Barbarossa Luca, Zandonà Martina, Garo Maria Luisa, Mjahed Ribal Bou, D'Amelio Patrizia
Geriatric Service, Clinica Luganese di Moncucco, 6900 Lugano, Switzerland.
Family Medicine Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland.
Nutrients. 2025 Apr 16;17(8):1354. doi: 10.3390/nu17081354.
Phosphorus plays a fundamental role in cellular and extracellular metabolism, contributing to nucleic acid synthesis, enzymatic activity, neurologic function, and skeletal mineralization. Despite its significance, non-severe hypophosphatemia (HP) remains largely asymptomatic and underdiagnosed, with limited data on its prevalence in the general population. Most studies focus on specific subgroups, such as critically ill or dialysis patients, while the impact of mild HP in older adults, a potentially vulnerable demographic, is not well understood. The objective of this systematic review is to investigate the prevalence and clinical implications of non-severe HP in older adults. The study followed PRISMA guidelines to assess HP in patients aged ≥ 65 years without critical illnesses or genetic disorders. A systematic search was conducted in PubMed, Web of Science, and Scopus (March 2024). Eligible studies included RCTs and prospective/retrospective studies, excluding cancer-related studies or insufficient phosphate data. We identified 1350 articles, with 26 meeting eligibility criteria. Ultimately, eight studies involving 26,548 patients were included, with an HP prevalence of 12.5%. Studies reveal a higher prevalence of HP in frail individuals, particularly those with increased frailty scores, and an association between HP and cognitive decline, depressed mood, falls, and chronic comorbidities. HP was also prevalent in infectious diseases, especially bacterial pneumonia, with longer hospital stays and increased mortality rates. Malnutrition was significantly more common in HP patients, characterized by weight loss and poor nutritional status. Furthermore, HP increased fall risk during hospitalization and worsened outcomes after coronary artery bypass graft surgery, including higher mortality and graft failure rates, underscoring its clinical importance. This review identified that non-severe hypophosphatemia (HP) is associated with conditions such as frailty, cognitive decline, and an increased risk of falls. The evidence suggests that low phosphate levels may negatively impact health, increasing mortality and the risk of adverse clinical outcomes. Despite limitations in diagnostic criteria and sample variability, the findings indicate that HP can be a useful marker for identifying patients at risk of health deterioration. Further research is needed to clearly define the management and treatment of HP in this vulnerable population.
磷在细胞内和细胞外代谢中起着至关重要的作用,有助于核酸合成、酶活性、神经功能和骨骼矿化。尽管其意义重大,但非严重低磷血症(HP)在很大程度上仍无症状且未得到充分诊断,关于其在普通人群中的患病率的数据有限。大多数研究集中在特定亚组,如重症患者或透析患者,而轻度HP对老年人这一潜在脆弱人群的影响尚未得到充分了解。本系统评价的目的是调查老年人中非严重HP的患病率及其临床意义。该研究遵循PRISMA指南,对年龄≥65岁、无危重症或遗传疾病的患者进行HP评估。于2024年3月在PubMed、科学网和Scopus上进行了系统检索。符合条件的研究包括随机对照试验以及前瞻性/回顾性研究,不包括癌症相关研究或磷酸盐数据不足的研究。我们共识别出1350篇文章,其中26篇符合纳入标准。最终,纳入了8项涉及26548名患者的研究,HP患病率为12.5%。研究表明,虚弱个体中HP的患病率更高,尤其是那些虚弱评分增加的个体,并且HP与认知能力下降、情绪低落、跌倒和慢性合并症之间存在关联。HP在传染病中也很普遍,尤其是细菌性肺炎,患者住院时间更长,死亡率更高。营养不良在HP患者中明显更为常见,其特征为体重减轻和营养状况不佳。此外,HP增加了住院期间的跌倒风险,并使冠状动脉搭桥手术后的结局恶化,包括更高的死亡率和移植失败率,突出了其临床重要性。本综述发现,非严重低磷血症(HP)与虚弱、认知能力下降和跌倒风险增加等情况有关。证据表明,低磷水平可能对健康产生负面影响,增加死亡率和不良临床结局的风险。尽管诊断标准和样本变异性存在局限性,但研究结果表明,HP可以作为识别健康状况恶化风险患者的有用指标。需要进一步研究以明确该脆弱人群中HP的管理和治疗方法。