Investigation of Gender Heterogeneity in the Associations of Serum Phosphorus With Incident Coronary Artery Disease and All-Cause Mortality
Investigation of Gender Heterogeneity in the Associations of Serum Phosphorus With Incident Coronary Artery Disease and All-Cause Mortality
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DOI：
10.1093/aje/kwn285
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发表时间：
2009-01-01
影响因子：
5
通讯作者：
Raggi, Paolo
中科院分区：
文献类型：
--
作者：
Onufrak, Stephen J.;Bellasi, Antonio;Raggi, Paolo
一般人群的血清磷水平与心血管疾病的发病率和死亡率以及颈动脉内膜中层厚度增加有关。作者使用社区动脉粥样硬化风险研究（1987-2001）的数据，研究了磷与全因死亡率和冠状动脉疾病事件相关性的性别异质性。女性的基线磷水平较高，并且与传统动脉粥样硬化危险因素（如年龄、低密度脂蛋白胆固醇、糖尿病和高血压）的相关性在男性和女性中不同。在多变量校正模型中，血清磷水平最高五分位数（> 3.8 mg/dL）的男性死亡率增加（风险比= 1.45，95%置信区间：1.12，1.88），而女性则没有（风险比= 1.18，95%置信区间：0.89，1.57）。对于全因死亡率，按性别进行的效应修正的多变量似然比检验在α = 0.1（P = 0.085）时具有显著性。虽然磷与冠状动脉疾病的关系在性别上也存在很大差异，但效应修正的多变量检验表明，这种差异与随机变异一致（P = 0.195）。这些结果表明，需要进一步调查的性别差异的矿物代谢的贡献，心血管疾病的一般人群。
Serum phosphorus levels in the general population have been reported to be associated with cardiovascular morbidity and mortality and increased carotid intima-media thickness. The authors examined gender heterogeneity in the association of phosphorus with all-cause mortality and incident coronary artery disease using data from the Atherosclerosis Risk in Communities Study (1987-2001). Baseline phosphorus levels were higher in women and were associated differently among men and women with traditional atherosclerosis risk factors such as age, low density lipoprotein cholesterol, diabetes mellitus, and hypertension. In a multivariable-adjusted model, men in the highest quintile of serum phosphorus level (> 3.8 mg/dL) had an increased mortality rate (hazard ratio = 1.45, 95% confidence interval: 1.12, 1.88), while women did not (hazard ratio = 1.18, 95% confidence interval: 0.89, 1.57). The multivariable likelihood ratio test of effect modification by gender was significant at alpha = 0.1 (P = 0.085) for all-cause mortality. Although the associations of phosphorus with coronary artery disease also appeared to differ substantially by gender, the multivariable test for effect modification suggested that the difference was consistent with random variation (P = 0.195). These results suggest the need for further investigation into gender differences in the contribution of mineral metabolism to cardiovascular disease in the general population.