Serum Phosphate in the General Population: A Need for Sex-Specific Reference Intervals

Area of Science:

• Biochemistry
• Endocrinology
• Gerontology

Background:

• Serum phosphate is vital for metabolic functions and bone health.
• Existing research indicates sex-based disparities in phosphate levels and disease associations.
• Current adult phosphate reference intervals often overlook age and sex variations.

Purpose of the Study:

• To investigate sex differences in serum phosphate concentrations within large population cohorts.
• To assess the adequacy of current standard reference intervals for serum phosphate in adults.
• To explore variations in serum phosphate by menopausal status in women.

Main Methods:

• Analysis of serum phosphate in 8837 participants from the Rotterdam Study and 422,443 from the UK Biobank.
• Inclusion of participants aged 40 and older, excluding those with chronic kidney disease.
• Stratification of analyses by sex and menopausal status in women.

Main Results:

• Women exhibited higher serum phosphate concentrations and a broader population range than men across all cohorts.
• Hypophosphatemia was more frequent in men, while hyperphosphatemia was more prevalent in women.
• Significant sex differences in phosphate levels were observed across all age groups, with perimenopausal women showing higher levels than men.

Conclusions:

• Women consistently present with higher serum phosphate levels compared to men.
• Serum phosphate significantly increases in women during menopause.
• The findings advocate for the establishment of sex-specific reference intervals for serum phosphate in adults over 45.