Moore Linda W, Nolte Joy V, Gaber A Osama, Suki Wadi N
Departments of Surgery and
Departments of Surgery and.
Am J Clin Nutr. 2015 Aug;102(2):444-53. doi: 10.3945/ajcn.114.102715. Epub 2015 Jun 3.
The health implications of dietary phosphorus intake and the role of kidney function in managing serum phosphorus homeostasis are well studied. However, examining the source of dietary phosphorus intake and its impact on serum phosphorus has not been characterized in population studies.
This study aimed to distinguish the association of food sources of organic phosphorus and inorganic phosphate additives with serum phosphorus concentration.
A cross-sectional analysis of 24-h food recall data from 7895 adult participants in the National Health and Nutrition Examination Survey 2003-2006 was performed. Phosphorus content of foods was categorized as organic or inorganic. Correlations of serum phosphorus to clinical and dietary intake variables were achieved by using multiple regression analysis.
After controlling for estimated glomerular filtration rate (eGFR), body mass index (BMI; in kg/m²), and albumin-to-creatinine ratio, a significant increase in serum phosphorus occurred with dairy foods with inorganic phosphates [parameter estimate (PE) ± SE: 0.07 ± 0.02 mg/dL, P < 0.01] or without inorganic phosphates (PE: 0.02 ± 0.01, P < 0.001) and cereals/grains with inorganic phosphates (PE: 0.005 ± 0.002, P < 0.01). Significantly higher serum phosphorus occurred when eGRF was <30 (PE: 0.24 ± 0.08, P < 0.0001), but eGFR 30-44 (PE: -0.11 ± 0.04, P < 0.01) and 45-60 (PE: -0.10 ± 0.04, P < 0.01) were associated with lower serum phosphorus; higher serum phosphorus was associated with BMI <18.5 (PE: 0.18 ± 0.05, P = 0.0009) but lower with BMI ≥35-39 (PE: -0.09 ± 0.03, P = 0.0013) or ≥40 (PE: -0.10 ± 0.03, P = 0.014).
This analysis shows that dairy products and cereals/grains having inorganic phosphate additives significantly increase serum phosphorus concentration, despite being consumed less frequently than foods without phosphate additives. It seems prudent for the Nutrient Facts Label to include phosphorus but also for food manufacturers to consider alternatives to phosphate additives.
饮食中磷摄入量对健康的影响以及肾功能在维持血清磷稳态中的作用已得到充分研究。然而，在人群研究中，尚未对饮食中磷摄入的来源及其对血清磷的影响进行特征描述。
本研究旨在区分有机磷食物来源和无机磷酸盐添加剂与血清磷浓度之间的关联。
对2003 - 2006年美国国家健康与营养检查调查中7895名成年参与者的24小时食物召回数据进行横断面分析。食物中的磷含量分为有机磷或无机磷。通过多元回归分析得出血清磷与临床和饮食摄入变量之间的相关性。
在控制了估计肾小球滤过率（eGFR）、体重指数（BMI；单位：kg/m²）和白蛋白与肌酐比值后，含有无机磷酸盐的乳制品（参数估计值[PE]±标准误：0.07±0.02mg/dL，P<0.01）或不含无机磷酸盐的乳制品（PE：0.02±0.01，P<0.001）以及含有无机磷酸盐的谷物/粮食（PE：0.005±0.002，P<0.01）会使血清磷显著升高。当eGFR<30时，血清磷显著升高（PE：0.24±0.08，P<0.0001），但eGFR为30 - 44（PE： - 0.11±0.04，P<0.01）和45 - 60（PE： - 0.10±0.04，P<0.01）时与较低的血清磷相关；较高的血清磷与BMI<18.5相关（PE：0.18±0.05，P = 0.0009），但与BMI≥35 - 39（PE： - 0.09±0.03，P = 0.0013）或≥40（PE： - 0.10±0.03，P = 0.014）时较低的血清磷相关。
该分析表明，尽管含有无机磷酸盐添加剂的乳制品和谷物/粮食的食用频率低于不含磷酸盐添加剂的食物，但它们会显著增加血清磷浓度。营养成分标签中包含磷似乎是谨慎之举，食品制造商也应考虑使用磷酸盐添加剂的替代品。
