1.
Serum Phosphate and the Risk of New-Onset Hyperuricemia in Hypertensive Patients.
Cao, J, Zhang, J, Li, Q, Jiang, C, Song, Y, Liu, C, Liu, L, Wang, B, Li, J, Zhang, Y, et al
Hypertension (Dallas, Tex. : 1979). 2019;(1):102-110
Abstract
The relationship of serum phosphate and new-onset hyperuricemia remains uncertain. We aimed to evaluate the relationship of serum phosphate with the risk of new-onset hyperuricemia, and to examine any possible effect modifiers in hypertensive patients. This is a post hoc analysis of the Uric Acid substudy of the CSPPT (China Stroke Primary Prevention Trial). A total of 10 612 participants with normal uric acid levels (<357 μmol/L [6 mg/dL]) at baseline were included in the current study. The primary outcome was new-onset hyperuricemia, which was defined as a uric acid concentration ≥417 μmol/L (7 mg/dL) in men or ≥357 μmol/L (6 mg/dL) in women. During a median follow-up of 4.4 years, 1663 (15.7%) participants developed new-onset hyperuricemia. Overall, there was a significant inverse association between serum phosphate and the risk of new-onset hyperuricemia (per SD increment; odds ratio, 0.71; 95% CI, 0.66-0.76). When serum phosphate was assessed as quartiles, a significantly lower risk of new-onset hyperuricemia was found in participants in quartile 4 (≥1.4 mmol/L; odds ratio, 0.48; 95% CI, 0.40-0.57) compared with those in quartile 1 (<1.2 mmol/L). Similar results were found in males and females. In summary, there was an inverse association between serum phosphate and the risk of new-onset hyperuricemia in hypertensive adults.
2.
Serum Alkaline Phosphatase, Phosphate, and In-Hospital Mortality in Acute Ischemic Stroke Patients.
Zhong, C, You, S, Chen, J, Zhai, G, Du, H, Luo, Y, Dong, X, Cao, Y, Liu, CF, Zhang, Y
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2018;(1):257-266
Abstract
BACKGROUND The clinical impacts of serum alkaline phosphatase (ALP) and phosphate on early death are not fully understood in patients with acute ischemic stroke. We examined the associations between serum ALP, phosphate, and in-hospital mortality after ischemic stroke. METHODS Serum ALP and phosphate were measured in 2944 ischemic stroke patients from 22 hospitals in Suzhou City from December 2013 to May 2014. Cox proportional hazard models and restricted cubic splines were used to estimate the relationships between serum ALP and phosphate (both as categorical and continuous variables) and risk of in-hospital mortality. RESULTS During hospitalization, 111 patients (3.7%) died from all causes. After multivariable adjustment, the hazard ratio (HR) of the highest quartile compared with the lowest quartile of ALP was 2.19 (95% confidence interval [CI], 1.20-4.00) for early death. Restricted cubic spline analysis indicated a significant linear association between ALP and death (P-linearity = .017). A U-shaped association of phosphate with in-hospital mortality was observed (P-nonlinearity = .011). Compared with the third quartile of phosphate (1.08-1.21 mmol/L), HRs of the lowest and highest quartiles for early death were 2.17 (1.15-4.08) and 1.70 (.88-3.30), respectively. Sensitivity analyses further confirmed our findings. CONCLUSIONS We observed a graded relationship between serum ALP levels and risk of early death in patients with acute ischemic stroke. There was a U-shaped association between phosphate and all-cause mortality with significantly increased risk among patients with lower phosphate levels.