Department of Food and Environmental Sciences Calcium Research Unit, University of Helsinki, P.O. Box 66, Helsinki 00014, Finland.
Nutr J. 2013 Jul 10;12:94. doi: 10.1186/1475-2891-12-94.
Dietary phosphorus (P) intake in Western countries is 2- to 3-fold higher than recommended, and phosphate is widely used as a food additive in eg. cola beverages and processed meat products. Elevated serum phosphate concentrations have been associated with cardiovascular disease (CVD) risk factors and CVD itself in several studies in patients with renal dysfunction and in a few studies in the general population. Carotid intima-media thickness (IMT) is a CVD risk factor, thus the aim of the study was to determine if an association between dietary P, especially food additive phosphate (FAP), intake, and IMT exists.
Associations among total phosphorus (TP) and FAP intake and carotid IMT were investigated in a cross-sectional study of 37- to 47-year-old females (n = 370) and males (n = 176) in Finland. Associations among TP intake, FAP intake, and IMT were tested by analysis of covariance (ANCOVA) in quintiles (TP) and sextiles (FAP) using sex, age, low-density/high-density lipoprotein cholesterol ratio, smoking status, and IMT sonographer as covariates.
No significant associations were present between TP or FAP intake and IMT (p > 0.05, ANCOVA), but in between-group comparisons some differences were found indicating higher IMT among subjects with higher P intake. When testing for a significant linear trend with contrast analysis, a positive trend was observed between energy-adjusted TP intake and IMT among all subjects (p = 0.039), and among females a tendency for a trend existed (p = 0.067). Among all subjects, a significant positive linear trend was also present between FAP intake and IMT (p = 0.022); this trend was also seen in females (p = 0.045). In males, no significant associations or trends were noted between TP or FAP intake and IMT (p > 0.05).
Our results indicate that a significant linear trend exists between energy-adjusted TP intake and FAP intake, and IMT among all subjects. Based on these results, high dietary P intake should be further investigated due to its potential association with adverse cardiovascular health effects in the general population.
西方国家的膳食磷（P）摄入量是推荐量的 2 到 3 倍，而磷酸盐被广泛用作食品添加剂，例如可乐饮料和加工肉类产品。几项肾功能障碍患者的研究以及少数普通人群的研究表明，血清磷酸盐浓度升高与心血管疾病（CVD）风险因素和 CVD 本身有关。颈动脉内膜中层厚度（IMT）是 CVD 的一个风险因素，因此本研究的目的是确定膳食 P（尤其是食品添加剂磷酸盐（FAP））摄入量与 IMT 之间是否存在关联。
在芬兰对 37 至 47 岁的女性（n = 370）和男性（n = 176）进行横断面研究，调查总磷（TP）和 FAP 摄入量与颈动脉 IMT 之间的关联。使用协方差分析（ANCOVA）在五分位数（TP）和六分位数（FAP）中检验 TP 摄入量、FAP 摄入量和 IMT 之间的关联，同时调整性别、年龄、低密度/高密度脂蛋白胆固醇比值、吸烟状况和 IMT 超声检查者。
TP 或 FAP 摄入量与 IMT 之间无显著相关性（p > 0.05，ANCOVA），但在组间比较中发现一些差异，表明高 P 摄入量的受试者 IMT 较高。当使用对比分析检验线性趋势是否显著时，发现所有受试者中能量调整后的 TP 摄入量与 IMT 之间呈正相关趋势（p = 0.039），且女性中存在趋势（p = 0.067）。在所有受试者中，FAP 摄入量与 IMT 之间也存在显著的正线性趋势（p = 0.022）；这一趋势在女性中也存在（p = 0.045）。在男性中，TP 或 FAP 摄入量与 IMT 之间无显著相关性或趋势（p > 0.05）。
我们的结果表明，所有受试者中能量调整后的 TP 摄入量和 FAP 摄入量与 IMT 之间存在显著的线性趋势。基于这些结果，由于高膳食 P 摄入可能与普通人群的不良心血管健康影响有关，因此应进一步研究。
