Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Sci Rep. 2023 May 23;13(1):8310. doi: 10.1038/s41598-023-34800-w.
Sex differences in serum phosphate and calcium have been reported but the exact nature and underlying regulatory mechanisms remain unclear. We aimed to compare calcium and phosphate concentrations between sexes, and explore potential covariates to elucidate underlying mechanisms of sex differences in a prospective, population-based cohort study. Pooled data of subjects > 45 years from three independent cohorts of the Rotterdam Study (RS) were used: RS-I-3 (n = 3623), RS-II-1 (n = 2394), RS-III-1 (n = 3241), with separate analyses from an additional time point of the first cohort RS-I-1 (n = 2688). Compared to men, women had significantly higher total serum calcium and phosphate concentrations which was not explained by BMI, kidney function nor smoking. Adjustment for serum estradiol diminished sex differences in serum calcium while adjustment for serum testosterone diminished sex differences in serum phosphate. Adjustment for vitamin D and alkaline phosphatase did not change the association between sex and calcium or phosphate in RS-I-1. In the sex-combined group, both serum calcium and phosphate decreased with age with a significant interaction for sex differences for serum calcium but not phosphate. In sex-stratified analyses, serum estradiol but not testosterone was inversely associated with serum calcium in both sexes. Serum estradiol was inversely associated with serum phosphate in both sexes to a similar degree, while serum testosterone was inversely associated with serum phosphate in both sexes with an apparent stronger effect in men than in women. Premenopausal women had lower serum phosphate compared to postmenopausal women. Serum testosterone was inversely associated with serum phosphate in postmenopausal women only. In conclusion, women > 45 years have higher serum calcium and phosphate concentrations compared to men of similar age, not explained by vitamin D or alkaline phosphatase concentrations. Serum estradiol but not testosterone was inversely associated with serum calcium while serum testosterone was inversely associated with serum phosphate in both sexes. Serum testosterone may in part explain sex differences in serum phosphate while estradiol could partly explain sex differences in serum calcium.
血清磷酸盐和钙的性别差异已被报道，但确切性质和潜在的调节机制仍不清楚。我们旨在比较男女之间的钙和磷浓度，并探讨潜在的协变量，以阐明在一项前瞻性、基于人群的队列研究中性别差异的潜在机制。使用来自鹿特丹研究（RS）三个独立队列的>45 岁受试者的汇总数据：RS-I-3（n=3623）、RS-II-1（n=2394）、RS-III-1（n=3241），并对第一队列 RS-I-1 的另一个时间点进行单独分析（n=2688）。与男性相比，女性的总血清钙和磷浓度明显更高，这不能用 BMI、肾功能或吸烟来解释。调整血清雌二醇可降低血清钙的性别差异，而调整血清睾酮可降低血清磷的性别差异。调整维生素 D 和碱性磷酸酶不会改变 RS-I-1 中性别与钙或磷之间的关联。在男女混合组中，血清钙和磷随年龄增长而降低，血清钙的性别差异有显著交互作用，但血清磷没有。在性别分层分析中，血清雌二醇但不是睾酮与两性的血清钙呈负相关。血清雌二醇与两性的血清磷呈负相关，程度相似，而血清睾酮与两性的血清磷呈负相关，且在男性中的作用明显强于女性。绝经前妇女的血清磷比绝经后妇女低。只有绝经后妇女的血清睾酮与血清磷呈负相关。总之，>45 岁的女性与年龄相似的男性相比，血清钙和磷浓度更高，这不能用维生素 D 或碱性磷酸酶浓度来解释。血清雌二醇但不是睾酮与血清钙呈负相关，而血清睾酮与两性的血清磷呈负相关。血清睾酮可能部分解释了血清磷的性别差异，而雌二醇可能部分解释了血清钙的性别差异。
