Abstract

Context

Hyperphosphatemia and high levels of fibroblast growth factor 23 (FGF23) are risk factors for cardiovascular events in patients with chronic kidney diseases. However, the impact of an inorganic phosphorus additive in healthy people is largely unknown.

Objective

To investigate the acute effect of excessive dietary phosphorus administered as sodium-dihydrogen phosphate on the postprandial levels of Pi and FGF23 and the response to food.

Design

Double-blind placebo-controlled crossover study.

Setting

General community.

Participants

Twenty-nine healthy males and females.

Intervention

Administration of a single dose of either 700 mg phosphorus (NaH₂PO₄) or a sodium-adjusted placebo in combination with a test meal.

Main Outcome Measure

Postprandial plasma levels of Pi and FGF23.

Results

Compared to placebo, oral phosphorus increased the plasma Pi level, which remained elevated during the ensuing 8 h (at 480 min: 1.31 vs. 1.16 mmol/l, P < 0.001), increased urinary Pi (iAUC_0-480 789 vs. 95 mmol/mmol, P < 0.001), reduced tubular Pi reabsorption (iAUC_0-480 -31.5 vs. -6.2, P < 0.001), decreased urinary calcium (iAUC_0-240 30.6 vs. 53.0 mmol/mmol, P = 0.009), and stimulated the release of parathyroid hormone (iAUC_0-480 2212 vs. 768 ng/l, P < 0.001). However, the FGF23 levels did not change. Postprandial levels of glucose, insulin, and lipids were not substantially affected by phosphorus vs. placebo.

Conclusion

An oral phosphorus load can induce elevated postprandial levels of circulating Pi for hours in healthy subjects, despite rapid homeostatic counterreactions. FGF23 levels and the postprandial response to food were not affected.

中文翻译：

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无机磷添加剂对健康受试者矿物质代谢和心脏代谢危险因素的急性影响

摘要

语境

高磷血症和高水平的成纤维细胞生长因子 23 (FGF23) 是慢性肾病患者心血管事件的危险因素。然而，无机磷添加剂对健康人的影响在很大程度上是未知的。

客观的

研究过量膳食磷以磷酸二氢钠形式给药对餐后 Pi 和 FGF23 水平以及对食物的反应的急性影响。

设计

双盲安慰剂对照交叉研究。

环境

一般社区。

参与者

二十九名健康男性和女性。

干涉

将单剂量的 700 毫克磷 (NaH ₂ PO ₄ ) 或钠调整安慰剂与测试餐组合给药。

主要结果测量

Pi 和 FGF23 的餐后血浆水平。

结果

与安慰剂相比，口服磷增加血浆 Pi 水平，在随后的 8 小时内保持升高（480 分钟：1.31 与 1.16 mmol/l，P < 0.001），增加尿 Pi（iAUC _0-480 789 与 95 mmol/mmol, P < 0.001)，肾小管 Pi 重吸收减少（iAUC _0-480 -31.5 vs. -6.2，P < 0.001），尿钙减少（iAUC _0-240 30.6 vs. 53.0 mmol/mmol，P = 0.009） ，并刺激甲状旁腺激素的释放（iAUC _0-480 2212 vs. 768 ng/l，P < 0.001）。然而，FGF23 水平没有改变。与安慰剂相比，磷对餐后葡萄糖、胰岛素和脂质的水平没有显着影响。

结论

口服磷负荷可导致健康受试者餐后循环 Pi 水平升高数小时，尽管有快速的稳态反反应。FGF23 水平和餐后对食物的反应不受影响。