Yeh M H, Chen Y H, Lee A J, Chu M L, Chen C H
Department of Pediatrics, Tri-Service General Hospital, Taipei, Taiwan, R.O.C.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1991 Sep-Oct;32(5):303-13.
To further elucidate the data of high serum phosphorus concentration reported for foreign children, this study compared the values of serum phosphorus concentration in ethnic Chinese children with foreigners' results, and investigated the potential causes of high serum phosphorus concentration. This study included 33 healthy term male neonates from 2-3 days to 5-7 days old, 1,094 children of 6-18 years old (elementary school-senior high school) and 62 adults. A total of 1,189 persons were studied. Value of serum phosphorus concentration showed no significant difference between boys and girls, and no age dependency; there was notable change in serum phosphorus concentration in growing children of different ages. The mean values of serum phosphorus concentration of neonates aged 2-3 days and 5-7 days (7.20 mg/dl and 7.65 mg/dl, respectively) were the highest; boys aged 6-11 years 5.15-5.50 mg/dl and girls aged 6-11 years 5.14-5.28 mg/dl were the second; boys aged 12-18 years 4.31-4.94 mg/dl and girls aged 12-18 years 4.44-4.96 mg/dl were the lowest. These findings are similar to the conclusions of foreign reports that the older the subjects of the study, the less their serum phosphorus concentration. The maximal transport rates of tubular phosphate reabsorption were determined from a Walton-Bijvoet nomogram using the side-rule method they recommend. The renal phosphate threshold concentration of neonates aged 2-3 days 8.41 mg/100 ml GFR and 5-7 days 7.76 mg/dl GFR was also the highest; boys aged 6-11 years 5.84-6.32 mg/dl GFR and girls aged 6-11 years 5.82-6.10 mg/dl GFR and 5.44-6.10 mg/dl GFR was the second; adult males 3.51 mg/dl GFR and adult females 3.62 mg/dl GFR was the lowest. Increased intestinal absorption of phosphorus, low GFR and low clearance of phosphorus might be the contributing factors to cause high serum phosphorus concentration. Although high renal phosphate threshold capacity is important, increased absorption of phosphorus by G-I tract seems to be another factor in accordance with the need of phosphorus of the growing body cells.
为进一步阐明国外报道的儿童高血清磷浓度数据,本研究比较了华裔儿童与外国儿童的血清磷浓度值,并调查了高血清磷浓度的潜在原因。本研究纳入了33名2至3日龄至5至7日龄的健康足月儿男婴、1094名6至18岁(小学至高中)儿童和62名成年人。共研究了1189人。血清磷浓度值在男孩和女孩之间无显著差异,也无年龄依赖性;不同年龄的成长中儿童血清磷浓度有显著变化。2至3日龄和5至7日龄新生儿的血清磷浓度平均值最高(分别为7.20mg/dl和7.65mg/dl);6至11岁男孩为5.15至5.50mg/dl,6至11岁女孩为5.14至5.28mg/dl,排第二;12至18岁男孩为4.31至4.94mg/dl,12至18岁女孩为4.44至4.96mg/dl,最低。这些发现与国外报道的结论相似,即研究对象年龄越大,血清磷浓度越低。采用他们推荐的旁侧规则法,根据沃尔顿 - 比约沃特列线图测定肾小管磷重吸收的最大转运率。2至3日龄新生儿的肾磷阈值浓度为8.41mg/100ml肾小球滤过率(GFR),5至7日龄为7.76mg/dl GFR,也是最高的;6至11岁男孩为5.84至6.32mg/dl GFR,6至11岁女孩为5.82至6.10mg/dl GFR和5.44至6.10mg/dl GFR,排第二;成年男性为3.51mg/dl GFR,成年女性为3.62mg/dl GFR,最低。肠道磷吸收增加、低GFR和低磷清除率可能是导致高血清磷浓度的因素。尽管高肾磷阈值能力很重要,但胃肠道对磷吸收的增加似乎是另一个与生长中的体细胞对磷的需求相符的因素。