Serum Phosphorus Levels and the Spectrum of Ankle-Brachial Index in Older Men: The Osteoporotic Fractures in Men (MrOS) Study

摘要

A higher serum phosphorus level is associated with cardiovascular disease (CVD) events among community-nliving populations. Mechanisms are unknown. The ankle-brachial index (ABI) provides information on both ath-nerosclerosis and arterial stiffness. In this cross-sectional study (2000–2002), the authors evaluated the associationnof serum phosphorus levels with low (<0.90) and high (u00011.40 or incompressible) ABI as compared with interme-ndiate ABI in 5,330 older US men, among whom the mean serum phosphorus level was 3.2 mg/dL (standardndeviation, 0.4), 6% had a low ABI, and 5% had a high ABI. Each 1-mg/dL increase in serum phosphorus levelnwas associated with a 1.6-fold greater prevalence of low ABI (95%confidence interval (CI): 1.2, 2.1; P < 0.001) andna 1.4-fold greater prevalence of high ABI (95% CI: 1.0, 1.9; P ¼ 0.03) in models adjusted for demographic factors,ntraditional CVD risk factors, and kidney function. However, the association of phosphorus with high ABI differed bynchronic kidney disease (CKD) status (in persons with CKD, prevalence ratio ¼ 2.96, 95% CI: 1.61, 5.45; in personsnwithout CKD, prevalence ratio ¼ 1.14, 95% CI: 0.81, 1.61; interaction P ¼ 0.04). In conclusion, among community-nliving older men, higher phosphorus levels are associated with low ABI and are also associated with high ABI innpersons with CKD. These associations may explain the link between serum phosphorus levels and CVD events.