Serum phosphorus and subclinical coronary atherosclerosis in asymptomatic subjects without kidney dysfunction.

Abstract

There is limited data on the association between serum phosphorus concentration (SPC) and subclinical coronary atherosclerosis in low-risk asymptomatic subjects without kidney dysfunction. We retrospectively analyzed 1,636 Korean individuals (mean age 52.6±7.6 years; males: 712 (43.5%)) without traditional cardiovascular risk factors (CVRFs) and kidney dysfunction who voluntarily underwent coronary computed tomography angiography (CCTA) as part of a general health examination. Traditional CVRFs were defined as follows: systolic/diastolic blood pressure ≥140/90mmHg, fasting blood glucose ≥126mg/dL, hemoglobin A1c ≥6.5%, total cholesterol ≥240mg/dL, low-density lipoprotein cholesterol ≥160mg/dL, high-density lipoprotein cholesterol <40mg/dL, body mass index ≥25.0kg/m2, currently smoking, and medical history of hypertension, diabetes, and hyperlipidemia. Study participants were stratified into tertiles according to their SPC levels (≤3.2, 3.3-3.6, and ≥3.7mg/dL). 297 (18.2%) study participants had subclinical coronary atherosclerosis, characterized by any coronary plaque on CCTA. In multivariable regression analysis, the risk of subclinical coronary atherosclerosis increased in the second (odds ratio (OR): 1.629; 95% confidence interval (CI): 1.149-2.308; p=0.006) and third (OR: 1.645; 95% CI: 1.093-2.476; p=0.017) SPC tertiles compared to the first SPC tertile. In addition, the risk of calcified plaque increased in the second (OR: 1.605; 95% CI: 1.124-2.292; p=0.009) and third (OR 1.790; 95% CI 1.179-2.716; p=0.006) SPC tertiles. In low-risk asymptomatic Korean individuals without kidney dysfunction, a higher SPC level was an independent predictor of subclinical coronary atherosclerosis.