Serum Phosphate Is Related With Fracture Danger: The Rotterdam Examine and MrOS.
J Bone Miner Res. 2017 Jun;32(6):1182-1193
Authors: Campos-Obando N, Koek WNH, Hooker ER, van der Eerden BC, Pols HA, Hofman A, van Leeuwen JP, Uitterlinden AG, Nielson CM, Zillikens MC
Excessive phosphate ranges (P) have been related to mineralization defects and elevated fracture danger. Whether or not P inside regular vary is said to bone well being within the common inhabitants isn’t effectively understood. To analyze the affiliation of P with bone mineral density (BMD) and fracture danger, we assessed two population-based cohorts: the Dutch Rotterdam Examine (RS-I, RS-II, RS-III; n?=?6791) and the US Osteoporotic Fractures in Males (MrOS; n?=?5425) examine. The connection of P with lumbar backbone (LS) and femoral neck (FN) BMD was examined in all cohorts by way of linear fashions; fracture danger was examined in RS-I, RS-II, and MrOS by Cox fashions, after follow-up of eight.6, 6.6, and 10.9 years, respectively. Changes had been made for age, physique mass index, smoking, serum ranges of calcium, potassium, 25-hydroxyvitamin D, estimated glomerular filtration fee (eGFR), FN-BMD, prevalent diabetes, and heart problems. Extra changes had been made for phosphate consumption, parathyroid hormone, and fibroblast development issue 23 ranges in MrOS. We additional stratified by eGFR. Outcomes had been pooled by study-level meta-analyses. Hazard ratios (HR) and betas (?) (from meta-analyses) are expressed per 1?mg/dL P enhance. P was positively related to fracture danger in women and men from RS, and findings had been replicated in MrOS (pooled HR all [95% CI]: 1.47 [1.31-1.65]). P was related to fracture danger in topics with out continual kidney illness (CKD): all (1.44 [1.26-1.63]) and in males with CKD (1.93 [1.42-2.62]). P was inversely associated to LS-BMD in males (?: -Zero.06 [-0.11 to -0.02]) and to not FN-BMD in both intercourse. In abstract, serum P was positively associated to fracture danger independently from BMD and phosphate consumption after changes for potential confounders. P and LS-BMD had been negatively associated in males. Our findings recommend that elevated P ranges even inside regular vary may be deleterious for bone well being within the regular inhabitants. © 2017 American Society for Bone and Mineral Analysis.
PMID: 28177140 [PubMed – indexed for MEDLINE]