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Phosphate, the Missing Piece in Cardiovascular Disease Control
Hsin-Bang Leu
No.201, Sec. 2, Shipai Rd., Beitou District, Taiwan
Phosphate has fundamental roles in multiple physiologic functions. It is regulated by the interplay of parathyroid hormone
(PTH), 1,25-dihydroxycholecalciferol (1,25 VitD), and fibroblast growth factor 23 (FGF23). Dysregulation of phosphate is related
to the mechanisms of atherosclerotic diseases. Both phosphate dysregulation and its regulatory hormones are involved in the
atherosclerotic disease process. Clinical studies have found that phosphate level has a U-shaped association with cardiovascular
outcomes. However, effective treatment trials are currently lacking. In this article, we reviewed the evidence of phosphate as a marker of atherosclerosis. Its roles in all aspects of cardiovascular disease, from pathogenesis to manifestation, should prompt us to explore treating hyperphosphatemia as a means of CVD prevention.