ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2017
Serum Phosphate Is Associated With Fracture Risk: The Rotterdam Study and MrOS.
Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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Who cites it
39 citing papers in PubMed, 63 citations in OpenAlex.
- Association of Serum Phosphate, Calcium and Alkaline Phosphatase With Risk of Incident Fractures in Healthy Older Adults.The Journal of clinical endocrinology and metabolism · 2024Trial
- Impact of Intravenous Iron Substitution on Serum Phosphate Levels and Bone Turnover Markers-An Open-Label Pilot Study.Nutrients · 2023Trial
- Bispecific antibody against sclerostin and DKK1 improves bone health and reduces bone marrow adipose tissue accumulation in experimental chronic kidney disease.Bone research · 2026Article
- Prevalence and risk factors of CKD-associated osteoporosis in maintenance hemodialysis patients aged over 50 years: a cross-sectional study.Scientific reports · 2026Article
- Serum magnesium is associated with osteoporosis risk in postmenopausal women: a retrospective study and risk-prediction model.Frontiers in medicine · 2026Article
- The Conundrum of Medical Fracture Prevention in Chronic Kidney Disease-Summary of the Evidence and Pragmatic Clinical Guidance.Journal of clinical medicine · 2025Review
- Serum Sodium, Potassium, Magnesium, Calcium, and Phosphorus Levels and Risk of Fracture in the Community.The Journal of clinical endocrinology and metabolism · 2025Article
- Multiscale Analysis Reveals Altered Characteristics in Femur and Mandible of Mice on a High Phosphate Diet.Calcified tissue international · 2025Article
- Association between serum phosphorus levels and pelvic bone mineral density in U.S. adults aged 18-59 years.BMC musculoskeletal disorders · 2025Article
- Serum Phosphate in the General Population: A Need for Sex-Specific Reference Intervals.The Journal of clinical endocrinology and metabolism · 2025Article
- Dietary phosphorus intake modifies the association between total cholesterol and lumbar spine bone mineral density: results from NHANES 2011-2016.Frontiers in nutrition · 2025Article
- Bone marrow adipose tissue expansion and bone loss in experimental chronic kidney disease is independent of altered bone marrow stromal cell lineage determination.Frontiers in endocrinology · 2025Article
- Organic phosphate but not inorganic phosphate regulatesiScience · 2024Article
- Serum phosphate is associated with increased risk of bone fragility fractures in haemodialysis patients.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Observational
- Features of patients and fracture risk in hypoparathyroidism; a single center study.Journal of endocrinological investigation · 2024Article
- Prevalence and risk factors predisposing low bone mineral density in patients with thalassemia.Frontiers in endocrinology · 2024Article
- Factors influencing the bone mineral density in Duroc boars.Porcine health management · 2023Article
- Risk factors for subchondral insufficiency fracture of the femoral head in renal transplant patients.Journal of bone and mineral metabolism · 2022Article
- Anemia is associated with increased risk of non-vertebral osteoporotic fractures in elderly men: the MrOS Sweden cohort.Archives of osteoporosis · 2022Article
- FGF23-Klotho Axis and Fractures in Patients Without and With Early CKD: A Case-Cohort Analysis of CARTaGENE.The Journal of clinical endocrinology and metabolism · 2022Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
Extreme phosphate levels (P) have been associated with mineralization defects and increased fracture risk. Whether P within normal range is related to bone health in the general population is not well understood. To investigate the association of P with bone mineral density (BMD) and fracture risk, we assessed two population-based cohorts: the Dutch Rotterdam Study (RS-I, RS-II, RS-III; n = 6791) and the US Osteoporotic Fractures in Men (MrOS; n = 5425) study. The relationship of P with lumbar spine (LS) and femoral neck (FN) BMD was tested in all cohorts via linear models; fracture risk was tested in RS-I, RS-II, and MrOS through Cox models, after follow-up of 8.6, 6.6, and 10.9 years, respectively. Adjustments were made for age, body mass index, smoking, serum levels of calcium, potassium, 25-hydroxyvitamin D, estimated glomerular filtration rate (eGFR), FN-BMD, prevalent diabetes, and cardiovascular disease. Additional adjustments were made for phosphate intake, parathyroid hormone, and fibroblast growth factor 23 levels in MrOS. We further stratified by eGFR. Results were pooled through study-level meta-analyses. Hazard ratios (HR) and betas (β) (from meta-analyses) are expressed per 1 mg/dL P increase. P was positively associated with fracture risk in men and women from RS, and findings were replicated in MrOS (pooled HR all [95% CI]: 1.47 [1.31-1.65]). P was associated with fracture risk in subjects without chronic kidney disease (CKD): all (1.44 [1.26-1.63]) and in men with CKD (1.93 [1.42-2.62]). P was inversely related to LS-BMD in men (β: -0.06 [-0.11 to -0.02]) and not to FN-BMD in either sex. In summary, serum P was positively related to fracture risk independently from BMD and phosphate intake after adjustments for potential confounders. P and LS-BMD were negatively related in men. Our findings suggest that increased P levels even within normal range might be deleterious for bone health in the normal population. © 2017 American Society for Bone and Mineral Research.
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