Serum Phosphate and Retinal Microvascular Changes: The Multi-Ethnic Study of Atherosclerosis and the Beaver Dam Eye Study.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 9435674 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-5086 (Electronic) Linking ISSN: 09286586 NLM ISO Abbreviation: Ophthalmic Epidemiol Subsets: MEDLINE

Publication: London : Informa Healthcare
Original Publication: Buren, The Netherlands : Aeolus Press, c1994-

Ethnicity* ; Microcirculation*; Atherosclerosis/*blood ; Phosphates/*blood ; Retinal Diseases/*blood ; Retinal Vessels/*pathology; Adult ; Aged ; Aged, 80 and over ; Atherosclerosis/diagnosis ; Atherosclerosis/ethnology ; Biomarkers/blood ; Cross-Sectional Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Retinal Diseases/diagnosis ; Retinal Diseases/ethnology ; Retinal Vessels/physiopathology ; Risk Factors ; United States/epidemiology

Purpose: Higher levels of serum phosphate are strongly linked to increased risk of cardiovascular disease and therapies aimed to lower serum phosphate are employed in the management of patients with chronic kidney disease (CKD). Data are limited, however, on serum phosphate as a risk factor for microvascular disease in community-based populations. It is important to determine the impact of novel risk factors, such as phosphate, on the microvasculature.
Methods: We conducted a prospective study of 3919 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA) and 3544 individuals in the Beaver Dam Eye Study (BDES) to test the associations of serum phosphate with retinopathy and retinal vessel caliber, and change in retinopathy severity and change in retinal vessel caliber.
Results: Mean (standard deviation) serum phosphate was 3.66 (0.52) mg/dl in the MESA and 3.77 (0.55) mg/dl in the BDES. In multivariable adjusted models, phosphate was significantly associated with prevalent retinopathy in the MESA (Odds Ratio [OR] per 1 mg/dl increase in phosphate, 1.22; Confidence Interval [CI] 1.02-1.47) and the BDES (OR 1.06; CI 1.01-1.11). In stratified analyses, these relationships were even stronger and only seen in individuals with diabetes in both the MESA (OR 1.81; CI 1.30-2.53) and the BDES (OR 1.16; CI 1.05-1.29). Phosphate was not associated with incident or change in retinopathy severity, nor any retinal caliber outcome.
Conclusions: Among community-living individuals with low prevalence of CKD, higher serum phosphate was associated with prevalent retinopathy in individuals with diabetes. Further longitudinal assessments in patients with diabetes necessitate further investigation.

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N01HC95160 United States HL NHLBI NIH HHS; UL1 TR001079 United States TR NCATS NIH HHS; U10 EY006594 United States EY NEI NIH HHS; N01HC95169 United States HL NHLBI NIH HHS; N01 HC095164 United States HC NHLBI NIH HHS; N01HC95168 United States HL NHLBI NIH HHS; N01HC95165 United States HL NHLBI NIH HHS; N01HC95159 United States HL NHLBI NIH HHS; N01 HC095168 United States HC NHLBI NIH HHS; UL1 TR000040 United States TR NCATS NIH HHS; N01 HC095163 United States HC NHLBI NIH HHS; N01HC95166 United States HL NHLBI NIH HHS; N01 HC095162 United States HC NHLBI NIH HHS; R01 HL096875 United States HL NHLBI NIH HHS; K23 DK063274 United States DK NIDDK NIH HHS; N01 HC095159 United States HC NHLBI NIH HHS; N01 HC095167 United States HC NHLBI NIH HHS; N01HC95163 United States HL NHLBI NIH HHS; N01 HC095166 United States HC NHLBI NIH HHS; N01HC95164 United States HL NHLBI NIH HHS; DP3 DK108248 United States DK NIDDK NIH HHS; N01 HC095160 United States HC NHLBI NIH HHS; N01HC95162 United States HL NHLBI NIH HHS; R01 DK102438 United States DK NIDDK NIH HHS; N01HC95161 United States HL NHLBI NIH HHS; N01 HC095169 United States HC NHLBI NIH HHS; N01 HC095165 United States HC NHLBI NIH HHS; HHSN268201500003I United States HL NHLBI NIH HHS; R01 DK099199 United States DK NIDDK NIH HHS; N01HC95167 United States HL NHLBI NIH HHS

Keywords: Diabetes; microvascular disease; phosphate; retinopathy

0 (Biomarkers)
0 (Phosphates)

Date Created: 20170414 Date Completed: 20171120 Latest Revision: 20240620

20240620

PMC5844221

10.1080/09286586.2017.1304562

28402694