de Boer Ian H, Rue Tessa C, Kestenbaum Bryan
Division of Nephrology, University of Washington, Seattle, WA 98104-2499, USA.
Am J Kidney Dis. 2009 Mar;53(3):399-407. doi: 10.1053/j.ajkd.2008.07.036. Epub 2008 Nov 6.
Higher serum phosphorus concentrations within the normal laboratory range have been associated with cardiovascular events and mortality in large prospective cohort studies of individuals with and without kidney disease. Reasons for interindividual variation in steady-state serum phosphorus concentrations are largely unknown.
Cross-sectional study.
SETTING & PARTICIPANTS: 15,513 participants in the Third National Health and Nutrition Examination Survey.
Demographic data, dietary intake measured by means of 24-hour dietary recall and food-frequency questionnaire, and established cardiovascular risk factors.
OUTCOME & MEASUREMENTS: Serum phosphorus concentration.
Mean serum phosphorus concentrations were significantly greater in women (+0.16 mg/dL versus men; P < 0.001) and people of non-Hispanic black and Hispanic race/ethnicity (+0.06 and +0.07 mg/dL versus non-Hispanic white, respectively; P < 0.001). Dietary intakes of phosphorus and phosphorus-rich foods were associated only weakly with circulating serum phosphorus concentrations, if at all. Higher serum phosphorus levels were associated with lower calculated Framingham coronary heart disease risk scores, which are based on traditional atherosclerosis risk factors. In aggregate, demographic, nutritional, cardiovascular, and kidney function variables explained only 12% of the variation in circulating serum phosphorus concentrations.
Results may differ with advanced kidney disease.
Serum phosphorus concentration is weakly related to dietary phosphorus and not related to a diverse array of phosphorus-rich foods in the general population. Factors determining serum phosphorus concentration are largely unknown. Previously observed associations of serum phosphorus concentrations with cardiovascular events are unlikely to be a result of differences in dietary intake or traditional cardiovascular risk factors.
在针对患有和未患有肾脏疾病的个体开展的大型前瞻性队列研究中，正常实验室范围内较高的血清磷浓度与心血管事件及死亡率相关。稳态血清磷浓度个体差异的原因在很大程度上尚不清楚。
横断面研究。
第三次全国健康与营养检查调查中的15,513名参与者。
人口统计学数据、通过24小时饮食回顾和食物频率问卷测量的饮食摄入量，以及已确定的心血管危险因素。
血清磷浓度。
女性的平均血清磷浓度显著高于男性（高出0.16mg/dL；P<0.001），非西班牙裔黑人和西班牙裔种族/族裔的人群的平均血清磷浓度也高于非西班牙裔白人（分别高出0.06mg/dL和0.07mg/dL；P<0.001）。磷及富含磷食物的饮食摄入量与循环血清磷浓度之间的关联即便存在也很微弱。较高的血清磷水平与基于传统动脉粥样硬化危险因素计算的弗明汉姆冠心病风险评分较低相关。总体而言，人口统计学、营养、心血管和肾功能变量仅解释了循环血清磷浓度变异的12%。
晚期肾脏疾病患者的结果可能有所不同。
在一般人群中，血清磷浓度与饮食磷的关系较弱，与多种富含磷的食物无关。决定血清磷浓度的因素在很大程度上尚不清楚。先前观察到的血清磷浓度与心血管事件之间的关联不太可能是饮食摄入量差异或传统心血管危险因素所致。
