PHEX Protein in the Parathyroid Gland Contributes to Phosphate Sensing
Authors' conclusion
iPTH increased in accordance with Pi levels, with a greater slope observed in XLH than in TIO after oral Pi loading. This finding suggests that PHEX in the parathyroid glands might also determine the serum Pi-sensing threshold and mediate PTH secretion in the case of abrupt fluctuations in serum Pi levels, which may explain the high prevalence of secondary and tertiary hyperparathyroidism in patients with XLH.
Study context
- Population
- Patients with X-linked hypophosphatemia (XLH) or TIO given oral phosphate 300 to 1500 mg
- Participants
- 6 vs 13
- Exposure
- XLH vs TIO: PTH response to oral phosphate load
- XLHn = 6
- TIOn = 13reference
- Outcome
- Slope of intact PTH (iPTH) (pg/mL) vs Pi (mg/dL) after oral Pi load per patient
- Follow-up
- 1 hour after oral phosphate
Main finding
As reported in the abstract
Slope of iPTH (pg/mL) vs Pi (mg/dL) after oral Pi load
XLH
41.4
median
TIO
7.1
P = 0.034
Observational data: associations, not effects.
Further findings
Serum Pi and cCa after oral Pi load · 1 hour
- Serum Pi significantly increased after oral Pi load, whereas serum cCa was stable
Original publication
PHEX Protein in the Parathyroid Gland Contributes to Phosphate Sensing. J Clin Endocrinol Metab. Published 13 June 2025. doi:10.
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