Serum phosphorus levels and the spectrum of ankle-brachial index in older men: the Osteoporotic Fractures in Men (MrOS) study.
A higher serum phosphorus level is associated with cardiovascular disease (CVD) events among community-living populations. Mechanisms are unknown. The ankle-brachial index (ABI) provides information on both atherosclerosis and arterial stiffness. In this cross-sectional study (2000-2002), the authors evaluated the association of serum phosphorus levels with low (<0.90) and high (> or =1.40 or incompressible) ABI as compared with intermediate ABI in 5,330 older US men, among whom the mean serum phosphorus level was 3.2 mg/dL (standard deviation, 0.4), 6% had a low ABI, and 5% had a high ABI. Each 1-mg/dL increase in serum phosphorus level was associated with a 1.6-fold greater prevalence of low ABI (95% confidence interval (CI): 1.2, 2.1; P < 0.001) and a 1.4-fold greater prevalence of high ABI (95% CI: 1.0, 1.9; P = 0.03) in models adjusted for demographic factors, traditional CVD risk factors, and kidney function. However, the association of phosphorus with high ABI differed by chronic kidney disease (CKD) status (in persons with CKD, prevalence ratio = 2.96, 95% CI: 1.61, 5.45; in persons without CKD, prevalence ratio = 1.14, 95% CI: 0.81, 1.61; interaction P = 0.04). In conclusion, among community-living older men, higher phosphorus levels are associated with low ABI and are also associated with high ABI in persons with CKD. These associations may explain the link between serum phosphorus levels and CVD events.
Division of Nephrology, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California, USA.
Jerry
J
Meng
Christina L
CL
Wassel
Bryan R
BR
Kestenbaum
Tracie C
TC
Collins
Michael H
MH
Criqui
Cora E
CE
Lewis
Steve R
SR
Cummings
Joachim H
JH
Ix
D000368:Aged; D000704:Analysis of Variance; D055109:Ankle Brachial Index; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D050723:Fractures, Bone / Q000150:complications / Q000453:epidemiology; D006801:Humans; D054559:Hyperphosphatemia / Q000097:blood / Q000150:complications / Q000453:epidemiology; D017674:Hypophosphatemia / Q000097:blood / Q000150:complications / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008571:Men; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D010758:Phosphorus / Q000097:blood*; D015995:Prevalence; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D010758:Phosphorus