Lower concentrations of serum phosphorus within the normal range could be associated with less calcification of the coronary artery in Koreans with normal renal function

Serum phosphorus concentrations are associated with an increased risk of cardiovascular disease (CVD) and mortality in patients with renal insufficiency. This association has also been reported in Western individuals without chronic kidney disease (CKD). It is unclear, however, whether this correlation occurs in Korean individuals without CKD, who usually ingest less phosphorus than do Western individuals. We reviewed the findings in 402 healthy Korean adults with a mean (±SD) age of 50.8 ± 8.5 y (n = 257 men and 145 women) and a glomerular filtration rate of 83.5 ± 14.1 mL/min, who underwent health screening with electron-beam computed tomography (EBCT). The study population was separated into 4 groups on the basis of the coronary calcium concentration (Agatston score: 0, >0 to ≤10, >10 to ≤100, and >100). Mean serum phosphorus concentrations, measured ≥10 y before EBCT, were compared. Multivariate analysis showed that age (P = 0.001), male sex (P = 0.002), family history of CVD (P = 0.006), serum glucose (P = 0.003), and serum phosphorus >3.6 mg/dL (P = 0.008) were significant factors influencing the coronary calcification group with an Agatston score >100, when those with an Agatston score of 0 were considered as the reference group. Compared with the group with a serum phosphorus concentration ≤3.3 mg/dL, the OR of an Agatston score >100 in individuals with a serum phosphorus concentration >3.6 to ≤3.9 mg/dL was 3.89 (95% CI: 1.43, 10.63; P = 0.008) and in those with a serum phosphorus concentration >3.9 mg/dL was 3.17 (95% CI: 1.19, 8.41; P = 0.021). A lower concentration of serum phosphorus within the normal range could be associated with less calcification of the coronary artery in Koreans with normal renal function.