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Cited by 21Parathyroid Disorders and TreatmentsIron Metabolism and DisordersPhytase and its Applications

Acute Effects of an Inorganic Phosphorus Additive on Mineral Metabolism and Cardiometabolic Risk Factors in Healthy Subjects

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Volk, Christin, Schmidt, Benjamin, Brandsch, Corinna, Kurze, Tabea, Schlegelmilch, Ulf, Grosse, Ivo, Ulrich, Christof, Girndt, Matthias +1 more·2022·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/clinem/dgab635
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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: We aimed 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. Methods: This study was a double-blind placebo-controlled crossover study with 29 healthy male and female participants from the general community who were administered a single dose of either 700 mg phosphorus (NaH2PO4) or a sodium-adjusted placebo in combination with a test meal. Postprandial plasma levels of Pi and FGF23 were measured. Results: Compared with placebo, oral phosphorus increased the plasma Pi level, which remained elevated during the ensuing 8 hours (at 480 minutes: 1.31 vs 1.16 mmol/l; P < 0.001), increased urinary Pi (iAUC0-480 789 vs 95 mmol/mmol; P < 0.001), reduced tubular Pi reabsorption (iAUC0-480 −31.5 vs −6.2; P < 0.001), decreased urinary calcium (iAUC0-240 30.6 vs 53.0 mmol/mmol; P = 0.009), and stimulated the release of parathyroid hormone (iAUC0-480 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.

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Crossref · 10.1210/clinem/dgab635

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  • Acute increases in dietary Pi intake as well as enteral or i.v. Pi loading cause a rapid increase in PTH and calcitriol, and timely delayed elevation of iFGF23.

    “Acute increases in dietary Pi intake as well as enteral or i.v. Pi loading cause a rapid increase in PTH and calcitriol, and timely delayed elevation of iFGF23 [44, 50, 59].”

    From Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels (2025) · cites this paper as [59]

    The Discussion (page not provided) reports an acute increase in PTH after oral phosphorus intake and cites other studies finding higher FGF23 after several days of loading. This study found no FGF23 increase within eight hours, however, and the cited passages do not support a rapid rise in calcitriol or a response to intravenous loading. (LLM, conf=0.87)

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  • Controlled experiments in healthy humans examined periods of either a few hours or several weeks, and often varied dietary calcium intake.

    “controlled experiments in healthy humans examined periods of either a few hours or several weeks, and often varied dietary calcium intake.”

    From Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels (2025) · cites this paper as [59]

    The Study Design and Discussion (page not available in our copy) describe a controlled trial in healthy adults that measured responses for eight hours. The Discussion also mentions other studies lasting several days and using diets with different calcium content, but it does not establish that the experiments lasted several weeks or that this trial varied calcium intake; its test meal had a fixed calcium content. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Short-term oral Pi loading in healthy subjects is accompanied by an increase in PTH.

    “This was accompanied by an increase in PTH and, in some studies, by an increase in intact FGF23 (iFGF23) [44, 59].”

    From Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels (2025) · cites this paper as [59]

  • Short-term oral Pi loading in healthy subjects is sometimes accompanied by an increase in iFGF23.

    “This was accompanied by an increase in PTH and, in some studies, by an increase in intact FGF23 (iFGF23) [44, 59].”

    From Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels (2025) · cites this paper as [59]

  • Short-term oral Pi loading in healthy subjects causes a post-prandial rise in serum Pi and urinary Pi excretion.

    “In short-term studies, where healthy subjects were orally loaded with Pi and followed up for eight hours, a post-prandial rise in serum Pi and urinary Pi excretion was observed.”

    From Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels (2025) · cites this paper as [59]

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Research works printed but not linked: 2

  1. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington (DC): National Academies Press (US); 1997.
  2. McClure ST, Chang AR, Selvin E, Rebholz CM, Appel LJ. Dietary sources of phosphorus among adults in the United States: results from NHANES 2001-2014. Nutrients. 2017;9(2). doi:10.3390/ nu9020095 · DOI

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Authors
Volk, C., Schmidt, B., Brandsch, C., Kurze, T., Schlegelmilch, U., Grosse, I., Ulrich, C., Girndt, M., & Stangl, G. I.
Affiliations
  • Martin Luther University Halle-Wittenberg (DE)
  • German Centre for Integrative Biodiversity Research (DE)
Corresponding author
Stangl, Gabriele I
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2021-08-27
Volume
107
Issue
2
Pages
e852-e864
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/clinem/dgab635
OpenAlex
W3195314902
Cited by
21
References
55
Citations by year
2026: 7 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 2 · 2021: 1
FWCI
1.88
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
Bundesministerium für Bildung und Forschung (01EA1808C)
Topics
  • Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
  • Life Sciences › Agricultural and Biological Sciences › Plant Science › Phytase and its Applications
Keywords
dietary phosphorus, sodium dihydrogen phosphate, hyperphosphatemia, fibroblast growth factor 23, plasma inorganic phosphate, urinary phosphorus, renal phosphate reabsorption, urinary calcium, parathyroid hormone, postprandial response, cardiometabolic risk factors, chronic kidney disease, phosphorus homeostasis
MeSH terms
Cardiometabolic Risk Factors, Fibroblast Growth Factor-23, Administration, Oral, Adolescent, Adult, Double-Blind Method, Female, Humans, Male, Phosphates, Cross-Over Studies, Postprandial Period, Dietary Supplements, Young Adult, Healthy Volunteers

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