungsmethoden. 3 Aufl. Springer, HeidelbergGoogle Scholar
  10. 10.
    Vaughan OW, Filer LJ (1960) The enhancing action of certain carbohydrates on the intestinal absorption of calcium in the rat. J Nutr 71: 10–14PubMedGoogle Scholar
  11. 11.
    Kelly SE, Chawla-Singh K, Sellin JH, Yasillo NJ, Rosenberg JH (1984) Effect of meal composition on calcium absorption: enhancing effect of carbohydrate polymers. Gastroenterology 87: 596–600PubMedGoogle Scholar
  12. 12.
    Lemann J, Litzow JR, Lennon EJ (1967) Studies of the mechanism by which chronic metabolic acidosis augments renal calcium excretion in man. J Clin Invest 46: 1318–1328PubMedCrossRefGoogle Scholar
  13. 13.
    Lemann J, Piering WF, Lennon EJ (1969) Possible role of carbohydrate-induced calciuria in calcium oxalate kidney-stone formation. New Engl J Med 280: 232–237PubMedCrossRefGoogle Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG., Darmstadt 1980

Authors and Affiliations

  • G. Rümenapf
    • 1
  • Paul Otto Schwille
    • 1
    • 2
  1. 1.Mineral Metabolism and Endocrine Research Laboratory, Departments of Surgery and UrologyUniversity of ErlangenWest Germany
  2. 2.Experimental Surgery and UrologyUniversity HospitalErlangenGermany

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