Case Control Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Oct 15, 2020; 11(10): 416-424
Published online Oct 15, 2020. doi: 10.4239/wjd.v11.i10.416
Importance of serum phosphate in elderly patients with diabetes mellitus
Vaia D Raikou, Despina Kyriaki, Sotiris Gavriil
Vaia D Raikou, Department of Nephrology, Doctors’ Hospital, Athens 11257, Greece
Despina Kyriaki, Department of Nuclear Medicine, General Hospital “LAΪKO”, Athens 11527, Greece
Sotiris Gavriil, Department of Bariatric Surgery, Doctors’ Hospital, Athens 11257, Greece
Author contributions: Raikou VD and Gavriil S designed the research plan, data collection, biostatistic analyses and manuscript writing; Kyriaki D performed the biochemical measurements and immunoassays; all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the ethics committee of Doctors’ Hospital (Athens, Greece).
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at vraikou@med.uoa.gr.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Corresponding author: Vaia D Raikou, PhD, Chief Doctor, Department of Nephrology, Doctors’ Hospital, 26 Kefallinias, Athens 11257, Greece. vraikou@med.uoa.gr
Received: February 4, 2020
Peer-review started: February 4, 2020
First decision: April 22, 2020
Revised: May 11, 2020
Accepted: August 25, 2020
Article in press: August 25, 2020
Published online: October 15, 2020
Processing time: 252 Days and 19.2 Hours
ARTICLE HIGHLIGHTS
Research background

Metabolic disorders contribute to the prediction of morbidity and mortality in patients with type 2 diabetes mellitus (type 2 DM). Changes in serum calcium, magnesium or P are related to the prevalence of type 2 DM mainly in combination with obesity.

Research motivation

We determined the importance of serum P levels in elderly patients with type 2 DM compared to those without DM in relation to renal function clustering in chronic kidney disease stages 1-4.

Research objectives

One hundred-ten subjects with a mean age of 69.02 ± 14.3 years were included. Twenty-nine participants had type 2 DM (26.4%).

Research methods

The participants were classified into both estimated glomerular filtration rate (eGFR) and albuminuria categories according to the Kidney Disease Improving Global Outcomes 2012 criteria. The incidence of hypertension, smoking and those receiving vitamin D derivates were recorded.

Research results

We divided the patients in two groups according to the P cut-off point related to type 2 DM. A significant association was observed between high P and type 2 DM, hypertension, receiving vitamin D, smoking and eGFR (χ2 = 6.3, P = 0.01, χ2 = 3.9, P = 0.03, χ2 = 6.9, P = 0.009, χ2 = 7.04, P = 0.01 and χ2 = 7.36, P = 0.04, respectively). A multi-factorial model showed that older age, female gender and increased BMI were significant predictors of type 2 DM after entering the covariates.

Research conclusions

High serum P contributes to vascular and metabolic disturbances in elderly patients with type 2 DM and renal impairment.

Research perspectives

Compared with high serum P, traditional factors such as older age, female gender and high BMI were proved to be stronger predictors of type 2 DM.