Sex-Specific Associations Between Serum Phosphate Concentration and Cardiometabolic Disease: A Cohort Study on the Community-Based Older Chinese Population

Abstract

Purpose

This study aimed to investigate the association between sex-specific baseline serum phosphate and the incidence of new-onset cardiometabolic disease in a cohort of Shanghai-based older Chinese individuals.

Patients and Methods

A community cohort of 5000 disease-free Chinese men and women was recruited in 2013 and followed until 2017 for the development of cardiometabolic disease. Participants underwent index and follow-up health screens at the Tongji Medical School affiliated Shanghai East Hospital, including blood biochemistry analysis, anthropometric measurements, interview on health-related behaviors, and clinical evaluation.

Results

Higher baseline serum phosphate (>1.25 mmol/L) was significantly associated with new-onset type-2 diabetes mellitus (HR 1.730, 95% CI 1.127–2.655) and metabolic syndrome (HR 0.640, 95% CI 1.085–2.155) in women. Baseline serum phosphate was associated with age, BMI, waist circumference, SBP, total calcium, bicarbonate, and total cholesterol in women. The estimated risk of developing diabetes mellitus in women with inorganic phosphate >1.25 mmol/L was 14.54%. Inorganic phosphate accounted for 9.2% of the variance explained in a total estimated 14.52% of variance attributed to BMI, total cholesterol, total calcium, waist circumference, and inorganic phosphate.

Conclusion

Serum phosphate concentration showed sex-specific associations with diabetes and metabolic syndrome. Higher inorganic phosphate was associated with increased risk of developing diabetes mellitus in women. These findings may be important in the assessment of individualized metabolic risk.

Keywords:

• inorganic phosphate
• diabetes mellitus
• metabolic syndrome
• older women
• cohort study

Disclosure

Qin Lan and Yuming Zhang are co-first authors for this study. The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by National Nature Science Foundation of China (81670458, 81470393, and 81370434), Shanghai Three year plan on promoting TCM development (ZY(2018-2020)-FWTX-2007), Key Discipline of the Health Industry Project of Pudong Health Bureau of Shanghai (PWZxk2017-01), Three year plan of Pudong Health Bureau of Shanghai (PWYgf2018-05), Three-year plan on TCM of Pudong Health Bureau of Shanghai (PDZY-2018-0603), The National Key Research and Development Program of China (2017YFA0105600), The Science and Technology Commission of Shanghai Municipality(17431906600),The Health Industry Project of Pudong Health Bureau of Shanghai (no. PW2013E-1).