Chapter I

THE PROBLEM AND ITS BACKGROUND

Introduction

Phosphorus is the second to the most abundant important mineral in the human

body after calcium (Raina, et al. 2012). Most blood phosphate is derived from diet and

is usually present in all food, but some is also derived from bone metabolism. The

average dietary intake for adults is about 8001400 mg, most of which is derived from

dairy products, cereals, eggs, and meat (Mcpherson and Pincus, 2011).

Phosphate in the blood may be absorbed in the intestine from dietary sources,

released from cells into blood, and lost from bone. In healthy individuals, all these

processes are relatively constant and easily regulated by renal excretion or reabsorption

of phosphate (Bishop, 2010).

Plasma contains both inorganic and organic phosphate, but inorganic phosphate

is the one being measured. The apparent concentration of inorganic phosphate in whole

blood specimens may decrease or increase with time. McPherson and Pincus (2009)

stated that diurnal variation may also affect its levels.

Increased phosphate level in the blood is termed hyperphosphatemia. Patients

who are at greatest risk for this are those who have acute or chronic renal failure. It

may also be from its increased intake increased release of cellular phosphate.

In contrast, starvation and alcoholism can cause the levels of phosphate to fall.

The same is true of disorders that make it hard for certain individuals to absorb
nutrients, such as in Crohns and celiac disease. Some drugs like antacids and diuretics

may similarly lower the level of phosphate in the blood (Bishop, 2012).

In any laboratory procedures, one of the most significant aspects to be

recognized is the preanalytical factors which will include patient related variables such

as fasting requirements that might affect the test results if not taken into consideration

(Strasinger and Lorenzo, 2011).

Customarily, when subjected into a phosphorus test, patients arent required to

fast. However, it was stated in the 6 th edition of the book by Bishop entitled Clinical

Chemistry: Techniques, Principles, Correlations that patients are not required to fast for

phosphate determinations. But, according to an article in Food and Nutrition Board,

Institute of Medicine, patients it is advised to fast for at least 12 to 14 hours prior to the

test. Furthermore, in the 5 th edition of the Clinical Chemistry by Tietz, a fasting serum

specimen is recommended for phosphate determination.

Other than that, in a survey conducted by the researchers in Koronadal City as

well as in General Santos City, 4 out of 8 ( 50%) clinical laboratories does not require

fasting preparations for a serum phosphate test.

This contradicting fact urged the researchers to investigate in order to know if

there was a significant difference in the results which was conducted between the non-

fasting and fasting specimens for serum phosphate level determinations. This study

helped provide information on which specimen will give accurate results.

Conceptual Framework

This study determined the relationship between and among variables such as the

independent variables, intervening variables and dependent variables.

Independent Intervening Dependent Variables

Variables Variables
Serum Phosphate
Non-fasting and Age Levels
Fasting State of the
Respondents Gender

Figure 1: Conceptual Framework

Figure 1: shows the framework which the researchers used to investigate if there

was a significant difference between the non-fasting and fasting state of male and

female Medical Technology Students of the St. Alexius College between 18-25 years

old.

The age and the gender of the participants was considered as the intervening

variables in the study.

Statement of the Problem

This study determined and compared the serum phosphate levels of the 30

selected male and female Medical Technology Students between 18-25 years old in

non-fasting and fasting state. Specifically, the following were answered:

1. What were the serum phosphate values of Medical Technology Students of

St. Alexius College between 18-25 years old in:

A. Male
B. Female

2. What were the serum phosphate values of Medical Technology Students of

St. Alexius College in:

A. Non-fasting State
B. Fasting State

3. Was there any significant difference between the values of serum

phosphate in non-fasting and fasting state in relation to the male and

female Medical Technology Students of St Alexius College between 18-25

years old?

Scope and Limitation of the Study

To determine the serum phosphate levels from the respondents, this study used

blood samples obtained from 60 (30 male and 30 female) randomly selected Medical
Technology Students of St. Alexius College between 18-25 years old. A

spectrophotometric method was utilized using the ammonium molybdate reagent.

The results was compared using t-test as the statistical method to know if there

was a significant difference in the values obtained from non-fasting and fasting male

and female Medical Technology students.

Significance of the Study

This study was highly valuable to the following:

1. Medical professionals - the results of this research was helpful to the medical

professionals especially to the doctors because helped them decide whether to let a

patient fast or not during a serum phosphate test and thus they can have faster results

and diagnosis.

This also provided awareness as well as information not just to the physician but

also to the medical technologists who were responsible for performing the test.

2. Clinical laboratories this study also offered additional statistics to the clinical

laboratories which runs tests on serum phosphate levels.

3. Patients this research gave the patients an additional information regarding the

serum phosphate test

Definition of Terms
 1. Spectrophotometry this method used a spectrophotometer to determine the

serum phosphate levels of the blood specimens obtained from the subjects of the study

using an ammonium molybdate reagent.

2. Basal state collection this is the preferred state on which the specimens shall be

obtained from the patient. When in the fasting state, the blood was collected early in the

morning after 12 to 14 hours.

3. Fasting this is a specimen requirement requiring the patients to avoid intake of

food for 12-14 hours.

4. Ammonium molybdate was the reagent used to determine the serum phosphate

levels in the body of the patient.

5. Serum phosphate was the level of inorganic phosphate in the body specifically in

the blood which was measured in this study.