Effects of sex and postmenopausal estrogen use on serum phosphorus levels: A cross-sectional study of the national health and nutrition examination survey (NHANES) 2003-2006

Dihua Zhang, Naim M. Maalouf, Beverley Adams-Huet, Orson W. Moe, Khashayar Sakhaee

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background Elevation of serum phosphorus concentrations has been associated with cardiovascular events in older women and men. Whether age, sex, or estrogen therapy is associated with different phosphorus levels is unknown. Study Design Cross-sectional study. Setting & Participants 7,005 participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006. Predictors Demographic data; body measurement indexes; dietary intake by 24-hour dietary recall and food-frequency questionnaire; data for reproductive health, prescription medication, cardiovascular disease, osteoporosis, and diabetes mellitus obtained by questionnaire; and blood chemistry indexes. Outcomes & Measurements Serum phosphorus concentrations. Results In both males and premenopausal females, serum phosphorus levels decline progressively with age. In males, the decline continues over the entire age range of 21-85 years. In contrast, in females, serum phosphorus levels increase between ages 46-60 years (sex × age interaction; P < 0.001). The increase in serum phosphorus levels in older women is independent of changes in serum parathyroid hormone levels, daily dietary phosphorus intake, and estimated glomerular filtration rate. In analysis of covariance, we show that postmenopausal women receiving estrogen therapy have significantly lower serum phosphorus levels than non-estrogen users after adjusting for age, race, body mass index, daily dietary phosphorus intake, and serum albumin, serum parathyroid hormone, and 25-hydroxyvitamin D levels (3.83 vs 3.98 mg/dL; P < 0.001). Limitations The study was cross-sectional in design and estrogen therapy was not randomly assigned or concealed. Important phosphorus regulatory factors such as serum fibroblast growth factor 23 and klotho were not available in the study. Conclusions Estrogen status may account for the difference in serum phosphorus levels in postmenopausal women.

Original languageEnglish (US)
Pages (from-to)198-205
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume63
Issue number2
DOIs
StatePublished - Feb 2014

Fingerprint

Nutrition Surveys
Phosphorus
Estrogens
Cross-Sectional Studies
Serum
Dietary Phosphorus
Parathyroid Hormone
Reproductive Health
Glomerular Filtration Rate
Serum Albumin
Osteoporosis
Prescriptions
Diabetes Mellitus
Body Mass Index
Cardiovascular Diseases
Therapeutics
Demography
Food

Keywords

  • cardiovascular disease
  • estrogen
  • gender heterogeneity
  • menopause
  • Serum phosphorus

ASJC Scopus subject areas

  • Nephrology

Cite this

@article{f44ece093a9a4162a713d1c262af1404,
title = "Effects of sex and postmenopausal estrogen use on serum phosphorus levels: A cross-sectional study of the national health and nutrition examination survey (NHANES) 2003-2006",
abstract = "Background Elevation of serum phosphorus concentrations has been associated with cardiovascular events in older women and men. Whether age, sex, or estrogen therapy is associated with different phosphorus levels is unknown. Study Design Cross-sectional study. Setting & Participants 7,005 participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006. Predictors Demographic data; body measurement indexes; dietary intake by 24-hour dietary recall and food-frequency questionnaire; data for reproductive health, prescription medication, cardiovascular disease, osteoporosis, and diabetes mellitus obtained by questionnaire; and blood chemistry indexes. Outcomes & Measurements Serum phosphorus concentrations. Results In both males and premenopausal females, serum phosphorus levels decline progressively with age. In males, the decline continues over the entire age range of 21-85 years. In contrast, in females, serum phosphorus levels increase between ages 46-60 years (sex × age interaction; P < 0.001). The increase in serum phosphorus levels in older women is independent of changes in serum parathyroid hormone levels, daily dietary phosphorus intake, and estimated glomerular filtration rate. In analysis of covariance, we show that postmenopausal women receiving estrogen therapy have significantly lower serum phosphorus levels than non-estrogen users after adjusting for age, race, body mass index, daily dietary phosphorus intake, and serum albumin, serum parathyroid hormone, and 25-hydroxyvitamin D levels (3.83 vs 3.98 mg/dL; P < 0.001). Limitations The study was cross-sectional in design and estrogen therapy was not randomly assigned or concealed. Important phosphorus regulatory factors such as serum fibroblast growth factor 23 and klotho were not available in the study. Conclusions Estrogen status may account for the difference in serum phosphorus levels in postmenopausal women.",
keywords = "cardiovascular disease, estrogen, gender heterogeneity, menopause, Serum phosphorus",
author = "Dihua Zhang and Maalouf, {Naim M.} and Beverley Adams-Huet and Moe, {Orson W.} and Khashayar Sakhaee",
year = "2014",
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T1 - Effects of sex and postmenopausal estrogen use on serum phosphorus levels

T2 - A cross-sectional study of the national health and nutrition examination survey (NHANES) 2003-2006

AU - Zhang, Dihua

AU - Maalouf, Naim M.

AU - Adams-Huet, Beverley

AU - Moe, Orson W.

AU - Sakhaee, Khashayar

PY - 2014/2

Y1 - 2014/2

N2 - Background Elevation of serum phosphorus concentrations has been associated with cardiovascular events in older women and men. Whether age, sex, or estrogen therapy is associated with different phosphorus levels is unknown. Study Design Cross-sectional study. Setting & Participants 7,005 participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006. Predictors Demographic data; body measurement indexes; dietary intake by 24-hour dietary recall and food-frequency questionnaire; data for reproductive health, prescription medication, cardiovascular disease, osteoporosis, and diabetes mellitus obtained by questionnaire; and blood chemistry indexes. Outcomes & Measurements Serum phosphorus concentrations. Results In both males and premenopausal females, serum phosphorus levels decline progressively with age. In males, the decline continues over the entire age range of 21-85 years. In contrast, in females, serum phosphorus levels increase between ages 46-60 years (sex × age interaction; P < 0.001). The increase in serum phosphorus levels in older women is independent of changes in serum parathyroid hormone levels, daily dietary phosphorus intake, and estimated glomerular filtration rate. In analysis of covariance, we show that postmenopausal women receiving estrogen therapy have significantly lower serum phosphorus levels than non-estrogen users after adjusting for age, race, body mass index, daily dietary phosphorus intake, and serum albumin, serum parathyroid hormone, and 25-hydroxyvitamin D levels (3.83 vs 3.98 mg/dL; P < 0.001). Limitations The study was cross-sectional in design and estrogen therapy was not randomly assigned or concealed. Important phosphorus regulatory factors such as serum fibroblast growth factor 23 and klotho were not available in the study. Conclusions Estrogen status may account for the difference in serum phosphorus levels in postmenopausal women.

AB - Background Elevation of serum phosphorus concentrations has been associated with cardiovascular events in older women and men. Whether age, sex, or estrogen therapy is associated with different phosphorus levels is unknown. Study Design Cross-sectional study. Setting & Participants 7,005 participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006. Predictors Demographic data; body measurement indexes; dietary intake by 24-hour dietary recall and food-frequency questionnaire; data for reproductive health, prescription medication, cardiovascular disease, osteoporosis, and diabetes mellitus obtained by questionnaire; and blood chemistry indexes. Outcomes & Measurements Serum phosphorus concentrations. Results In both males and premenopausal females, serum phosphorus levels decline progressively with age. In males, the decline continues over the entire age range of 21-85 years. In contrast, in females, serum phosphorus levels increase between ages 46-60 years (sex × age interaction; P < 0.001). The increase in serum phosphorus levels in older women is independent of changes in serum parathyroid hormone levels, daily dietary phosphorus intake, and estimated glomerular filtration rate. In analysis of covariance, we show that postmenopausal women receiving estrogen therapy have significantly lower serum phosphorus levels than non-estrogen users after adjusting for age, race, body mass index, daily dietary phosphorus intake, and serum albumin, serum parathyroid hormone, and 25-hydroxyvitamin D levels (3.83 vs 3.98 mg/dL; P < 0.001). Limitations The study was cross-sectional in design and estrogen therapy was not randomly assigned or concealed. Important phosphorus regulatory factors such as serum fibroblast growth factor 23 and klotho were not available in the study. Conclusions Estrogen status may account for the difference in serum phosphorus levels in postmenopausal women.

KW - cardiovascular disease

KW - estrogen

KW - gender heterogeneity

KW - menopause

KW - Serum phosphorus

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