Details
| Original language | English |
|---|---|
| Article number | bvad150 |
| Journal | Journal of the Endocrine Society |
| Volume | 8 |
| Issue number | 1 |
| Early online date | 4 Dec 2023 |
| Publication status | Published - Jan 2024 |
Abstract
Impairments in musculoskeletal and mental health are common in adults with Hypophosphatasia (HPP). Restricted phosphorus intake has been suggested to positively affect symptoms in HPP, but there is lack of interventional evidence.
Objective
To evaluate the impact of a phosphorus-restricted, calcium-adjusted diet on musculoskeletal and mental health in HPP.
Design
Prospective, non-controlled, single-center interventional study (NuSTEPS II).
Setting
Outpatients at the Osteology Department, University of Wuerzburg, Germany.
Participants
26 adults with established HPP diagnosis.
Intervention
Standardized diet with defined daily intake of phosphorus (1160-1240 mg/d) and calcium (870-930 mg/d) over 8 weeks.
Main Outcome Measures
Functional testing and patient-reported outcome measures.
Results
At 8 weeks, significant improvements were observed in usual gait speed (p=.028) and the chair-rise test (p=.019) while no significant changes were seen in the 6-minute walk test (p=.468) and the timed up-and-go test (p=.230). Pain was not significantly reduced according to visual analogue scale (VAS) (p=.061), pain subscale of the 36-Item Short-Form Health Survey (SF-36) (p=.346) and Pain Disability Index (p=.686). Further, there was a significant improvement in the SF-36 vitality subscale (p=.022) while all other subscales as well as the Lower Extremity Functional Scale (p=.670) and the Fatigue Assessment Scale (p=.392) did not change significantly. Adjustments of mineral intake were not associated with relevant alterations regarding the intake of energy and energy-supplying nutrients or body composition.
Conclusion
Adjusting phosphorus and calcium intake may positively affect individual symptoms in adults with HPP, but overall clinical effectiveness regarding major issues like pain and endurance appears limited.
Keywords
- dietary calcium, dietary phosphorus, fatigue, hypophosphatasia, pain, physical function
ASJC Scopus subject areas
- Medicine(all)
- Endocrinology, Diabetes and Metabolism
Sustainable Development Goals
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In: Journal of the Endocrine Society, Vol. 8, No. 1, bvad150, 01.2024.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Impact of restricted phosphorus, calcium-adjusted diet on musculoskeletal and mental health in Hypophosphatasia
AU - Kuehn, Katinka
AU - Hahn, Andreas
AU - Seefried, Lothar
N1 - Publisher Copyright: © The Author(s) 2023.
PY - 2024/1
Y1 - 2024/1
N2 - ContextImpairments in musculoskeletal and mental health are common in adults with Hypophosphatasia (HPP). Restricted phosphorus intake has been suggested to positively affect symptoms in HPP, but there is lack of interventional evidence.ObjectiveTo evaluate the impact of a phosphorus-restricted, calcium-adjusted diet on musculoskeletal and mental health in HPP.DesignProspective, non-controlled, single-center interventional study (NuSTEPS II).SettingOutpatients at the Osteology Department, University of Wuerzburg, Germany.Participants26 adults with established HPP diagnosis.InterventionStandardized diet with defined daily intake of phosphorus (1160-1240 mg/d) and calcium (870-930 mg/d) over 8 weeks.Main Outcome MeasuresFunctional testing and patient-reported outcome measures.ResultsAt 8 weeks, significant improvements were observed in usual gait speed (p=.028) and the chair-rise test (p=.019) while no significant changes were seen in the 6-minute walk test (p=.468) and the timed up-and-go test (p=.230). Pain was not significantly reduced according to visual analogue scale (VAS) (p=.061), pain subscale of the 36-Item Short-Form Health Survey (SF-36) (p=.346) and Pain Disability Index (p=.686). Further, there was a significant improvement in the SF-36 vitality subscale (p=.022) while all other subscales as well as the Lower Extremity Functional Scale (p=.670) and the Fatigue Assessment Scale (p=.392) did not change significantly. Adjustments of mineral intake were not associated with relevant alterations regarding the intake of energy and energy-supplying nutrients or body composition.ConclusionAdjusting phosphorus and calcium intake may positively affect individual symptoms in adults with HPP, but overall clinical effectiveness regarding major issues like pain and endurance appears limited.
AB - ContextImpairments in musculoskeletal and mental health are common in adults with Hypophosphatasia (HPP). Restricted phosphorus intake has been suggested to positively affect symptoms in HPP, but there is lack of interventional evidence.ObjectiveTo evaluate the impact of a phosphorus-restricted, calcium-adjusted diet on musculoskeletal and mental health in HPP.DesignProspective, non-controlled, single-center interventional study (NuSTEPS II).SettingOutpatients at the Osteology Department, University of Wuerzburg, Germany.Participants26 adults with established HPP diagnosis.InterventionStandardized diet with defined daily intake of phosphorus (1160-1240 mg/d) and calcium (870-930 mg/d) over 8 weeks.Main Outcome MeasuresFunctional testing and patient-reported outcome measures.ResultsAt 8 weeks, significant improvements were observed in usual gait speed (p=.028) and the chair-rise test (p=.019) while no significant changes were seen in the 6-minute walk test (p=.468) and the timed up-and-go test (p=.230). Pain was not significantly reduced according to visual analogue scale (VAS) (p=.061), pain subscale of the 36-Item Short-Form Health Survey (SF-36) (p=.346) and Pain Disability Index (p=.686). Further, there was a significant improvement in the SF-36 vitality subscale (p=.022) while all other subscales as well as the Lower Extremity Functional Scale (p=.670) and the Fatigue Assessment Scale (p=.392) did not change significantly. Adjustments of mineral intake were not associated with relevant alterations regarding the intake of energy and energy-supplying nutrients or body composition.ConclusionAdjusting phosphorus and calcium intake may positively affect individual symptoms in adults with HPP, but overall clinical effectiveness regarding major issues like pain and endurance appears limited.
KW - dietary calcium
KW - dietary phosphorus
KW - fatigue
KW - hypophosphatasia
KW - pain
KW - physical function
UR - http://www.scopus.com/inward/record.url?scp=85180765772&partnerID=8YFLogxK
U2 - 10.1210/jendso/bvad150
DO - 10.1210/jendso/bvad150
M3 - Article
VL - 8
JO - Journal of the Endocrine Society
JF - Journal of the Endocrine Society
IS - 1
M1 - bvad150
ER -