Serum Phosphorus as a Risk Factor for Cardiovascular Morbidity in Type 2 Diabetes Mellitus Patients

Phosphorus plays an important role in many physiological functions. Numerous studies have linked phosphorus concentration to cardiovascular (CV) disease and mortality rates. In this study, we investigated the association between high-normal serum phosphorus levels and CV morbidity in patients with type 2 diabetes. Two groups of patients with type 2 diabetes were studied, comprising both males and females aged 18 years and older. One group (140 subjects) had no CV events, while the other group (140 subjects) had one or more CV events. In both groups, we collected fasting laboratory values, medical history, and examination findings. Serum phosphorus levels were statistically significant- ly higher in patients with CV events and had statistically significant but relatively modest discriminatory properties (AUC 0.591; 95% confidence interval (CI) 0.531-0.649; p=0.008). A univariate logistic re- gression model of serum phosphorus as a continuous variable revealed a statistically significant associ- ation with the presence of a cardiovascular event (odds ratio (OR) 7.1849, 95% CI 1.7728 - 29.1190; p=0.0057). For each 1 mmol/L increase in serum phosphorus, the probability of a CV event increased 7.4-fold. After a multivariable logistic regression model, serum phosphorus was associated with a CV event (p=0.0016, OR 16.6), regardless of age, sex, total cholesterol, and systolic blood pressure.