Prospective study reveals regulatory pathways governing calcium, phosphorus, and vitamin D metabolism in infants, highlighting key enzymatic interactions controlling mineral balance.
Calcium (Ca) and phosphorus (Pi) are tightly regulated by parathyroid hormone (PTH), vitamin D and FGF23 via intestinal absorption, kidney reabsorption, and bone apposition.Vitamin D metabolism is regulated by alfa1-hydroxylase (CYP27B1), hydroxylating 25(OH)D to active 1,25(OH) 2 D, and by 24-hydroxylase (CYP24A1), hydroxylating it to 24,25(OH) 2 D. This 24,25(OH) 2 D metabolite retains partial biological activity: it undergoes further renal hydroxylation to 1,24,25(OH) 3 D, which is active on the intestine, and is inactivated only upon subsequent oxidation to the water-soluble calcitroic acid [1].The 25(OH)D-to-24,25(OH) 2 D ratio reflects CYP24A1 activity [2].Bone-derived FGF23 suppresses both kidney Pi reabsorption and CYP27B1.
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Gurevich et al. (2026) studied this question.
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