BACKGROUND Hypophosphatemia is common in severe infections including malaria. Previous studies suggested that serum phosphate concentrations correlate with temperature, but it is unclear whether the type of infection and other factors occurring during infection influence this association. Here relationships were investigated between serum phosphate levels, cause of fever, demographic, clinical and laboratory parameters. METHODS Anonymized data were analysed from 633 adults with malaria or other febrile illness admitted to Northwick Park Hospital, London, UK. Univariable and multivariable generalized linear model analyses were performed to examine associations with serum phosphate levels. Interaction terms were included to investigate whether cause of fever (malaria vs other illness), malaria parasite species, or malaria severity influenced the association of other variables with phosphate. RESULTS Hypophosphatemia was common in subjects with malaria (211/542 (39%)), and in other febrile illnesses (24/91 (26%)), however median phosphate levels did not differ significantly by diagnostic group, parasite species or severity of malaria. In all analyses, there were highly significant negative associations between serum phosphate and axillary temperature, and positive associations between serum phosphate and platelet count. There were no significant interactions between these variables and cause of fever, parasite species or severity of illness. Sodium and potassium concentrations were associated with serum phosphate in subjects with malaria and when data from all subjects was combined. CONCLUSION Serum phosphate is consistently associated with temperature and platelet count in adults with diverse causes of fever. This may be a consequence of phosphate shifts from plasma into cells to support ATP generation for thermogenesis and platelet activation.

中文翻译：

---

与疟疾和其他发热性疾病中血清磷酸盐浓度相关的临床和实验室特征。

背景低磷血症在包括疟疾在内的严重感染中很常见。先前的研究表明，血清磷酸盐浓度与温度相关，但尚不清楚感染类型和感染期间发生的其他因素是否会影响这种关联。这里研究了血清磷酸盐水平、发热原因、人口统计学、临床和实验室参数之间的关系。方法 分析了来自英国伦敦诺斯威克公园医院的 633 名患有疟疾或其他发热性疾病的成年人的匿名数据。进行单变量和多变量广义线性模型分析以检查与血清磷酸盐水平的关联。包括交互项以调查发热原因（疟疾与其他疾病）、疟疾寄生虫种类、或疟疾严重程度影响其他变量与磷酸盐的关联。结果 低磷血症在疟疾患者 (211/542 (39%)) 和其他发热性疾病 (24/91 (26%)) 中很常见，但是中位磷酸盐水平在诊断组、寄生虫种类或严重程度之间没有显着差异。疟疾。在所有分析中，血清磷酸盐与腋窝温度呈显着负相关，血清磷酸盐与血小板计数呈正相关。这些变量与发烧原因、寄生虫种类或疾病严重程度之间没有显着的相互作用。在合并所有受试者的数据时，钠和钾浓度与疟疾受试者的血清磷酸盐相关。结论 血清磷酸盐始终与成人发烧的体温和血小板计数相关。这可能是磷酸盐从血浆转移到细胞以支持 ATP 生成以促进产热和血小板活化的结果。