Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.
Division of Nutrition, Huashan Hospital, Fudan University, Shanghai, China.
J Clin Hypertens (Greenwich). 2021 Apr;23(4):849-859. doi: 10.1111/jch.14182. Epub 2021 Jan 24.
Whether increasing exposure to dietary phosphorus can lead to adverse clinical outcomes in healthy people is not clear. In this open-label prospective cross-over study, we are to explore the impact of various dietary phosphorus intake on mineral, sodium metabolisms and blood pressure in young healthy adults. There were 3 separate study periods of 5 days, each with a 5 days washout period between different diets interventions. Six young healthy male volunteers with normal nutrition status were recruited in Phase I Clinical Research Center and sequentially exposed to the following diets: (a) normal-phosphorus diet (NPD): 1500 mg/d, (b) low-phosphorus diet (LPD): 500 mg/d, (c) high-phosphorus diet (HPD): 2300 mg/d. HPD induced a significant rise in daily average serum phosphate (1.47 ± 0.02 mmol/L [4.56 ± 0.06 mg/dl]) compared to NPD (1.34 ± 0.02 mmol/L [4.15 ± 0.06 mg/dL]) and LPD (1.17 ± 0.02 mmol/L [3.63 ± 0.06 mg/dL]) (p < .05). Daily average levels of serum parathyroid hormone and fibroblast growth factor 23 in HPD were significantly higher, and serum 1,25(OH) D was remarkably lower than those in LPD. HPD induced a significant decrease in daily average serum aldosterone and an increase in daily average atrial natriuretic peptide level compared to LPD. The 24-hour urine volume in HPD subjects was less than that in LPD subjects. HPD significantly increased daily average systolic blood pressure by 6.02 ± 1.24 mm Hg compared to NPD and by 8.58 ± 1.24mm Hg compared to LPD (p < .05). Our study provides the first evidence that 5-day high-phosphorus diet can induce elevation in SBP in young healthy adults, which may due to volume expansion.
在健康人群中，增加膳食磷的摄入量是否会导致不良临床结局尚不清楚。在这项开放标签的前瞻性交叉研究中，我们旨在探索不同的膳食磷摄入量对年轻健康成年人矿物质、钠代谢和血压的影响。该研究有 3 个独立的 5 天研究期，每个研究期之间有 5 天的洗脱期，用于不同饮食干预。在一期临床研究中心招募了 6 名营养状况正常的年轻健康男性志愿者，他们依次接受以下饮食干预：（a）正常磷饮食（NPD）：1500mg/d；（b）低磷饮食（LPD）：500mg/d；（c）高磷饮食（HPD）：2300mg/d。与 NPD（1.34±0.02mmol/L[4.15±0.06mg/dL]）和 LPD（1.17±0.02mmol/L[3.63±0.06mg/dL]）相比，HPD 显著升高了血清磷酸盐的日平均水平（1.47±0.02mmol/L[4.56±0.06mg/dL]）（p<.05）。HPD 组的血清甲状旁腺激素和成纤维细胞生长因子 23 的日平均水平显著升高，血清 1,25（OH）D 水平明显低于 LPD 组。与 LPD 相比，HPD 诱导的日平均血清醛固酮显著降低，心房利钠肽水平显著升高。与 LPD 组相比，HPD 组 24 小时尿容量减少。与 NPD 相比，HPD 使收缩压的日平均水平升高 6.02±1.24mmHg，与 LPD 相比升高 8.58±1.24mmHg（p<.05）。本研究首次提供证据表明，5 天高磷饮食可使年轻健康成年人的收缩压升高，这可能与容量扩张有关。
