Clin Nephrol. 2022 Aug;98(2):83-91. doi: 10.5414/CN110792.
There is limited data on the association between serum phosphorus concentration (SPC) and subclinical coronary atherosclerosis in low-risk asymptomatic subjects without kidney dysfunction.
We retrospectively analyzed 1,636 Korean individuals (mean age 52.6 ± 7.6 years; males: 712 (43.5%)) without traditional cardiovascular risk factors (CVRFs) and kidney dysfunction who voluntarily underwent coronary computed tomography angiography (CCTA) as part of a general health examination. Traditional CVRFs were defined as follows: systolic/diastolic blood pressure ≥ 140/90 mmHg, fasting blood glucose ≥ 126 mg/dL, hemoglobin A1c ≥ 6.5%, total cholesterol ≥ 240 mg/dL, low-density lipoprotein cholesterol ≥ 160 mg/dL, high-density lipoprotein cholesterol < 40 mg/dL, body mass index ≥ 25.0 kg/m, currently smoking, and medical history of hypertension, diabetes, and hyperlipidemia. Study participants were stratified into tertiles according to their SPC levels (≤ 3.2, 3.3 - 3.6, and ≥ 3.7 mg/dL).
297 (18.2%) study participants had subclinical coronary atherosclerosis, characterized by any coronary plaque on CCTA. In multivariable regression analysis, the risk of subclinical coronary atherosclerosis increased in the second (odds ratio (OR): 1.629; 95% confidence interval (CI): 1.149 - 2.308; p = 0.006) and third (OR: 1.645; 95% CI: 1.093 - 2.476; p = 0.017) SPC tertiles compared to the first SPC tertile. In addition, the risk of calcified plaque increased in the second (OR: 1.605; 95% CI: 1.124 - 2.292; p = 0.009) and third (OR 1.790; 95% CI 1.179 - 2.716; p = 0.006) SPC tertiles.
In low-risk asymptomatic Korean individuals without kidney dysfunction, a higher SPC level was an independent predictor of subclinical coronary atherosclerosis.
目前，关于血清磷浓度（SPC）与无肾功能障碍的低危无症状人群亚临床冠状动脉粥样硬化之间的关联，数据有限。
我们回顾性分析了 1636 名韩国人（平均年龄 52.6±7.6 岁；男性 712 名[43.5%]），他们没有传统的心血管危险因素（CVRFs）和肾功能障碍，自愿接受冠状动脉计算机断层扫描血管造影（CCTA）作为一般健康检查的一部分。传统的 CVRFs 定义为：收缩压/舒张压≥140/90mmHg，空腹血糖≥126mg/dL，糖化血红蛋白≥6.5%，总胆固醇≥240mg/dL，低密度脂蛋白胆固醇≥160mg/dL，高密度脂蛋白胆固醇<40mg/dL，体重指数≥25.0kg/m，目前吸烟，以及高血压、糖尿病和高脂血症的病史。根据 SPC 水平（≤3.2、3.3-3.6 和≥3.7mg/dL）将研究参与者分为三组。
297 名（18.2%）研究参与者存在亚临床冠状动脉粥样硬化，表现为 CCTA 上存在任何冠状动脉斑块。多变量回归分析显示，与第一 SPC 三分位组相比，第二（比值比（OR）：1.629；95%置信区间（CI）：1.149-2.308；p=0.006）和第三（OR：1.645；95%CI：1.093-2.476；p=0.017）SPC 三分位组的亚临床冠状动脉粥样硬化风险增加。此外，第二（OR：1.605；95%CI：1.124-2.292；p=0.009）和第三（OR：1.790；95%CI：1.179-2.716；p=0.006）SPC 三分位组的钙化斑块风险增加。
在无肾功能障碍的低危无症状韩国人群中，较高的 SPC 水平是亚临床冠状动脉粥样硬化的独立预测因素。
