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Association of serum phosphate levels with glucose tolerance, insulin sensitivity and insulin secretion in non-diabetic subjects

European Journal of Clinical Nutrition volume 60, pages 734–739 (2006)Cite this article

Abstract

Background:

Hypophosphatemia is associated with impaired glucose tolerance and insulin resistance in primary hyperparathyroidism. However, little is known about the association between serum phosphate and glucose metabolism in healthy subjects.

Methods:

We measured fasting serum phosphate levels (SP, normal range 2.6–4.5 mg/dl) and serum calcium (S-Ca, normal range 2.1–2.6 mmol/l) in 881 non-diabetic subjects (341 male/540 female, age: 38±1 years, body mass index 25.9±0.2 kg/m2 (mean±standard error of the mean). An oral glucose tolerance test (OGTT) with determination of glucose and insulin every 30 min was performed in all subjects. Insulin secretion and insulin sensitivity (IS) were estimated from the OGTT using validated indices. Furthermore, we tested whether serum phosphate predicts glucose tolerance in 115 subjects during a lifestyle intervention program (LIP).

Results:

Serum phosphate was negatively correlated with 2-h blood glucose levels independent of age, gender and percent body fat (r=−0.13, P<0.0001). This association remained significant after additional adjustment for S-Ca, creatinine and parathyroid hormone. Serum phosphate was positively correlated with IS (r=0.10, P=0.0006), but not with insulin secretion. This was independent of age, gender, percent body fat, S-Ca and serum creatinine. In the subjects taking part in the LIP low serum phosphate levels at baseline were associated with higher postprandial glucose levels.

Conclusions:

In non-diabetic subjects, low serum phosphate levels are associated with high 2-h blood glucose levels and reduced IS. Whether low serum phosphate levels are a cause or a consequence of low IS and impairment of glucose tolerance needs to be tested in further studies.

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Acknowledgements

We thank the volunteers for their participation. We gratefully acknowledge the superb technical assistance of Anna Teigeler, Marjo Graf and Heike Luz. The studies were in part supported by grants from the Deutsche Forschungsgemeinschaft (KFO 114/1) and the Interdisciplinary Center of Clinical Research Tübingen (IZKF).

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  1. M Haap and E Heller: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology, Metabolism, Pathobiochemistry, Vascular Medicine and Nephrology, University of Tübingen, Tübingen, Germany

    M Haap, E Heller, C Thamer, O Tschritter, N Stefan & A Fritsche

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  1. M Haap
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  2. E Heller
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  3. C Thamer
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Correspondence to A Fritsche.

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Haap, M., Heller, E., Thamer, C. et al. Association of serum phosphate levels with glucose tolerance, insulin sensitivity and insulin secretion in non-diabetic subjects. Eur J Clin Nutr 60, 734–739 (2006). https://doi.org/10.1038/sj.ejcn.1602375

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602375

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