Ethnic differences in parathyroid hormone secretion and mineral metabolism in response to oral phosphate administration

Yan, Lei; Schoenmakers, Inez; Zhou, Bo; Jarjou, Landing; Smith, Emily; Nigdikar, Shailja; Goldberg, Gail; Prentice, Ann

doi:10.1016/j.bone.2009.04.237

Cited by 26 publications

(45 citation statements)

References 35 publications

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“…A study describing ethnic differences in phosphorus homeostasis was excluded from our review, because results were not presented in an appropriate way. The study showed that phosphorus supplementation influences plasma phosphorus and calcium in a similar way in British, Gambian and Chinese subjects, but secretion of 1,25(OH) 2 D, PTH and excretion of calcium after supplementation differ between ethnicity (Yan et al 2009). Still, in the prospective cohort study of Alonso et al that was included in our review, pooled analysis of data from two prospective cohort studies was stratified for Caucasians and African Americans, but both strata showed similar results: no significant association between dietary phosphorus and hypertension was observed .…”

Section: Bioavailability and Affecting Factorsmentioning

confidence: 99%

“…The European Food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors. The article does not meet the requirements on conducting a systematic review Whybro, et al 1998 Article included in the review of Williams, et al 1996 No representative population, patients with osteopetrosis Wood, et al 1995 The article does not meet the requirements on conducting a systematic review Yan, et al 2009 Results only presented in figures Yang, et al 1994 No quantifiable information on the amount of phosphorus in the supplement, also calcium supplementation Yang, et al 2011 The article does not meet the requirements on conducting a systematic review The present document has been produced and adopted by the bodies identified above as author(s). This task has been carried out exclusively by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure.…”

Section: Jones 2011mentioning

confidence: 99%

“…This study was excluded from our review, because results were not presented in an appropriate way. However, the study, which was performed according to an appropriate study protocol, suggests that after phosphorus supplementation, plasma phosphorus and calcium react in a similar way in British, Gambian and Chinese subjects, but secretion of 1,25(OH)2D, PTH and excretion of calcium differ between the ethnic groups (Yan, Schoenmakers et al 2009). …”

Section: Bioavailability and Affecting Factorsmentioning

confidence: 99%

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Literature search and review related to specific preparatory work in the establishment of Dietary Reference Values for Phosphorus, Sodium and Chloride

Eeuwijk¹,

Oordt²,

Noordegraaf‐Schouten³

2013

EFSA Supporting Publications

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The aim of this review was to identify the scientific data from 1990 onwards upon which Dietary Reference Values (DRVs) for phosphorus, sodium and chloride may potentially be based. Searches were performed in PubMed (all nutrients) and Cochrane Library (phosphorus). References were checked for relevance and study quality was appraised. For phosphorus, 21 articles were included in the review. Four articles described the association between phosphorus and intermediate health markers and seventeen articles described the association between phosphorus intake or blood concentrations and health outcomes (i.e. bone health, cancer, hypertension, muscle mass, cardiovascular diseases and kidney disease). For sodium and chloride, 23 articles were included. Eleven studies described the association between dietary intake of sodium in relation to urinary excretion or plasma/serum sodium concentration. Fourteen studies described the association between sodium and intermediate health markers (renin-aldosterone-angiotensin system, cholesterol concentrations) and four studies described the associations between sodium and insulin resistance. One article described the association between blood levels of chloride and mortality. Results indicate that phosphorus homeostasis is regulated by the hormones PTH, FGF-23 and 1,25(OH)2D that react on short term changes in phosphorus intake. Inconsistent evidence was found for the association of phosphorus intake and cancer types, but positive associations were found between serum inorganic phosphorus levels and mortality from cardiovascular causes, incident cardiovascular disease, heart failure and coronary artery calcification. Maternal intake of phosphorus may affect bone mineral status in the infant, but results are inconclusive. The review on sodium chloride showed that sodium restriction increases activity of the renin-aldosterone-angiotensin system, whereas HDL or triglyceride concentrations are not affected. Associations between intake and most health-related outcomes appear to be inconsistent. Prospective cohort data show that low sodium intakes may be associated with increased mortality. Effects of sodium restriction may be modified by race-ethnicity and salt-sensitivity status. KEY WORDSphosphorus, sodium, chloride, comprehensive literature review, Dietary Reference Values (DRVs), dietary requirements, health outcomes DISCLAIMERThe present document has been produced and adopted by the bodies identified above as author(s). This task has been carried out exclusively by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the a...

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Section: Bioavailability and Affecting Factorsmentioning

confidence: 99%

Section: Jones 2011mentioning

confidence: 99%

Section: Bioavailability and Affecting Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Literature search and review related to specific preparatory work in the establishment of Dietary Reference Values for Phosphorus, Sodium and Chloride

Eeuwijk¹,

Oordt²,

Noordegraaf‐Schouten³

2013

EFSA Supporting Publications

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“…There are ethnic differences in the metabolism of the bone forming minerals, calcium (Ca) and phosphate (P), with differences in renal Ca excretion, even at similar intakes and rates of absorption. We have previously reported a lower urinary Ca excretion in Black Gambian (G) compared to Caucasian British (B) subjects (1) . These ethnic groups are known to differ in their dietary Ca intake and vitamin D (VD) status.…”

mentioning

confidence: 99%

“…Anthropometry was performed. Blood ionised Ca (iCa), plasma (p) total Ca (pCa), P (pP), 25-hydroxy VD (25VD), 1,25-dihydroxy VD (1,25VD), parathyroid hormone (PTH), and urinary (u) Ca (uCa), creatinine (uCr), and uP were analysed (1) . The fractional excretion of Ca (FECa) and the tubular maximum of Ca (TmCa) were calculated (2) .…”

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confidence: 99%

Renal conservation of calcium in Gambian compared to British older adults

et al. 2013

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Ethnic groups vary in their risk of age-related osteoporosis. There are ethnic differences in the metabolism of the bone forming minerals, calcium (Ca) and phosphate (P), with differences in renal Ca excretion, even at similar intakes and rates of absorption. We have previously reported a lower urinary Ca excretion in Black Gambian (G) compared to Caucasian British (B) subjects (1) . These ethnic groups are known to differ in their dietary Ca intake and vitamin D (VD) status. We have investigated ethnic differences in urinary Ca excretion while allowing for other known predictors of renal Ca handling, including dietary Ca.Subjects were healthy older (60-75 years) G (n = 61) and B (n = 60) men and women. Blood and timed 2 h urine samples were collected after an overnight fast. Dietary intake was assessed with country specific food diaries and food composition tables. Anthropometry was performed. Blood ionised Ca (iCa), plasma (p) total Ca (pCa), P (pP), 25-hydroxy VD (25VD), 1,25-dihydroxy VD (1,25VD), parathyroid hormone (PTH), and urinary (u) Ca (uCa), creatinine (uCr), and uP were analysed (1) . The fractional excretion of Ca (FECa) and the tubular maximum of Ca (TmCa) were calculated (2) . Multiple regression was performed to investigate the effect of predictors of renal Ca handling. Ethnicity was used as an independent binary variable to test for differences between ethnic groups in a regression model. Data were transformed to natural logarithms to allow for the expression of ethnic differences (D) between G and B subjects as a % (3) . G subjects had significantly lower body weight [DG-B: -31( -37, -25) %; P < 0.001], pCa [DG-B: -5( -7, -2) %; P < 0.001], and higher 25VD [DG-B: + 35( + 22, + 48)%; P < 0.001], PTH [DG-B: + 62( + 38, + 85) %; P < 0.001] and 1,25VD [DG-B: + 48( + 38, + 58)%; P < 0.001]. Markers of bone turnover were higher in G compared to B subjects (P < 0.001).There were significant ethnic differences in renal Ca handling as measured by uCa (mmol/minute); uCa/uCr (mmol/mmol); FECa (%); and TmCa (mmol/L) (P < 0.001). The p-value and the effect size of these ethnic differences were similar after including dietary Ca (mg/day), or dietary Ca:P ratio (mg/mg) in the model (see table). In a multiple regression analysis without ethnicity, the significant predictors of uCa/uCr were: dietary Ca, diastolic blood pressure, iCa, pP, P1NP, CTX and uP. However, in a model including ethnicity, dietary Ca was no longer a significant predictor of uCa/uCr; whereas diastolic BP, iCa, pP, P1NP, CTX and uP remained significant predictors of uCa/uCr. Ethnicity was a significant predictor of uCa/uCr in the multivariate model ([DG-B: -133( -175, -107) %; P < 0.001]). These data suggest that G subjects have higher renal Ca conservation than B counterparts. The ethnic differences remained in the presence of other known predictors of renal Ca handling.

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Impaired Phosphate Tolerance Revealed With an Acute Oral Challenge

Turner

White

Hopman

et al. 2017

Journal of Bone and Mineral Research

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Elevated serum phosphate is consistently linked with cardiovascular disease (CVD) events and mortality in the setting of normal and impaired kidney function. However, serum phosphate does not often exceed the upper limit of normal until glomerular filtration rate (GFR) falls below 30 mL/min/m 2 . It was hypothesized that the response to an oral, bioavailable phosphate load will unmask impaired phosphate tolerance, a maladaptation not revealed by baseline serum phosphate concentrations. In this study, rats with varying kidney function as well as normo-phosphatemic human subjects, with inulin-measured GFR (13.2 to 128.3mL/min), received an oral phosphate load. Hormonal and urinary responses were evaluated over 2 hours. Results revealed that the more rapid elevation of serum phosphate was associated with subjects and rats with higher levels of kidney function, greater responsiveness to acute changes in parathyroid hormone (PTH), and significantly more urinary phosphate at 2 hours. In humans, increases in urinary phosphate to creatinine ratio did not correlate with baseline serum phosphate concentrations but did correlate strongly to early increase of serum phosphate. The blunted rise in serum phosphate in rats with CKD was not the result of altered absorption. This result suggests acute tissue deposition may be altered in the setting of kidney function impairment. Early recognition of impaired phosphate tolerance could translate to important interventions, such as dietary phosphate restriction or phosphate binders, being initiated at much higher levels of kidney function than is current practice.

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Ethnic differences in parathyroid hormone secretion and mineral metabolism in response to oral phosphate administration

Cited by 26 publications

References 35 publications

Literature search and review related to specific preparatory work in the establishment of Dietary Reference Values for Phosphorus, Sodium and Chloride

Literature search and review related to specific preparatory work in the establishment of Dietary Reference Values for Phosphorus, Sodium and Chloride

Renal conservation of calcium in Gambian compared to British older adults

Impaired Phosphate Tolerance Revealed With an Acute Oral Challenge

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