Clinical Division of Anesthesiology and Intensive Therapy of the Department of Anesthesiology, Intensive Treatment and Emergency Medicine, Medical University of Silesia, 41-800 Zabrze, Poland.
Department of Toxicology and Health Protection, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland.
Nutrients. 2021 Nov 10;13(11):4004. doi: 10.3390/nu13114004.
Higher serum phosphorus has detrimental health effects. Even high-normal rage sP is associated with worse outcomes. The relationship of serum phosphorus with prognostic markers in heart failure remains unclear. We investigated the association of serum phosphorus with heart failure prognostic factors and risk of mortality related to serum phosphorus. In 1029 stable heart failure patients, we investigated the distribution of markers of more advanced heart failure stage across quintiles of serum phosphorus and estimated the relative risk of mortality in comparison to reference. Higher serum phosphorus levels sP were associated with markers of a worse outcome. The best survival was observed in low-normal serum levels. The unadjusted hazard ratio for mortality increased toward higher phosphorus quintiles but not to lower levels of sP. The correction for age, sex, BMI, percent weight loss, inflammation, kidney function, and LVEF did not modify the risk profile substantially. The adjustment for NYHA, natriuretic peptides, serum sodium, and treatment characteristics broke down the risk relationship completely. A higher serum phosphorus is associated with markers of a more risky profile of heart failure. Elevated serum levels of phosphorus sP does not provide independent prognostic information beyond the strongest markers of the severity of the syndrome. The potential involvement of higher serum phosphorus as a mediator in the pathophysiology of heart failure warrants further study.
血清磷水平升高对健康有害。即使是高正常值的磷水平也与预后不良相关。血清磷与心力衰竭预后标志物的关系仍不清楚。我们研究了血清磷与心力衰竭预后因素的关系，以及与血清磷相关的死亡率风险。在 1029 例稳定的心力衰竭患者中，我们研究了血清磷五分位与更晚期心力衰竭阶段标志物的分布，并与参考值相比估计了死亡率的相对风险。较高的血清磷水平与预后不良的标志物相关。在低正常值血清水平下观察到最佳生存。死亡率的未调整风险比随着磷五分位的升高而增加，但在 sP 较低水平时并未增加。对年龄、性别、BMI、体重减轻百分比、炎症、肾功能和 LVEF 的校正并没有显著改变风险状况。对 NYHA、利钠肽、血清钠和治疗特征的调整完全打破了风险关系。较高的血清磷与心力衰竭风险更高的特征标志物相关。血清磷水平升高不能提供比综合征严重程度的最强标志物更独立的预后信息。更高的血清磷作为心力衰竭病理生理学中介物的潜在作用需要进一步研究。
