University of Oulu

Laura Koljonen, Maria Enlund-Cerullo, Helena Hauta-alus, Elisa Holmlund-Suila, Saara Valkama, Jenni Rosendahl, Sture Andersson, Minna Pekkinen, Outi Mäkitie, Phosphate Concentrations and Modifying Factors in Healthy Children From 12 to 24 Months of Age, The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 10, October 2021, Pages 2865–2875,

Phosphate concentrations and modifying factors in healthy children from 12 to 24 months of age

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Author: Koljonen, Laura1,2; Enlund-Cerullo, Maria1,2,3; Hauta-alus, Helena2,3,4,5;
Organizations: 1Folkhälsan Research Center, 00290 Helsinki, Finland
2Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
3Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
4National Institute for Health and Welfare (THL), 00271 Helsinki, Finland
5PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, 90014 Oulu, Finland
6Department of Molecular Medicine and Surgery, Karolinska Institutet, and Clinical Genetics, Karolinska University Hospital, 17176 Stockholm, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.8 MB)
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Language: English
Published: Endocrine society, 2021
Publish Date: 2021-11-12


Context: Phosphate homeostasis and its modifiers in early childhood are inadequately characterized.

Objective: To determine physiological plasma phosphate concentration and modifying factors in healthy infants at 12 to 24 months of age.

Design: This study included 525 healthy infants (53% girls), who participated in a randomized vitamin D intervention trial and received daily vitamin D₃ supplementation of either 10 or 30 μg from age 2 weeks to 24 months. Biochemical parameters were measured at 12 and 24 months. Dietary phosphate intake was determined at 12 months.

Main Outcome Measures: Plasma phosphate concentrations at 12 and 24 months of age.

Results: Mean (SD) phosphate concentration decreased from 12 months (1.9 ± 0.15 mmol/L) to 24 months (1.6 ± 0.17 mmol/L) of age (P < 0.001 for repeated measurements). When adjusted by covariates, such as body size, creatinine, serum 25-hydroxyvitamin D, intact and C-terminal fibroblast growth factor 23, mean plasma phosphate was higher in boys than girls during follow-up (P = 0.019). Phosphate concentrations were similar in the vitamin D intervention groups (P > 0.472 for all). Plasma iron was associated positively with plasma phosphate at both time points (B, 0.006 and 0.005; 95% CI, 0.004-0.009 and 0.002-0.008; P < 0.001 at both time points, respectively). At 24 months of age, the main modifier of phosphate concentration was plasma creatinine (B, 0.007; 95% CI 0.003-0.011, P < 0.001).

Conclusion: Plasma phosphate concentration decreased from age 12 to 24 months. In infants and toddlers, the strongest plasma phosphate modifiers were sex, iron, and creatinine, whereas vitamin D supplementation did not modify phosphate concentrations.

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Series: Journal of clinical endocrinology & metabolism
ISSN: 0021-972X
ISSN-E: 1945-7197
ISSN-L: 0021-972X
Volume: 106
Issue: 10
Pages: 2865 - 2875
DOI: 10.1210/clinem/dgab495
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: The Sigrid Jusélius Foundation, Academy of Finland, Swedish Research Council, Novo Nordisk Foundation, Folkhälsan Research Foundation, Finnish Medical Foundation, Victoriastiftelsen, Orion Research Foundation, Instrumentarium Science Foundation, Paulo Foundation, Päivikki and Sakari Sohlberg Foundation, Juho Vainio Foundation, Finnish Pediatric Research Foundation, Finska Läkaresällskapet, Stiftelsen Dorothea Olivia, Karl Walter och Jarl Walter Perkléns minne, and state funding for university-level health research in Finland.
Copyright information: © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.