Hypophosphataemia: cause of the disturbed metabolism in the metabolic syndrome

The clustering of risk factors for cardiovascular disease (CVD) and non-ins ulin-dependent diabetes mellitus (NIDDM) in obese patients may be attributa ble to a disturbed metabolism caused by hypophosphataemia. A low serum phos phate (S-P) level may be a limiting factor for glucose metabolism and may a ccount for hyperglycaemia, with an increased risk of NIDDM and hypertension and consequent increased risk of stroke. Low S-HDL levels, known to exist in the metabolic syndrome, as well as high serum triglycerides may also hav e been the results of phosphate depletion. The hypothesis presents a new se rious disturbance which accounts for the dyslipidaemia, hyperglycaemia and the hypertension in metabolic syndrome. The proposed causal relationship be tween low S-P and the clustering of risk factors is based on results from a cross-sectional study of obese patients, where low S-P was associated with high body mass index (BMI), high blood glucose (B-glu), high systolic bloo d pressure (SBP), high diastolic blood pressure (DBP), but low serum high d ensity lipoprotein (S-HDL) and serum magnesium (S-Mg) levels. Knowledge fro m experimental and clinical studies on hypophosphataemia and/or phosphate d epletion are referred to when discussing the hypothesis. (C) 2001 Harcourt Publishers Ltd.