Abnormal maximal tubular reabsorption of phosphate as a novel biomarker of physical dysfunction in older adults
Bibliographic record
Abstract
BACKGROUND: Physical dysfunction is a preclinical stage of disability in older adults, linked to severe adverse outcomes such as death and hospitalization. Maximal tubular reabsorption of phosphate (TmP/GFR), as a key biomarker of phosphate metabolism, may be related to physical dysfunction, but this relationship has not yet been explored. METHODS: Using data from the Rugao Longitudinal Ageing Study (RLAS), longitudinal logistic regression was employed to explore the relationship between abnormal TmP/GFR and physical dysfunction. For validation, the UK Biobank dataset was combined, and mendelian randomization (MR) was conducted to investigate causality. The maximal phosphate reabsorption was assessed using TmP/GFR, while physical dysfunction were evaluated through grip strength and the Timed Up and Go (TUG) test. RESULTS: During the four-year follow-up, 89 (13.55%) and 279 (40.85%) participants were identified as having a new onset of decreased grip and TUG. The abnormal TmP/GFR population had a significantly higher risk of decreased grip (OR 2.03, 95% CI 1.20-3.49) and decreased TUG (OR 1.49, 95% CI 1.05-2.12). MR analysis demonstrated the causal effect of TmP/GFR dysfunction population had significantly lower grip and lower walking speed. CONCLUSION: This study first identifies abnormal TmP/GFR as a novel biomarker of physical dysfunction in older adults. Additionally, its causal relationship further substantiates the reliability of this finding. Abnormal TmP/GFR enables early detection of physical dysfunction, facilitating the prevention of severe adverse outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".