Asymptomatic Hyperphosphatemia in Healthy Young Men and Women: Potential Association with Electronic Nicotine Delivery Systems and Heated Tobacco Products

BACKGROUND: Hyperphosphatemia is defined as fasting phosphorus levels higher than 1.45 mmol/L. Although it is often asymptomatic, it can cause adverse effects, including hypocalcemia, decreased calcitriol levels, secondary hyperparathyroidism, ectopic calcification, hemodynamic disorders, and increased morbidity and mortality. Therefore, it is crucial to promptly identify and treat the underlying causes of hyperphosphatemia. Hyperphosphatemia is typically associated with renal failure. Less common causes include hypoparathyroidism; burn injury; metabolic and respiratory acidosis; rhabdomyolysis; tumor lysis syndrome; acromegaly; and excessive intake of phosphorus from food or medication. AIM: The study aimed to identify the possible causes of an asymptomatic increase in blood phosphorus levels in young healthy adults. METHODS: Laboratory tests were performed in young healthy men and women aged 18 to 35 years. RESULTS: Despite preserved renal function, asymptomatic hyperphosphatemia was diagnosed in 12 (9.9%) participants. A significant association was found between hyperphosphatemia and the use of electronic nicotine delivery systems and heated tobacco products (p = 0.0002). CONCLUSION: More research is needed on the effects of electronic nicotine delivery systems and heated tobacco products on human health, especially calcium and phosphorus metabolism.