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根据登载于11月5日美国肾脏学会期刊中的研究报告，高血磷值的年轻健康成人，其冠状动脉钙值比较可能增加。
明尼苏达大学、美国肾脏资料系统、心血管特殊研究中心的Robert N. Foley写道，动物实验与末期慢性肾脏病的人类研究皆显示，磷值与粥状动脉硬化有关，但是对于肾功能正常者是否也有此一关系则不清楚。本研究目标在确认磷值和冠状动脉钙值之间是否有关联，研究对象是社区基础的3015名健康年轻成人，属于前溯式“年轻成人的冠状动脉发生风险(Coronary Artery Risk Development in Young Adults,CARDIA)”研究。
参与者接受基础磷值测量，且在15年后以电脑断层评估冠状动脉钙值；研究开始时，平均年纪为25.2岁，平均磷值为3.6 mg/dL，平均钙值为9.5 mg/dL；只有0.2% 参与者的估计肾丝球过滤速率小于60 mL/min每1.73 m2 。
在未校正模式中，磷值与冠状动脉钙值有关，在多变项模式中，磷值与冠状动脉钙值程度有显著关系。
研究限制包括非实验式设计，无法确认磷值和冠状钙化之间的关系是否为真，或者是残余共同发现现象；无法确认基因和环境因素的相关影响；缺乏甲状腺荷尔蒙与维他命D资料；样本数有限，有些研究样本经过挑选。
研究作者写道，较高的血清磷值，即使在正常范围内，也可能是健康年轻成人冠状动脉粥状硬化的风险因素。除了基本决定因素之外，研究中发现的关联认为，高磷值也许有助于辨识那些具有可调控风险的年轻成人，可以更积极筛检和处置。
国家糖尿病与消化和肾脏病研究中心、国家健康研究中心资助本研究。作者中有3人与Amgen和/或Genzyme有各种的财经关系。
J Am Soc Nephrol. 线上登载于2008年11月5日。
Higher Blood Phosphorus Levels May Predict Increased Calcium Levels in Coronary Arteries
By Laurie Barclay, MD
Medscape Medical News
Young healthy adults with higher levels of phosphorus in the blood are more likely to have increased levels of calcium in the coronary arteries, according to the results of a study reported in the November 5 issue of the Journal of the American Society of Nephrology.
“Phosphorus levels correlate with atherosclerosis in both animal models and humans with advanced chronic kidney disease, but whether this relationship exists among individuals with normal kidney function is unknown,” write Robert N. Foley, from the Cardiovascular Special Studies Center, United States Renal Data System, and the University of Minnesota in Minneapolis, and colleagues. “This study aimed to determine whether an association exists between phosphorus levels and coronary artery calcium levels in a community-based cohort of 3015 healthy young adults in the prospective Coronary Artery Risk Development in Young Adults (CARDIA) study.”
Participants underwent baseline measurement of phosphorus levels and computed tomography 15 years later to evaluate the presence of coronary artery calcium. At study entry, mean age was 25.2 years; mean phosphorus level was 3.6 mg/dL, and mean calcium level was 9.5 mg/dL. Estimated glomerular filtration rate was less than 60 mL/min per 1.73 m2 in only 0.2% of participants.
In unadjusted models, phosphorus levels were associated with coronary artery calcium, and in multivariate models, phosphorus levels were significantly associated with the category of coronary artery calcium level.
Study limitations include nonexperimental design preventing determination of whether the association between phosphorus levels and coronary calcification is a true phenomenon or of the magnitude of residual confounding; inability to determine the relative contributions of genetic and environmental factors to the associations; lack of data on parathyroid hormone and vitamin D levels; limited sample size; and somewhat self-selected study sample.
“Higher serum phosphorus levels, even within the normal range, may be a risk factor for coronary artery atherosclerosis in healthy young adults,” the study authors write. “Quite apart from the underlying determinants, the associations seen in this study suggest that high phosphorus levels might help to identify young adults for whom modifiable risk factors might be screened and managed more aggressively.”
The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, funded this study. Three of the authors report various financial arrangements with Amgen and/or Genzyme.
J Am Soc Nephrol. Published online November 5, 2008.