Serum Phosphate and Left Ventricular Hypertrophy in Young Adults: The Coronary Artery Risk Development in Young Adults Study

Kidney Blood Press Res. 2009;32(1):37-44. doi: 10.1159/000203348. Epub 2009 Feb 20.


Background/aims: A relationship with vascular dysfunction in chronic kidney disease suggests a possible association of phosphate level with left ventricular hypertrophy development in people with normal kidney function. We aimed to determine whether such an association exists in community-dwelling young adults.

Methods: This is a cohort study of participants in the ongoing, community-based, prospective Coronary Artery Risk Development in Young Adults study (n = 4,055). Phosphate levels were measured at year 0, and left ventricular hypertrophy assessed by echocardiography at year 5.

Results: The mean age was 25.0 years. Mean values were: estimated glomerular filtration rate 118.5 ml/min/1.73 m(2); phosphate 3.7 mg/dl; left ventricular mass indexed to body surface area 80.5 g/m(2), and indexed to height(2.7) 35.2 g/m(2.7). Left ventricular hypertrophy was present in 4.5% of the population. As a continuous variable, the phosphate level was associated with left ventricular hypertrophy (odds ratio per standard deviation 1.27; 95% confidence interval 1.09-1.47; p = 0.0020). This association persisted after covariate adjustment (odds ratio per standard deviation 1.30; 95% confidence interval 1.10-1.54; p = 0.0018), and was most pronounced for fifth quintile phosphate levels (>4.0 mg/dl).

Conclusion: Phosphate level may be a risk factor for left ventricular hypertrophy in community-dwelling young adults. As phosphate levels may be modifiable, the causality of this association can be addressed with controlled trials.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Coronary Artery Disease / etiology
  • Electrocardiography
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertrophy, Left Ventricular / etiology*
  • Incidence
  • Male
  • Odds Ratio
  • Phosphates / blood*
  • Prospective Studies
  • Risk
  • Young Adult


  • Phosphates