Division of Nephrology, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California, USA.
Am J Epidemiol. 2010 Apr 15;171(8):909-16. doi: 10.1093/aje/kwq020. Epub 2010 Mar 17.
A higher serum phosphorus level is associated with cardiovascular disease (CVD) events among community-living populations. Mechanisms are unknown. The ankle-brachial index (ABI) provides information on both atherosclerosis and arterial stiffness. In this cross-sectional study (2000-2002), the authors evaluated the association of serum phosphorus levels with low (<0.90) and high (> or =1.40 or incompressible) ABI as compared with intermediate ABI in 5,330 older US men, among whom the mean serum phosphorus level was 3.2 mg/dL (standard deviation, 0.4), 6% had a low ABI, and 5% had a high ABI. Each 1-mg/dL increase in serum phosphorus level was associated with a 1.6-fold greater prevalence of low ABI (95% confidence interval (CI): 1.2, 2.1; P < 0.001) and a 1.4-fold greater prevalence of high ABI (95% CI: 1.0, 1.9; P = 0.03) in models adjusted for demographic factors, traditional CVD risk factors, and kidney function. However, the association of phosphorus with high ABI differed by chronic kidney disease (CKD) status (in persons with CKD, prevalence ratio = 2.96, 95% CI: 1.61, 5.45; in persons without CKD, prevalence ratio = 1.14, 95% CI: 0.81, 1.61; interaction P = 0.04). In conclusion, among community-living older men, higher phosphorus levels are associated with low ABI and are also associated with high ABI in persons with CKD. These associations may explain the link between serum phosphorus levels and CVD events.
血清磷水平较高与社区居民心血管疾病（CVD）事件有关。其机制尚不清楚。踝臂指数（ABI）可提供动脉粥样硬化和动脉僵硬的信息。在这项横断面研究（2000-2002 年）中，作者评估了血清磷水平与低（<0.90）和高（≥1.40 或不可压缩）ABI 与中等 ABI 相比，与 5330 名美国老年男性中的低 ABI 相关的关联，其中血清磷水平的平均值为 3.2mg/dL（标准差，0.4），6%的人 ABI 较低，5%的人 ABI 较高。血清磷水平每增加 1mg/dL，低 ABI 的患病率增加 1.6 倍（95%置信区间：1.2，2.1；P<0.001），高 ABI 的患病率增加 1.4 倍（95%置信区间：1.0，1.9；P=0.03），在调整了人口统计学因素、传统 CVD 危险因素和肾功能的模型中。然而，磷与高 ABI 的关联因慢性肾脏病（CKD）状态而异（在 CKD 患者中，患病率比=2.96，95%置信区间：1.61，5.45；在无 CKD 患者中，患病率比=1.14，95%置信区间：0.81，1.61；交互 P=0.04）。总之，在社区居住的老年男性中，较高的磷水平与低 ABI 相关，并且在 CKD 患者中也与高 ABI 相关。这些关联可能解释了血清磷水平与 CVD 事件之间的联系。
