Dietary Phosphate Deprivation in Women and Men: Effects on Mineral and Acid Balances, Parathyroid Hormone and the Metabolism of 25-OH-Vitamin D*

Abstract

We evaluated the effects of dietary PO⁴ restriction on 25-OH-Vitamin D₃ metabolism, serum iPTH levels, and mineral balances in healthy women and men. PO₄ balances were progressively negative because of fecal losses without sex difference. Turnover of the plasma 25-OH-D pool was increased from 5.8 ± 0.4 to 12 ± 1.2 nmol/day; P < 0.001, despite a fall in serum iPTH of −1.1 ± 0.3 μlEq/ml; P < 0.01. In both sexes, net intestinal calcium and magnesium absorption increased in proportion to a more rapid turnover of the plasma 25-OH-D pool, implying increased renal 1, 25-(OH)₂-D₃ production. By contrast, there was a striking sex difference in the response of serum PC₄, to dietary PO₄ deprivation; the levels falling progressively in women, but remaining at control levels in men. Women demonstrated progressive hypercalciuria and negative Ca balances while in men the increments in intestinal Ca absorption were approximately matched by the increments in urinary Ca excretion so that Ca balances were not different from zero.