TY - JOUR
T1 - Effects of sex and postmenopausal estrogen use on serum phosphorus levels
T2 - A cross-sectional study of the national health and nutrition examination survey (NHANES) 2003-2006
AU - Zhang, Dihua
AU - Maalouf, Naim M.
AU - Adams-Huet, Beverley
AU - Moe, Orson W.
AU - Sakhaee, Khashayar
PY - 2014/2
Y1 - 2014/2
N2 - Background Elevation of serum phosphorus concentrations has been associated with cardiovascular events in older women and men. Whether age, sex, or estrogen therapy is associated with different phosphorus levels is unknown. Study Design Cross-sectional study. Setting & Participants 7,005 participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006. Predictors Demographic data; body measurement indexes; dietary intake by 24-hour dietary recall and food-frequency questionnaire; data for reproductive health, prescription medication, cardiovascular disease, osteoporosis, and diabetes mellitus obtained by questionnaire; and blood chemistry indexes. Outcomes & Measurements Serum phosphorus concentrations. Results In both males and premenopausal females, serum phosphorus levels decline progressively with age. In males, the decline continues over the entire age range of 21-85 years. In contrast, in females, serum phosphorus levels increase between ages 46-60 years (sex × age interaction; P < 0.001). The increase in serum phosphorus levels in older women is independent of changes in serum parathyroid hormone levels, daily dietary phosphorus intake, and estimated glomerular filtration rate. In analysis of covariance, we show that postmenopausal women receiving estrogen therapy have significantly lower serum phosphorus levels than non-estrogen users after adjusting for age, race, body mass index, daily dietary phosphorus intake, and serum albumin, serum parathyroid hormone, and 25-hydroxyvitamin D levels (3.83 vs 3.98 mg/dL; P < 0.001). Limitations The study was cross-sectional in design and estrogen therapy was not randomly assigned or concealed. Important phosphorus regulatory factors such as serum fibroblast growth factor 23 and klotho were not available in the study. Conclusions Estrogen status may account for the difference in serum phosphorus levels in postmenopausal women.
AB - Background Elevation of serum phosphorus concentrations has been associated with cardiovascular events in older women and men. Whether age, sex, or estrogen therapy is associated with different phosphorus levels is unknown. Study Design Cross-sectional study. Setting & Participants 7,005 participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006. Predictors Demographic data; body measurement indexes; dietary intake by 24-hour dietary recall and food-frequency questionnaire; data for reproductive health, prescription medication, cardiovascular disease, osteoporosis, and diabetes mellitus obtained by questionnaire; and blood chemistry indexes. Outcomes & Measurements Serum phosphorus concentrations. Results In both males and premenopausal females, serum phosphorus levels decline progressively with age. In males, the decline continues over the entire age range of 21-85 years. In contrast, in females, serum phosphorus levels increase between ages 46-60 years (sex × age interaction; P < 0.001). The increase in serum phosphorus levels in older women is independent of changes in serum parathyroid hormone levels, daily dietary phosphorus intake, and estimated glomerular filtration rate. In analysis of covariance, we show that postmenopausal women receiving estrogen therapy have significantly lower serum phosphorus levels than non-estrogen users after adjusting for age, race, body mass index, daily dietary phosphorus intake, and serum albumin, serum parathyroid hormone, and 25-hydroxyvitamin D levels (3.83 vs 3.98 mg/dL; P < 0.001). Limitations The study was cross-sectional in design and estrogen therapy was not randomly assigned or concealed. Important phosphorus regulatory factors such as serum fibroblast growth factor 23 and klotho were not available in the study. Conclusions Estrogen status may account for the difference in serum phosphorus levels in postmenopausal women.
KW - Serum phosphorus
KW - cardiovascular disease
KW - estrogen
KW - gender heterogeneity
KW - menopause
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U2 - 10.1053/j.ajkd.2013.07.012
DO - 10.1053/j.ajkd.2013.07.012
M3 - Article
C2 - 24051078
AN - SCOPUS:84892926966
SN - 0272-6386
VL - 63
SP - 198
EP - 205
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 2
ER -