Seasonal variations in serum inorganic phosphate and calcium with special reference to parathyroid activity

Iwanami, Masaoki; Osiba, Susumu; Yamada, Tetsuo; Yoshimura, Hisato

doi:10.1113/jphysiol.1959.sp006322

Cited by 25 publications

(5 citation statements)

References 12 publications

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“…Other significant modifying factors were 25OHD and season. As previously published, seasonal fluctuations have been observed in phosphate concentrations ( 37 ); this was also seen in our models. In our study, children’s phosphate levels were slightly higher in winter than in other seasons, but the differences between seasons were minimal.…”

Section: Discussionsupporting

confidence: 90%

Phosphate Concentrations and Modifying Factors in Healthy Children From 12 to 24 Months of Age

Koljonen

Enlund-Cerullo

Hauta-alus

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Phosphate homeostasis and its modifiers in early childhood are inadequately characterized. Objective To determine physiological plasma phosphate concentration and modifying factors in healthy infants at 12 to 24 months of age. Design This study included 525 healthy infants (53% girls), who participated in a randomized vitamin D intervention (VIDI) trial and received daily vitamin D3 supplementation of either 10 or 30 μg from age two weeks to 24 months. Biochemical parameters were measured at 12 and 24 months. Dietary phosphate intake was determined at 12 months. Main Outcome Measures Plasma phosphate concentrations at 12 and 24 months of age. Results Mean (SD) phosphate concentration decreased from 12 months (1.9±0.15 mmol/L) to 24 months (1.6±0.17 mmol/L) of age (p<0.001 for repeated measurements). When adjusted by covariates, such as body size, creatinine, 25OHD, intact and C-terminal FGF23, mean plasma phosphate was higher in boys than girls during follow-up (p=0.019). Phosphate concentrations were similar in the vitamin D intervention groups (p>0.472 for all). Plasma iron was associated positively with plasma phosphate at both time points (B, 0.006 and 0.005, 95% CI 0.004 to 0.009 and 0.002 to 0.008, p<0.001 at both time points, respectively). At 24 months of age, the main modifier of phosphate concentration was plasma creatinine (B, 0.007, 95% CI 0.003 to 0.011, p<0.001). Conclusion Plasma phosphate concentration decreased from age 12 to 24 months. In infants and toddlers, the strongest plasma phosphate modifiers were sex, iron, and creatinine, whereas vitamin D supplementation did not modify phosphate concentrations.

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Section: Discussionsupporting

confidence: 90%

Phosphate Concentrations and Modifying Factors in Healthy Children From 12 to 24 Months of Age

Koljonen

Enlund-Cerullo

Hauta-alus

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…African Americans infected with SARS-CoV-2 have two times higher death rates than white Americans ( 35 ), twice the incidence of hypomagnesemia ( 36 ), and a vitamin D deficiency in ∼76% mainly due to the fact that pigmentation reduces vitamin D production in the skin ( 37 ). Seasonal effects showing low levels of serum phosphate [−36% ( 38 ); −10% ( 39 )] and Mg [−15% ( 39 )] in the winter, which are possibly linked to seasonally fluctuating vitamin D levels, have also been observed in patients with COVID-19, which would make more severe SARS-CoV-2 complications more likely in the winter. Patients with COVID-19 often develop renal failure, which typically begins with dysfunction of the proximal tubule [23% develop kidney injury ( 40 ), 75% proximal tubule abnormalities ( 41 )].…”

Section: Main Textmentioning

confidence: 99%

SARS-CoV-2: influence of phosphate and magnesium, moderated by vitamin D, on energy (ATP) metabolism and on severity of COVID-19

Kempen

Deixler²

2021

American Journal of Physiology-Endocrinology and Metabolism

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The use of vitamin D to reduce the severity of COVID-19 complications is receiving considerable attention, backed by encouraging data. Its purported mode of action is as an immune modulator. Vitamin D, however, also affects metabolism of phosphate and Mg, which may well play a critical role in SARS-CoV-2 pathogenesis. SARS-CoV-2 may induce a cytokine storm that drains ATP whose regeneration requires phosphate and Mg. These minerals, however, are often deficient in conditions that predispose people to severe COVID-19, including older age (especially males), diabetes, obesity, and usage of diuretics. Symptoms observed in severe COVID-19 also fit well with those seen in classical hypophosphatemia and hypomagnesemia, such as thrombocytopenia, coagulopathy, dysfunction of liver and kidneys, neurologic disturbances, immunodeficiency, failure of heart and lungs, delayed weaning from a respirator, cardiac arrhythmia, seizures, and finally multi-organ failure. Deficiencies of phosphate and Mg can be amplified by kidney problems commonly observed in COVID-19 patients resulting in their wastage into urine. Available data show that phosphate and Mg are deficient in COVID-19 with phosphate showing a remarkable correlation with its severity. In one experiment, COVID-19 patients were supplemented with a cocktail of vitamin D3, Mg, and vitamin B12, with very encouraging results. We thus argue that COVID-19 patients should be monitored and treated for phosphate and Mg deficiencies, ideally already in the early phases of infection. Supplementation of phosphate and Mg combined with vitamin D could also be implemented as a preventative strategy in populations at risk.

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“…Concerning serum calcium, conflicting data have been obtained. Reported significant seasonal variations have either involved a small number of subjects or random samples collected from large population studies throughout a year (2, 10, 17,20) and the patterns of variation have not been uniform. In a longitudinal study for two and a half years (231, variations over the year could not be confirmed.…”

Section: Dlscu Ssionmentioning

confidence: 99%

Calcium, Phosphate and Albumin in Serum

Ljunghall

Hedstrand

Hellsing

et al. 1977

Journal of Internal Medicine

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Serum values for calcium, phosphate and albumin have been determined in a population study of 2 322 49–50‐year‐old men participating in a health examination survey. Calcium and albumin were significantly correlated (r=0.34) but adjustment for albumin only caused minor effects on the distribution of calcium. No inverse relationship was found between calcium and phosphate. Seasonal variations over the three years of the health survey could not be established for either calcium or phosphate, whereas there was a slight tendency for albumin to decline during summer. The prevalence of hyperparathyroidism (HPT) in this population of men up to the age of 50 was 0.3% and among those with recurrent renal stones 5.3%. All subjects with verified HPT had a history of recurrent renal stones. One man on thiazide treatment had a slight elevation of calcium which returned to normal after cessation of the drug. No other case of hypercalcemia besides those caused by HPT was found. Mean values and frequency distributions for calcium, phosphate and albumin were almost identical in renal stone formers and matched controls. Hence it seems likely that other factors than those which markedly affect serum levels of calcium and phosphate are of major importance in common renal stone formation.

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Seasonal variations in serum inorganic phosphate and calcium with special reference to parathyroid activity

Cited by 25 publications

References 12 publications

Phosphate Concentrations and Modifying Factors in Healthy Children From 12 to 24 Months of Age

Phosphate Concentrations and Modifying Factors in Healthy Children From 12 to 24 Months of Age

SARS-CoV-2: influence of phosphate and magnesium, moderated by vitamin D, on energy (ATP) metabolism and on severity of COVID-19

Calcium, Phosphate and Albumin in Serum

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