De Lorenzo F, Hargreaves J, Kakkar V V
Beatrice Research Centre, London, UK.
Postgrad Med J. 1998 Apr;74(870):229-32. doi: 10.1136/pgmj.74.870.229.
Phosphate depletion is associated with neuromuscular dysfunction due to changes in mitochondrial respiration that result in a defect of intracellular oxidative metabolism. Phosphate diabetes causes phosphate depletion due to abnormal renal re-absorption of phosphate be the proximal renal tubule. Most of the symptoms presented by patients with phosphate diabetes such as myalgia, fatigue and mild depression, are also common in patients with chronic fatigue syndrome, but this differential diagnosis has not been considered. We investigated the possible association between chronic fatigue syndrome and phosphate diabetes in 87 patients who fulfilled the criteria for chronic fatigue syndrome. Control subjects were 37 volunteers, who explicitly denied fatigue and chronic illness on a screening questionnaire. Re-absorption of phosphate by the proximal renal tubule, phosphate clearance and renal threshold phosphate concentration were the main outcome measures in both groups. Of the 87 patients with chronic fatigue syndrome, nine also fulfilled the diagnostic criteria for phosphate diabetes. In conclusion, we report a previously undefined relationship between chronic fatigue syndrome and phosphate diabetes. Phosphate diabetes should be considered in differential diagnosis with chronic fatigue syndrome; further studies are needed to investigate the incidence of phosphate diabetes in patients with chronic fatigue syndrome and the possible beneficial effect of vitamin D and oral phosphate supplements.
由于线粒体呼吸变化导致细胞内氧化代谢缺陷，磷缺乏与神经肌肉功能障碍相关。磷酸盐性糖尿病因近端肾小管对磷的异常重吸收而导致磷缺乏。磷酸盐性糖尿病患者出现的大多数症状，如肌痛、疲劳和轻度抑郁，在慢性疲劳综合征患者中也很常见，但尚未考虑这种鉴别诊断。我们对87名符合慢性疲劳综合征标准的患者，研究了慢性疲劳综合征与磷酸盐性糖尿病之间可能存在的关联。对照组为37名志愿者，他们在筛查问卷中明确否认有疲劳和慢性疾病。两组的主要观察指标是近端肾小管对磷的重吸收、磷清除率和肾阈磷浓度。在87名慢性疲劳综合征患者中，有9名也符合磷酸盐性糖尿病的诊断标准。总之，我们报告了慢性疲劳综合征与磷酸盐性糖尿病之间一种以前未明确的关系。在与慢性疲劳综合征的鉴别诊断中应考虑磷酸盐性糖尿病；需要进一步研究来调查慢性疲劳综合征患者中磷酸盐性糖尿病的发病率，以及维生素D和口服磷补充剂可能的有益作用。
