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Relation of Serum Phosphorus Levels to Ankle Brachial Pressure Index (from the Third National Health and Nutrition Examination Survey)
Higher levels of serum phosphorus that remain within the reference range are associated with increased risk of cardiovascular disease (CVD). However, the mechanisms by which higher serum phosphorus concentrations may contribute to the development of CVD remain unclear. Cross-sectional association be...
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Published in: | The American journal of cardiology 2010-08, Vol.106 (4), p.564-568 |
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description | Higher levels of serum phosphorus that remain within the reference range are associated with increased risk of cardiovascular disease (CVD). However, the mechanisms by which higher serum phosphorus concentrations may contribute to the development of CVD remain unclear. Cross-sectional association between serum phosphorus levels and arterial stiffness as estimated by an ankle brachial pressure index (ABPI) >1.3 was examined in 581 participants in the Third National Health and Nutrition Examination Survey. Logistic regression analysis was performed to evaluate whether higher serum phosphorus levels were associated with high ABPI, independently of several potential confounders. Of 581 participants, 38% and 10% had a serum phosphorus levels >3.5 and >4.0 mg/dl, respectively. An ABPI >1.3 was present in 7.3% of participants. Higher quartiles of serum phosphorus levels were associated with a greater prevalence of high ABPI: 5.4%, 3.7%, 7.8%, and 12.9% for quartiles 1 ( |
doi_str_mv | 10.1016/j.amjcard.2010.03.070 |
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However, the mechanisms by which higher serum phosphorus concentrations may contribute to the development of CVD remain unclear. Cross-sectional association between serum phosphorus levels and arterial stiffness as estimated by an ankle brachial pressure index (ABPI) >1.3 was examined in 581 participants in the Third National Health and Nutrition Examination Survey. Logistic regression analysis was performed to evaluate whether higher serum phosphorus levels were associated with high ABPI, independently of several potential confounders. Of 581 participants, 38% and 10% had a serum phosphorus levels >3.5 and >4.0 mg/dl, respectively. An ABPI >1.3 was present in 7.3% of participants. Higher quartiles of serum phosphorus levels were associated with a greater prevalence of high ABPI: 5.4%, 3.7%, 7.8%, and 12.9% for quartiles 1 (<3.1 mg/dl), 2 (3.1 to 3.4 mg/dl), 3 (3.4 to 3.7 mg/dl), and 4 (3.7 to 5.0 mg/dl), respectively. There was a strong, positive association between the highest quartile of serum phosphorus (3.7 to 5.0 mg/dl) and high ABPI compared to the reference group (3.1 to 3.4 mg/dl) after adjustment for demographics, traditional CVD risk factors, kidney function, C-reactive protein, serum calcium, and 25-hydroxyvitamin D levels (adjusted odds ratio 4.78, 95% confidence interval 1.73 to 13.2, p = 0.003). In conclusion, serum phosphorus levels, even within the reference range, are independently associated with high ABPI, a marker of arterial stiffness, in the US adult population.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2010.03.070</identifier><identifier>PMID: 20691317</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Adults ; Aged ; Ankle Brachial Index ; Biological and medical sciences ; Blood ; Cardiology. 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All rights reserved. 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c644t-a7e777a6da097c1962f4a2630747c34b0b925e833e59bb36d42d244ab4c00a543</citedby><cites>FETCH-LOGICAL-c644t-a7e777a6da097c1962f4a2630747c34b0b925e833e59bb36d42d244ab4c00a543</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23179273$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20691317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kendrick, Jessica, MD</creatorcontrib><creatorcontrib>Ix, Joachim H., MD</creatorcontrib><creatorcontrib>Targher, Giovanni, MD</creatorcontrib><creatorcontrib>Smits, Gerard, PhD</creatorcontrib><creatorcontrib>Chonchol, Michel, MD</creatorcontrib><title>Relation of Serum Phosphorus Levels to Ankle Brachial Pressure Index (from the Third National Health and Nutrition Examination Survey)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Higher levels of serum phosphorus that remain within the reference range are associated with increased risk of cardiovascular disease (CVD). However, the mechanisms by which higher serum phosphorus concentrations may contribute to the development of CVD remain unclear. Cross-sectional association between serum phosphorus levels and arterial stiffness as estimated by an ankle brachial pressure index (ABPI) >1.3 was examined in 581 participants in the Third National Health and Nutrition Examination Survey. Logistic regression analysis was performed to evaluate whether higher serum phosphorus levels were associated with high ABPI, independently of several potential confounders. Of 581 participants, 38% and 10% had a serum phosphorus levels >3.5 and >4.0 mg/dl, respectively. An ABPI >1.3 was present in 7.3% of participants. Higher quartiles of serum phosphorus levels were associated with a greater prevalence of high ABPI: 5.4%, 3.7%, 7.8%, and 12.9% for quartiles 1 (<3.1 mg/dl), 2 (3.1 to 3.4 mg/dl), 3 (3.4 to 3.7 mg/dl), and 4 (3.7 to 5.0 mg/dl), respectively. There was a strong, positive association between the highest quartile of serum phosphorus (3.7 to 5.0 mg/dl) and high ABPI compared to the reference group (3.1 to 3.4 mg/dl) after adjustment for demographics, traditional CVD risk factors, kidney function, C-reactive protein, serum calcium, and 25-hydroxyvitamin D levels (adjusted odds ratio 4.78, 95% confidence interval 1.73 to 13.2, p = 0.003). In conclusion, serum phosphorus levels, even within the reference range, are independently associated with high ABPI, a marker of arterial stiffness, in the US adult population.</description><subject>Adult</subject><subject>Adults</subject><subject>Aged</subject><subject>Ankle Brachial Index</subject><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular Diseases - blood</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Demographics</subject><subject>Female</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nutrition Surveys</subject><subject>Phosphorus</subject><subject>Phosphorus - blood</subject><subject>Regression analysis</subject><subject>Risk factors</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNqFks9u1DAQxiMEoqXwCCALCQGHXezYieNLUakKrbSCii1ny3EmxFvHXuxk1X0BnhvvHxbohZPt8c_fzPibLHtO8JRgUr5bTFW_0Co00xynGKZTzPGD7JhUXEyIIPRhdowxzieCMHGUPYlxkY6EFOXj7CjHZSIIP85-fgWrBuMd8i2aQxh7dN35uOx8GCOawQpsRINHZ-7WAvoQlO6Msug6QIxjAHTlGrhDb9rgezR0gG46Exr0eSuZuEtQduiQcik2DsFsM13cqd64Xdb5GFawfvs0e9QqG-HZfj3Jvn28uDm_nMy-fLo6P5tNdMnYMFEcOOeqbBQWXBNR5i1TeUkxZ1xTVuNa5AVUlEIh6pqWDcubnDFVM42xKhg9yU53usux7qHR4IagrFwG06uwll4Z-e-NM5387lcyF4wWnCaB13uB4H-MEAfZm6jBWuXAj1FyVomiqihO5Mt75MKPIX3KBqJVhSkuElTsIB18jAHaQykEy43PciH3PsuNzxJTmXxO71783cfh1W9jE_BqD6iolW2DctrEP1xiRL7t5_2OSz7DykCQURtwGhoTQA-y8ea_pZzeU9DWOJOS3sIa4qFpImMusZxvhnIzkyRtqpIW9BebKN7B</recordid><startdate>20100815</startdate><enddate>20100815</enddate><creator>Kendrick, Jessica, MD</creator><creator>Ix, Joachim H., MD</creator><creator>Targher, Giovanni, MD</creator><creator>Smits, Gerard, PhD</creator><creator>Chonchol, Michel, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100815</creationdate><title>Relation of Serum Phosphorus Levels to Ankle Brachial Pressure Index (from the Third National Health and Nutrition Examination Survey)</title><author>Kendrick, Jessica, MD ; Ix, Joachim H., MD ; Targher, Giovanni, MD ; Smits, Gerard, PhD ; Chonchol, Michel, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c644t-a7e777a6da097c1962f4a2630747c34b0b925e833e59bb36d42d244ab4c00a543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Aged</topic><topic>Ankle Brachial Index</topic><topic>Biological and medical sciences</topic><topic>Blood</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Demographics</topic><topic>Female</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nutrition Surveys</topic><topic>Phosphorus</topic><topic>Phosphorus - blood</topic><topic>Regression analysis</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kendrick, Jessica, MD</creatorcontrib><creatorcontrib>Ix, Joachim H., MD</creatorcontrib><creatorcontrib>Targher, Giovanni, MD</creatorcontrib><creatorcontrib>Smits, Gerard, PhD</creatorcontrib><creatorcontrib>Chonchol, Michel, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kendrick, Jessica, MD</au><au>Ix, Joachim H., MD</au><au>Targher, Giovanni, MD</au><au>Smits, Gerard, PhD</au><au>Chonchol, Michel, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relation of Serum Phosphorus Levels to Ankle Brachial Pressure Index (from the Third National Health and Nutrition Examination Survey)</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2010-08-15</date><risdate>2010</risdate><volume>106</volume><issue>4</issue><spage>564</spage><epage>568</epage><pages>564-568</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Higher levels of serum phosphorus that remain within the reference range are associated with increased risk of cardiovascular disease (CVD). However, the mechanisms by which higher serum phosphorus concentrations may contribute to the development of CVD remain unclear. Cross-sectional association between serum phosphorus levels and arterial stiffness as estimated by an ankle brachial pressure index (ABPI) >1.3 was examined in 581 participants in the Third National Health and Nutrition Examination Survey. Logistic regression analysis was performed to evaluate whether higher serum phosphorus levels were associated with high ABPI, independently of several potential confounders. Of 581 participants, 38% and 10% had a serum phosphorus levels >3.5 and >4.0 mg/dl, respectively. An ABPI >1.3 was present in 7.3% of participants. Higher quartiles of serum phosphorus levels were associated with a greater prevalence of high ABPI: 5.4%, 3.7%, 7.8%, and 12.9% for quartiles 1 (<3.1 mg/dl), 2 (3.1 to 3.4 mg/dl), 3 (3.4 to 3.7 mg/dl), and 4 (3.7 to 5.0 mg/dl), respectively. There was a strong, positive association between the highest quartile of serum phosphorus (3.7 to 5.0 mg/dl) and high ABPI compared to the reference group (3.1 to 3.4 mg/dl) after adjustment for demographics, traditional CVD risk factors, kidney function, C-reactive protein, serum calcium, and 25-hydroxyvitamin D levels (adjusted odds ratio 4.78, 95% confidence interval 1.73 to 13.2, p = 0.003). In conclusion, serum phosphorus levels, even within the reference range, are independently associated with high ABPI, a marker of arterial stiffness, in the US adult population.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20691317</pmid><doi>10.1016/j.amjcard.2010.03.070</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Adults Aged Ankle Brachial Index Biological and medical sciences Blood Cardiology. Vascular system Cardiovascular Cardiovascular disease Cardiovascular Diseases - blood Cardiovascular Diseases - diagnosis Demographics Female Humans Logistic Models Male Medical sciences Middle Aged Nutrition Surveys Phosphorus Phosphorus - blood Regression analysis Risk factors |
title | Relation of Serum Phosphorus Levels to Ankle Brachial Pressure Index (from the Third National Health and Nutrition Examination Survey) |
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