Serum Phosphorus Concentrations in the Third National Health and Nutrition Examination Survey (NHANES III)
Received 31 March 2008; accepted 22 July 2008. published online 07 November 2008.
Refers to article:
The Ubiquitous Nature and Elusive Role of Phosphorus and Vascular Calcification
Jordi Goldstein-Fuchs, Denis Fouque
American Journal of Kidney Diseases
March 2009 (Vol. 53, Issue 3, Pages 363-365) Full Text |
Full-Text PDF (159 KB)
Background
Higher serum phosphorus concentrations within the normal laboratory range have been associated with cardiovascular events and mortality in large prospective cohort studies of individuals with and without kidney disease. Reasons for interindividual variation in steady-state serum phosphorus concentrations are largely unknown.
Study Design
Cross-sectional study.
Setting & Participants
15,513 participants in the Third National Health and Nutrition Examination Survey.
Predictors
Demographic data, dietary intake measured by means of 24-hour dietary recall and food-frequency questionnaire, and established cardiovascular risk factors.
Outcome & Measurements
Serum phosphorus concentration.
Results
Mean serum phosphorus concentrations were significantly greater in women (+0.16 mg/dL versus men; P < 0.001) and people of non-Hispanic black and Hispanic race/ethnicity (+0.06 and +0.07 mg/dL versus non-Hispanic white, respectively; P < 0.001). Dietary intakes of phosphorus and phosphorus-rich foods were associated only weakly with circulating serum phosphorus concentrations, if at all. Higher serum phosphorus levels were associated with lower calculated Framingham coronary heart disease risk scores, which are based on traditional atherosclerosis risk factors. In aggregate, demographic, nutritional, cardiovascular, and kidney function variables explained only 12% of the variation in circulating serum phosphorus concentrations.
Limitations
Results may differ with advanced kidney disease.
Conclusions
Serum phosphorus concentration is weakly related to dietary phosphorus and not related to a diverse array of phosphorus-rich foods in the general population. Factors determining serum phosphorus concentration are largely unknown. Previously observed associations of serum phosphorus concentrations with cardiovascular events are unlikely to be a result of differences in dietary intake or traditional cardiovascular risk factors.
1Division of Nephrology, University of Washington, Seattle, WA
2Department of Biostatistics, University of Washington, Seattle, WA
3Division of Nephrology, Harborview Medical Center, University of Washington, Seattle, WA
Address correspondence to Bryan Kestenbaum, MD, MS, University of Washington, Division of Nephrology, Harborview Medical Center, Rm 10EH11, Box 359764, Seattle, WA 98104-2499
ABSTRACT