Serum phosphate and left ventricular hypertrophy in young adults: the coronary artery risk development in young adults study.
OBJECTIVE
A relationship with vascular dysfunction in chronic kidney disease suggests a possible association of phosphate level with left ventricular hypertrophy development in people with normal kidney function. We aimed to determine whether such an association exists in community-dwelling young adults.


METHODS
This is a cohort study of participants in the ongoing, community-based, prospective Coronary Artery Risk Development in Young Adults study (n = 4,055). Phosphate levels were measured at year 0, and left ventricular hypertrophy assessed by echocardiography at year 5.


RESULTS
The mean age was 25.0 years. Mean values were: estimated glomerular filtration rate 118.5 ml/min/1.73 m(2); phosphate 3.7 mg/dl; left ventricular mass indexed to body surface area 80.5 g/m(2), and indexed to height(2.7) 35.2 g/m(2.7). Left ventricular hypertrophy was present in 4.5% of the population. As a continuous variable, the phosphate level was associated with left ventricular hypertrophy (odds ratio per standard deviation 1.27; 95% confidence interval 1.09-1.47; p = 0.0020). This association persisted after covariate adjustment (odds ratio per standard deviation 1.30; 95% confidence interval 1.10-1.54; p = 0.0018), and was most pronounced for fifth quintile phosphate levels (>4.0 mg/dl).


CONCLUSIONS
Phosphate level may be a risk factor for left ventricular hypertrophy in community-dwelling young adults. As phosphate levels may be modifiable, the causality of this association can be addressed with controlled trials.
Foley
Robert N
RN
United States Renal Data System, Minneapolis, Minn 55404, USA. rfoley@usrds.org
Collins
Allan J
AJ
Herzog
Charles A
CA
Ishani
Areef
A
Kalra
Philip A
PA
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology*; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D010710:Phosphates / Q000097:blood*; D011446:Prospective Studies; D012306:Risk; D055815:Young Adult
D010710:Phosphates