Where is calcium found in the body?
Approximately 99% of the calcium in the body is
found in the bones. The mineral phase of bone is composed of hydroxyapatite (Ca10(PO4)6(OH)2)
and other minerals. Hydroxyapatite is deposited in close association with an
organic phase composed primarily of collagen. Osteoblasts create new bone and
osteoclasts cause bone resorption.
The remainder of the calcium is found in
extracellular fluid (1%) and intracellular fluid (0.1%). Half of the
extra-cellular calcium is in the free ionized form. This is the important form
for physiologic processes. About 40% of extracellular calcium is bound to
albumin and globulins. Binding to albumin is decreased by acidosis and
increased by alkalosis. Increases or decreases in serum protein will change
total serum calcium without changing ionized calcium. For this reason, the most
meaningful laboratory test for calcium is serum ionized calcium, which is
widely available.
Intracellular free calcium concentrations are
about 0.01% of extracellular concentrations. Calcium is actively trans-ported
out of the cell by ATP-dependent pumps. Muscle cells sequester calcium in the
sarcoplasmic reticulum. This calcium is easily available during muscle
contraction, but not present as free calcium during rest.
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