Dietary phosphorus is associated with greater left ventricular mass

Yamamoto, Kara; Robinson‐Cohen, Cassianne; Oliveira, M. C. de S.; Kostina, A. N.; Nettleton, Jennifer A.; Ix, Joachim H.; Nguyen, Ha; Eng, John; Lima, João A.C.; Siscovick, David S.; Weiss, Noel S.; Kestenbaum, Bryan

doi:10.1038/ki.2012.303

Cited by 96 publications

(60 citation statements)

References 33 publications

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“…Furthermore, high dietary P i intake was associated with increased left ventricular mass (50). Although the detailed mechanism has not been clarified, elevated FGF23 resulting from intake of a diet with a high P i content may lead to increased left ventricular mass.…”

Section: Discussionmentioning

confidence: 99%

Effects of dietary phosphate on glucose and lipid metabolism

Abuduli

Ohminami

Otani

et al. 2016

American Journal of Physiology-Endocrinology and Metabolism

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Recent epidemiological and animal studies have suggested that excess intake of phosphate (Pi) is a risk factor for the progression of chronic kidney disease and its cardiovascular complications. However, little is known about the impact of dietary high Pi intake on the development of metabolic disorders such as obesity and type 2 diabetes. In this study, we investigated the effects of dietary Pi on glucose and lipid metabolism in healthy rats. Male 8-wk-old Sprague-Dawley rats were divided into three groups and given experimental diets containing varying amounts of Pi, i.e., 0.2 [low Pi (LP)], 0.6 [control Pi (CP)], and 1.2% [high Pi (HP)]. After 4 wk, the HP group showed lower visceral fat accumulation compared with other groups, accompanied by a low respiratory exchange ratio (V CO2/V O2) without alteration of locomotive activity. The HP group had lower levels of plasma insulin and nonesterified fatty acids. In addition, the HP group also showed suppressed expression of hepatic lipogenic genes, including sterol regulatory element-binding protein-1c, fatty acid synthase, and acetyl-CoA carboxylase, whereas there was no difference in hepatic fat oxidation among the groups. On the other hand, uncoupling protein (UCP) 1 and peroxisome proliferator-activated receptor-␥ coactivator-1␣ (PGC-1␣) expression were significantly increased in the brown adipose tissue (BAT) of the HP group. Our data demonstrated that a high-Pi diet can negatively regulate lipid synthesis in the liver and increase mRNA expression related to lipid oxidation and UCP1 in BAT, thereby preventing visceral fat accumulation. Thus, dietary P i is a novel metabolic regulator. dietary phosphate; energy metabolism; brown adipose tissue; visceral fat OBESITY CONTINUES TO BE A MAJOR PUBLIC HEALTH PROBLEM worldwide. Overnutrition and an increased consumption of fast foods are primary factors contributing to this problem. Fast foods or processed foods have high energy density and also frequently contain a large amount of P i as a food additive. Recent epidemiological studies have suggested that a high dietary P i intake can be associated with increased cardiovascular risk and other metabolic disorders.P i is an essential nutrient that significantly affects skeletal formation, energy metabolism, and intracellular signaling (43,45). P i homeostasis is regulated by the absorption of P i in the intestine, bone formation/resorption, and reabsorption of P i in the kidney. The kidney is particularly important in the regulation of P i homeostasis (36, 45). Most P i -regulating factors, such as high/low P i intake, 1,25-dihydroxyvitamin D [1,25(OH) 2 D], parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF23), can regulate P i reabsorption in the kidney to maintain the P i homeostasis (6, 36, 43).Recent epidemiological and animal studies have suggested that an excessive intake of P i is a risk factor for the progression of chronic kidney disease and the occurrence of cardiovascular complications (8, 45). Excess P i has been independently associated with ...

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Section: Discussionmentioning

confidence: 99%

Effects of dietary phosphate on glucose and lipid metabolism

Abuduli

Ohminami

Otani

et al. 2016

American Journal of Physiology-Endocrinology and Metabolism

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“…37 In patients free of known cardiovascular disease, dietary phosphorus was associated with a greater left ventricular mass. 38 The possible link between high phosphorus levels and cardiac hypertrophy might be increasing serum levels of fibroblast growth factor-23, which can induce left ventricular hypertrophy. 39 We observed uremia with hyperphosphatemia and cardiac hypertrophy with interstitial fibrosis in both rat models of UC.…”

Section: Discussionmentioning

confidence: 99%

Speckle Tracking Echocardiography Detects Uremic Cardiomyopathy Early and Predicts Cardiovascular Mortality in ESRD

Kramann¹,

Erpenbeck²,

Schneider

et al. 2014

Journal of the American Society of Nephrology

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Cardiovascular mortality is high in ESRD, partly driven by sudden cardiac death and recurrent heart failure due to uremic cardiomyopathy. We investigated whether speckle-tracking echocardiography is superior to routine echocardiography in early detection of uremic cardiomyopathy in animal models and whether it predicts cardiovascular mortality in patients undergoing dialysis. Using speckle-tracking echocardiography in two rat models of uremic cardiomyopathy soon (4-6 weeks) after induction of kidney disease, we observed that global radial and circumferential strain parameters decreased significantly in both models compared with controls, whereas standard echocardiographic readouts, including fractional shortening and cardiac output, remained unchanged. Furthermore, strain parameters showed better correlations with histologic hallmarks of uremic cardiomyopathy. We then assessed echocardiographic and clinical characteristics in 171 dialysis patients. During the 2.5-year follow-up period, ejection fraction and various strain parameters were significant risk factors for cardiovascular mortality (primary end point) in a multivariate Cox model (ejection fraction hazard ratio [HR], 0.97 [95% confidence interval (95% CI), 0.95 to 0.99; P=0.012]; peak global longitudinal strain HR, 1.17 [95% CI, 1.07 to 1.28; P,0.001]; peak systolic and late diastolic longitudinal strain rates HRs, 4.7 [95% CI, 1.23 to 17.64; P=0.023] and 0.25 [95% CI, 0.08 to 0.79; P=0.02], respectively). Multivariate Cox regression analysis revealed circumferential early diastolic strain rate, among others, as an independent risk factor for all-cause mortality (secondary end point; HR, 0.43; 95% CI, 0.25 to 0.74; P=0.002). Together, these data support speckle tracking as a postprocessing echocardiographic technique to detect uremic cardiomyopathy and predict cardiovascular mortality in ESRD.

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“…Recently, analyses of data from the Multi-Ethnic Study of Atherosclerosis (MESA) Study showed a strong, independent association between dietary phosphorus intake and left ventricular mass assessed by magnetic resonance (37). Acute oral phosphorus loads have been previously linked to impaired endothelial function as discussed earlier (17) as well as elevated FGF23 concentrations (38,39).…”

Section: Association Between Serum Phosphorus and Progression Of Kidnmentioning

confidence: 99%

Phosphorus and the Kidney: What Is Known and What Is Needed

Nadkarni

Uribarri

2014

Advances in Nutrition

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A major role of the kidneys is to maintain phosphorus homeostasis. High serum phosphorus has been linked to all-cause and cardiovascular mortality in chronic kidney disease (CKD) both before and after initiation of renal replacement therapy. Considering the clinical implications of uncontrolled hyperphosphatemia, maintenance of phosphorus concentrations within an optimum range is standard of care in this patient population. Recently, the epidemiologic associations between serum phosphorus and worse outcome have been extended to the general population. This becomes even more important in view of the increasing dietary phosphorus intake in the American diet due in large part to the greater consumption of foods processed with phosphate additives. A greater understanding of mechanisms and epidemiology of altered phosphorus metabolism and disease in CKD may help clarify the possible role of excess dietary phosphorus as a health risk factor in the general population. Adv. Nutr. 5: 98-103, 2014.

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Dietary phosphorus is associated with greater left ventricular mass

Cited by 96 publications

References 33 publications

Effects of dietary phosphate on glucose and lipid metabolism

Effects of dietary phosphate on glucose and lipid metabolism

Speckle Tracking Echocardiography Detects Uremic Cardiomyopathy Early and Predicts Cardiovascular Mortality in ESRD

Phosphorus and the Kidney: What Is Known and What Is Needed

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