中国实用儿科杂志 ›› 2024, Vol. 39 ›› Issue (10): 752-755.DOI: 10.19538/j.ek2024100608

• 专题笔谈 • 上一篇    下一篇

儿童磷代谢及磷稳态

  

  1. 河北医科大学第二医院 儿科,河北  石家庄  050000
  • 出版日期:2024-10-06 发布日期:2024-11-06
  • 通讯作者: 张会丰,电子信箱:13333015983@163.com

Phosphorus metabolism and phosphate homeostasis in children

  1. Department of Pediatrics,the Second Hospital of Hebei Medical University,Shijiazhuang  050000,China
  • Online:2024-10-06 Published:2024-11-06

摘要: 磷是体内含量丰富的元素,对细胞能量代谢、细胞信号传导、骨骼矿化及机体内环境维持等多种关键的生物过程至关重要。磷酸盐依赖的骨形成在生命早期尤为重要。儿童血磷总体较高,从儿童期到青春期呈逐渐下降趋势,直到成人阶段的低水平。磷稳态的维持需通过肠道磷酸盐吸收、肾磷酸盐处理及细胞内液体和骨磷池之间复杂的磷酸盐交换来实现。自然界中广泛存在富磷食物,肠道吸收膳食磷,1,25-二羟维生素D可促进磷吸收,而甲状旁腺素及成纤维细胞生长因子-23则抑制肾小管磷重吸收,增加尿磷排泄,进而维持血磷在生理范围内波动。肾小管磷重吸收对磷代谢至关重要,肾小管磷重吸收能力和肾磷阈的计算对研究磷稳态及鉴别磷代谢紊乱病因具有重要意义。

关键词: 磷, 成纤维细胞生长因子-23, 甲状旁腺素, 维生素D, 肾磷阈

Abstract: Phosphorus is an abundant element in the body, which is essential to various key biological processes such as cell energy metabolism, cell signaling,bone mineralization,and maintenance of the internal environment of the body.Phosphate-dependent bone formation is particularly important in early life. Blood phosphorus is generally higher in children and gradually decreases from childhood through adolescence to low level in adulthood. Phosphorus homeostasis is maintained through complex phosphate exchanges between intestinal phosphate absorption,renal phosphate handling,and intracellular fluid and bone phosphate pools. Phosphorus-rich foods are abundant in nature,and dietary phosphorus is absorbed in the intestines,a process promoted by 1,25(OH)2 vitamin D, while parathyroid hormone and fibroblast growth factor 23 can inhibit renal tubular phosphate reabsorption,and increase urinary phosphate excretion, thus maintaining blood phosphorus fluctuation within the physiological range. Renal tubular phosphate reabsorption is crucial for phosphorus metabolism,and the calculation of renal phosphate threshold and tubular phosphate reabsorption is important for studying phosphorus homeostasis and identifying the causes of phosphorus metabolism disorders.

Key words: phosphate, fibroblast growth factor 23, parathyroid hormone, vitamin D, renal phosphate threshold