Advertisement

Phosphorous Depletion and Vitamin D Metabolism

  • Louis V. Avioli
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 103)

Abstract

In man, phosphate deprivation (or depletion) is reportedly attended by decreased renal tubular reabsorption of sodium, magnesium, bicarbonate, uric acid and glucose, red cell dysfunction with decreased concentrations of 2,3-DPG and ATP, platelet abnormalities with thrombocytopenia, impairment of clot retraction, shortened survival time and decreased ATP levels, decreased leucocytic ATP concentrations with suppressed phagocytic, chemotactic and bacterocidal activities, central nervous system dysfunction characterized by varying degrees of numbness, dysarthria, paresthesiaes, convulsive diatheses, and coma, rhabdomyolysis and myalgia, abnormal hepatic cellular function, hypercalciuria, occasional hypercalcemia, augmentation of the intestinal absorption of calcium, hypophosphatemia and elevations in circulating 1,25(OH)2D in women (1–5). These latter alterations in calcium metabolism when documented in phosphate deprived laboratory animals (predominantly rats), have been attended by increased bone resorption (6,7) and stimulated renal 1-hydroxylase activity with more rapid conversion of 25OHD3 to 1,25(OH)2D3 (8–10). Stimulated 1-hydroxy-lase activity has also been documented in vitro using renal tubular mitochondrial preparations from hypophosphatemic chicks (11).

Keywords

Calcium Balance Intestinal Calcium Absorption Idiopathic Hypercalciuria Phosphate Depletion Phosphate Deprivation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kreisberg, R.A.: Phosphate deficiency and hypophosphatemia. Hospital Practice 12: 121, 1977.PubMedGoogle Scholar
  2. 2.
    Knochel, J.P.: The pathophysiology and clinical characteristics of severe hypophosphatemia. Arch. Int. Med. 137: 203, 1977.CrossRefGoogle Scholar
  3. 3.
    Lotz, M., Zisman, E. and Bartter, F.: Evidence for a phosphorus-depletion syndrome in man. N. Engl. J. Med. 278: 409, 1968.PubMedCrossRefGoogle Scholar
  4. 4.
    Dominguez, J.H., Gray, R.W. and Lemann, J., Jr.: Dietary phosphate deprivation in women and men: Effects on mineral and acid balances, parathyroid hormone and the metabolism of 25–0H vitamin D. J. Clin. Endo. Metab. 43: 1056, 1976.CrossRefGoogle Scholar
  5. 5.
    Gray, R.W., Wilz, D.R., Caldas, A.E. and Lemann, J., Jr.: Importance of phosphate in regulating plasma 1,25(OH)2 vitamin D levels in humans: Studies in healthy subjects in calcium stone formers and in patients with primary hyperparathyroidism. J. Clin. Endocr. Metab. 45: 299, 1977.PubMedCrossRefGoogle Scholar
  6. 6.
    Baylink, D., Wergedal, J., Stauffer, M.: Formation, mineralization and resorption of bone in hypophosphatemic rats. J. Clin. Invest. 50: 2519, 1971.PubMedCrossRefGoogle Scholar
  7. 7.
    Bruin, 1 1.J., Baylink, D.J. and Wergedal, J.E.: Acute inhibition of mineralization and stimulation of bone resorption mediated by hypophosphatemia. Endocrinology 96: 394, 1975.CrossRefGoogle Scholar
  8. 8.
    Tanaka, Y. and DeLuca, H.F.: The control of 25-hydroxyvitamin D metabolism by inorganic phosphorus. Arch. Biochem. Biophys. 154: 566, 1973.PubMedCrossRefGoogle Scholar
  9. 9.
    Ribovich, M.L. and DeLuca, H.F.: Influence of dietary calcium and phosphorus on intestinal calcium transport in rats given vitamin D metabolites. Arch. Biochem. Biophys. 170: 529, 1975.PubMedCrossRefGoogle Scholar
  10. 10.
    Lee, S.W., Russell, J. and Avioli, L.V.: 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol: Conversion impaired by systemic metabolic acidosis. Science 195: 994, 1977.PubMedCrossRefGoogle Scholar
  11. 11.
    Baxter, L.A. and DeLuca, H.F.: Stimulation of 25-hydroxyvitamin D3-lα-hydroxylase by phosphate depletion. J. Biol. Chem. 251: 3158, 1976.PubMedGoogle Scholar
  12. 12.
    Haddad, J.G., Jr. and Avioli, L.V.: Metabolism of vitamin D3 during phosphate depletion. J. Nutr. 102: 269, 1972.PubMedGoogle Scholar
  13. 13.
    Hughes, P1.R., Brumbaugh, P.F., Haussler, M.R., Wergedal, J.E. and Baylink, D.J.: Regulation of serum la25-dihydroxyvitamin D3 by calcium and phosphate in the rat. Science 190: 578, 1975.PubMedCrossRefGoogle Scholar
  14. 14.
    Henry, H.L., Midgett, R.J. and Norman, A.W.: Regulation of 25-hydroxyvitamin D3-1-hydroxylase in vivo. J. Biol. Chem. 294: 7584, 1974.Google Scholar
  15. 15.
    Bar, A. and Wasserman, R.H.: Control of calcium absorption and intestinal calcium-binding protein synthesis. Biochem. Biophys. Res. Comm. 54: 191, 1973.PubMedCrossRefGoogle Scholar
  16. 16.
    Thomasset, M., Cuisinier-Gleizes, P., Mathieu, H.: Duodenal calcium-binding protein (CaBP) and phosphorus deprivation in growing rats. Biomed. 25: 345, 1976.Google Scholar
  17. 17.
    Brautbar, N., Walling, M.W. and Coburn, J.W.: Studies of experimental phosphate depletion: Effect of vitamin D deficiency and vitamin D sterols. In Program of the Endocrine Society (1977).Google Scholar
  18. 18.
    Massry, S.G.: Effect of phosphate depletion on renal tubular transport. In Phosphate Metabolism, Kidney and Bone. Ed. Avioli, L., Bordier, P., Fleisch, H., Massry, S. and Slatopolsky, E. Nouvelle, Imprieve Fournie, France, p. 25, 1976.Google Scholar
  19. 19.
    Lee, D.B.N., Brautbar, N., Walling, M.W., Carlson, H.E., Golvin, C., Coburn, J.W. and Kleeman, C.R.: Mineral balance and gut-sac transport studies in phosphorus depleted intact and hypophosphysectomized rats. Presented at 3rd Int. Workshop on phosphate and other minerals, Madrid, Spain, July 1977.Google Scholar
  20. 20.
    Edelstein, S., Noff, D., Puchett, J., Golub, E.E. and Bronner, F.: Low phosphorus intake and vitamin D metabolism and expression in rats. Presented at 3rd Int. Workshop on phosphate and other minerals, Madrid, Spain, July 1977.Google Scholar
  21. 21.
    Tanaka, Y., Castillo, L. and DeLuca, H.F.: Control of renal vitamin D hydroxylases in birds by sex hormones. Proc. Nat. Acad. Sci. 73: 2701, 1976.PubMedCrossRefGoogle Scholar
  22. 22.
    Bloom, W., Flinchum, D.: Osteomalacia with pseudofracture caused by the ingestion of aluminum hydroxide. JAMA 174: 1327, 1960.Google Scholar
  23. 23.
    Henneman, P.H., Benedict, P.H., Forbes, A.P. et al.: Idiopathic hypercalciuria. N. Engl. J. Med. 259: 802, 1958.PubMedCrossRefGoogle Scholar
  24. 24.
    Parfitt, A.M., Higgins, B.A., Nassim, J.R. et al.: Metabolic studies in patients with hypercalciuria. Clin. Sci. 27: 463, 1964.PubMedGoogle Scholar
  25. 25.
    Haussler, M., Hughes, M., Baylink, D. et al.: Influence of phosphate depletion in the biosynthesis and circulating level of la,25-dihydroxyvitamin D. In Advances in Experimental Medicine and Biology 81:233, 1977.Google Scholar

Copyright information

© Plenum Press, New York 1978

Authors and Affiliations

  • Louis V. Avioli
    • 1
  1. 1.Division of Bone and Mineral MetabolismWashington University School of Medicine, The Jewish Hospital of St. LouisSt. LouisUSA

Personalised recommendations