title: Hyperphosphatemia is associated with anemia in adults without chronic kidney disease: results from the National Health and Nutrition Examination Survey (NHANES): 2005-2010.
abstract: BACKGROUND
  Hyperphosphatemia, serum phosphorus ≥ 4.4 mg/dL, is associated with increased risk for chronic kidney disease and cardiovascular disease. Previous studies have shown a weak association between dietary phosphorus intake and serum phosphorus concentrations. While much less common in the general population, hypophosphatemia (< 2.5 mg/dL) may be associated with metabolic syndrome and obesity.
  
  
  METHODS
  Using three cycles from the National Health and Nutrition Examination Survey (NHANES) (2005-2010), this study evaluated independent risk factors for hyperphosphatemia and hypophosphatemia.
  
  
  RESULTS
  Risk factors for hyperphosphatemia included higher adjusted calcium (OR 2.90, 95% CI 2.43-3.45), increasing cholesterol (OR 1.003, 95% CI 1.001-1.005), female gender (OR 1.61, 95% CI 1.39-1.87) and low hemoglobin (OR 1.52, 95% CI 1.17-1.98). Advanced age was protective (OR 0.98, 95% CI 0.977-0.987). Models that included fasting serum glucose found lower body mass index (BMI) to be protective (OR 0.97, 95% CI 0.96-0.99) and adjusting for serum vitamin D and parathyroid hormone removed the association with low hemoglobin and BMI. Risk factors for hypophosphatemia included the following protective factors: higher albumin (OR 0.56, 95% CI 0.35-0.93), higher BUN (OR 0.90, 95% CI 0.86, 0.95), corrected calcium (OR 0.38, 95% CI 0.23-0.63) and female gender (OR 0.47, 95% 0.24-0.94). In men, higher fasting glucose levels increased risk (OR 1.01, 95% CI 1.0004-1.01).
  
  
  CONCLUSIONS
  This study is the first to show an association between low hemoglobin levels and increased risk for hyperphosphatemia among individuals without chronic kidney disease. We did not find any association between diabetes mellitus, increasing BMI or fasting glucose levels and hypophosphatemia.
authors: Department of Pediatrics, University of California, San Francisco, CA 94134-0136, USA. wojcickij@peds.ucsf.edu
authors: Janet M
authors: JM
authors: Wojcicki
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D015984:Causality; D015897:Comorbidity; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D054559:Hyperphosphatemia / Q000097:blood* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology*; D010758:Phosphorus / Q000097:blood*; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000453:epidemiology*; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010758:Phosphorus
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