Cargando…
Milk Products in the Treatment of Hypophosphatemic Rickets: A Pilot Study
BACKGROUND: Standard treatment of hypophosphatemic rickets (HR) is oral phosphate tablets plus vitamin D. Due to the rapid absorption of phosphate tablets, frequent daily doses are necessary, which is cumbersome and may cause fluctuations in plasma phosphate and risk of secondary hyperparathyroidism...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kowsar
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935710/ https://www.ncbi.nlm.nih.gov/pubmed/31903094 http://dx.doi.org/10.5812/ijem.91454 |
_version_ | 1783483620607918080 |
---|---|
author | Jørgensen, Cecilie Siggaard Poulsen, Vibe Morgana Lund Sandahl, Mads Underbjerg, Line Kristensen, Simon Bang Piec, Isabelle Beck-Nielsen, Signe Sparre Rejnmark, Lars Birkebæk, Niels Holtum |
author_facet | Jørgensen, Cecilie Siggaard Poulsen, Vibe Morgana Lund Sandahl, Mads Underbjerg, Line Kristensen, Simon Bang Piec, Isabelle Beck-Nielsen, Signe Sparre Rejnmark, Lars Birkebæk, Niels Holtum |
author_sort | Jørgensen, Cecilie Siggaard |
collection | PubMed |
description | BACKGROUND: Standard treatment of hypophosphatemic rickets (HR) is oral phosphate tablets plus vitamin D. Due to the rapid absorption of phosphate tablets, frequent daily doses are necessary, which is cumbersome and may cause fluctuations in plasma phosphate and risk of secondary hyperparathyroidism. It was hypothesized that phosphate from milk or cheese is less rapidly absorbed, and reduces fluctuations in plasma phosphate. OBJECTIVES: The current randomized, multiple crossover study aimed at investigating if an equivalent phosphate dose given as milk or cheese is comparable to phosphate tablets in patients with HR. METHODS: Seven females with HR were included. They went through three different four-day treatment sessions of either oral phosphate tablets consisting of 800 mg elemental phosphorus divided into five doses over the day or an equivalent phosphorus dose ingested as skimmed milk or cheese divided over five daily doses. Blood and urine samples were taken from patients after each treatment session. Except the usual doses of vitamin D, no phosphate or calcium-modifying treatments were allowed. Statistical analyses were performed using mixed models. RESULTS: Treatment feasibility was independent of the phosphorus source. The study demonstrated reduced plasma levels of parathyroid hormone (PTH), reduced fluctuations in plasma phosphate and plasma PTH, and reduced renal phosphate excretion when ingesting phosphorus supplementation as milk compared to phosphate tablets. The same trend was observed when administering phosphorus as cheese, though not statistically significant. CONCLUSIONS: Phosphorus supplements can be administered as phosphate tablets, milk or cheese when given in equimolar doses. The current study findings indicated that milk may be superior to phosphate tablets as the phosphate source in patients with HR. |
format | Online Article Text |
id | pubmed-6935710 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Kowsar |
record_format | MEDLINE/PubMed |
spelling | pubmed-69357102020-01-03 Milk Products in the Treatment of Hypophosphatemic Rickets: A Pilot Study Jørgensen, Cecilie Siggaard Poulsen, Vibe Morgana Lund Sandahl, Mads Underbjerg, Line Kristensen, Simon Bang Piec, Isabelle Beck-Nielsen, Signe Sparre Rejnmark, Lars Birkebæk, Niels Holtum Int J Endocrinol Metab Research Article BACKGROUND: Standard treatment of hypophosphatemic rickets (HR) is oral phosphate tablets plus vitamin D. Due to the rapid absorption of phosphate tablets, frequent daily doses are necessary, which is cumbersome and may cause fluctuations in plasma phosphate and risk of secondary hyperparathyroidism. It was hypothesized that phosphate from milk or cheese is less rapidly absorbed, and reduces fluctuations in plasma phosphate. OBJECTIVES: The current randomized, multiple crossover study aimed at investigating if an equivalent phosphate dose given as milk or cheese is comparable to phosphate tablets in patients with HR. METHODS: Seven females with HR were included. They went through three different four-day treatment sessions of either oral phosphate tablets consisting of 800 mg elemental phosphorus divided into five doses over the day or an equivalent phosphorus dose ingested as skimmed milk or cheese divided over five daily doses. Blood and urine samples were taken from patients after each treatment session. Except the usual doses of vitamin D, no phosphate or calcium-modifying treatments were allowed. Statistical analyses were performed using mixed models. RESULTS: Treatment feasibility was independent of the phosphorus source. The study demonstrated reduced plasma levels of parathyroid hormone (PTH), reduced fluctuations in plasma phosphate and plasma PTH, and reduced renal phosphate excretion when ingesting phosphorus supplementation as milk compared to phosphate tablets. The same trend was observed when administering phosphorus as cheese, though not statistically significant. CONCLUSIONS: Phosphorus supplements can be administered as phosphate tablets, milk or cheese when given in equimolar doses. The current study findings indicated that milk may be superior to phosphate tablets as the phosphate source in patients with HR. Kowsar 2019-10-06 /pmc/articles/PMC6935710/ /pubmed/31903094 http://dx.doi.org/10.5812/ijem.91454 Text en Copyright © 2019, International Journal of Endocrinology and Metabolism http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited. |
spellingShingle | Research Article Jørgensen, Cecilie Siggaard Poulsen, Vibe Morgana Lund Sandahl, Mads Underbjerg, Line Kristensen, Simon Bang Piec, Isabelle Beck-Nielsen, Signe Sparre Rejnmark, Lars Birkebæk, Niels Holtum Milk Products in the Treatment of Hypophosphatemic Rickets: A Pilot Study |
title | Milk Products in the Treatment of Hypophosphatemic Rickets: A Pilot Study |
title_full | Milk Products in the Treatment of Hypophosphatemic Rickets: A Pilot Study |
title_fullStr | Milk Products in the Treatment of Hypophosphatemic Rickets: A Pilot Study |
title_full_unstemmed | Milk Products in the Treatment of Hypophosphatemic Rickets: A Pilot Study |
title_short | Milk Products in the Treatment of Hypophosphatemic Rickets: A Pilot Study |
title_sort | milk products in the treatment of hypophosphatemic rickets: a pilot study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935710/ https://www.ncbi.nlm.nih.gov/pubmed/31903094 http://dx.doi.org/10.5812/ijem.91454 |
work_keys_str_mv | AT jørgensenceciliesiggaard milkproductsinthetreatmentofhypophosphatemicricketsapilotstudy AT poulsenvibemorganalund milkproductsinthetreatmentofhypophosphatemicricketsapilotstudy AT sandahlmads milkproductsinthetreatmentofhypophosphatemicricketsapilotstudy AT underbjergline milkproductsinthetreatmentofhypophosphatemicricketsapilotstudy AT kristensensimonbang milkproductsinthetreatmentofhypophosphatemicricketsapilotstudy AT piecisabelle milkproductsinthetreatmentofhypophosphatemicricketsapilotstudy AT becknielsensignesparre milkproductsinthetreatmentofhypophosphatemicricketsapilotstudy AT rejnmarklars milkproductsinthetreatmentofhypophosphatemicricketsapilotstudy AT birkebæknielsholtum milkproductsinthetreatmentofhypophosphatemicricketsapilotstudy |