The pathophysiology of hypophosphatemia.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of Competing Interest N.I. receives research support from Kyowa Kirin co. ltd. The other authors (N.H., H.K.) have nothing to disclose. 2. Int J Mol Sci. 2022 Nov 28;23(23):14896. doi: 10.3390/ijms232314896. Osteomalacia Is Not a Single Disease. Cianferotti L(1). Author information: (1)Bone Metabolic Diseases Unit, Department of Experimental and Biomedical Sciences, University Hospital of Florence, University of Florence, 50139 Florence, Italy. Among bone-material qualities, mineralization is pivotal in conferring stiffness and toughness to the bone. Osteomalacia, a disease ensuing from inadequate mineralization of the skeleton, is caused by different processes leading to decreased available mineral (calcium and/or phosphate) or enzymatic alterations. Vitamin D deficiency, which remains the major cause of altered mineralization leading to inadequate intestinal calcium and phosphate absorption, may be also associated with other conditions primarily responsible for abnormal mineralization. Given the reality of widespread vitamin D inadequacy, a full biochemical assessment of mineral metabolism is always necessary to rule out or confirm other conditions. Both too-high or too-low serum alkaline phosphatase (ALP) levels are important for diagnosis. Osteomalacic syndrome is reversible, at least in part, by specific treatment. Osteomalacia and bone mineralization themselves constitute largely unexplored fields of research. The true prevalence of the different forms of osteomalacia and the recovery after proper therapy have yet to be determined in the real world. Although non-invasive techniques to assess bone mineralization are not available in clinical practice, the systematic assessment of bone quality could help in refining the diagnosis and guiding the treatment. This review summarizes what is known of osteomalacia recent therapeutic developments and highlights the future issues of research in this field. DOI: 10.3390/ijms232314896 PMCID: PMC9740398