La regulación del fosfato y su asociación con alteraciones en el metabolismo óseo y mineral.

ntroduction and objective: although high levels of serum phosphate have been related to the risk of fracture and aortic calcification, it is not known if there is any association of urinary phosphate with the incidence of osteoporotic fracture and aortic calcification. Material and methods: 141 postmenopausal women > 50 years of age underwent dorso-lumbar radiology that was repeated 4 years later, determining general biochemical markers and bone and mineral metabolism in blood and fresh urine, clinical and anthropometric parameters were collected. The appearance of new vertebral and non-vertebral fractures and new aortic calcification was radiographically confirmed. Women with estrogen and antiresorptive treatment > 3 months were excluded. Results: 11 new non-vertebral fractures were detected (7 Colles, 2 hip and 2 in other locations) and 10 incident vertebral fractures confirmed radiographically. Body mass index, phosphaturia, creatinuria, phosphaturia/creatinuria and estimated glomerular filtration rate (eGFR) were significantly lower and age was higher in the fractured women. Increases of 10 mg/ dL in phosphaturia were associated with 29 % fewer incident fractures [OR, 0.71; 95 % CI = (0.46-0.98)], after logistic regression adjusted for age, body mass index, creatinuria and eGFR. This effect was more marked with non-vertebral incident fractures [OR, 0.50; 95 % CI = (0.10-0.91)], while in vertebral this association was lost [OR, 0.83; 95 % CI = (0.54-1.14)]. Furthermore, 17 % of the cohort had new aortic calcifications. At a multivariate level, increases of 10 mg/dL of phosphaturia were associated with a lower incidence of aortic calcification [OR, 0.80; 95 % CI = (0.64-0.97)]. Conclusions: low phosphate levels seem to be associated with a higher incidence of osteoporotic fracture and aortic calcification in women. Phosphaturia could be an indicator of hormonal and renal effects on phosphate regulation and used as a risk factor for aortic fracture and calcification. [ABSTRACT FROM AUTHOR]