Clinical and laboratory features associated with serum phosphate concentrations in malaria and other febrile illnesses

Abstract

Background: Hypophosphatemia is common in severe infections including malaria. Previous studies suggested that serum phosphate concentrations correlate with temperature, but it is unclear whether the type of infection and other factors occurring during infection influence this association. Here relationships were investigated between serum phosphate levels, cause of fever, demographic, clinical and laboratory parameters.Methods: Anonymized data were analysed from 633 adults with malaria or other febrile illness admitted to Northwick Park Hospital, London, UK. Univariable and multivariable generalized linear model analyses were performed to examine associations with serum phosphate levels. Interaction terms were included to investigate whether cause of fever (malaria vs other illness), malaria parasite species, or malaria severity influenced the association of other variables with phosphate.Results: Hypophosphatemia was common in subjects with malaria (211/542 (39%)), and in other febrile illnesses (24/91 (26%)), however median phosphate levels did not differ significantly by diagnostic group, parasite species or severity of malaria. In all analyses, there were highly significant negative associations between serum phosphate and axillary temperature, and positive associations between serum phosphate and platelet count. There were no significant interactions between these variables and cause of fever, parasite species or severity of illness. Sodium and potassium concentrations were associated with serum phosphate in subjects with malaria and when data from all subjects was combined. Conclusion:Serum phosphate is consistently associated with temperature and platelet count in adults with diverse causes of fever. This may be a consequence of phosphate shifts from plasma into cells to support ATP generation for thermogenesis and platelet activation.

Non‐canonical metabolic pathways in the malaria parasite detected by isotope‐tracing metabolomics

“…Moreover, this work provides a baseline for understanding how environmental factors alter parasite metabolism. For example, phosphate levels in human plasma vary during the day (Lederer, 2014), fluctuate with diet (Goretti Penido & Alon, 2012), and disease severity (Lewis, 1987;Davis et al, 1991;Suen et al, 2020). Future studies investigating how parasite metabolism responds to fluctuations in plasma phosphate will be of great interest.…”

Enzyme Immobilization by Inkjet Printing on Reagentless Biosensors for Electrochemical Phosphate Detection

“…We achieved a wide linear range of 0.2 mM to 2.0 mM (R 2 = 0.997), with a detection limit of 0.13 mM (refer to Figure 6b). This range encompasses the clinically relevant concentration range, as the normal serum phosphate concentration in adults typically ranges from 0.81 to 1.45 mM [46]. Notably, an intercept occurs in Figure 6b because the peak current, ip, of the reversible redox process is described by the Randles-Sevcik equation.…”

Association between serum phosphate and mortality in critically ill patients: a large retrospective cohort study

“…Inorganic phosphate is the value of serum phosphate measured in the clinic. [1][2][3][4][5] Although serum phosphate content is very low in the body, it plays an important role in energy metabolism, bone metabolism and cell signal transduction. 1-3 6-9 For example, (1) participating in the composition of cell membranes in the form of phospholipids to maintain the integrity and function of the cell structure;…”