Serum calcium: A new, independent, prospective risk factor for myocardial infarction in middle-aged men followed for 18 years

Lind, Lars; Skarfors, Einar; Berglund, Lars; Lithell, Hans; Ljunghall, Sverker

doi:10.1016/s0895-4356(97)00104-2

Cited by 153 publications

(142 citation statements)

References 28 publications

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“…(40) However, serum calcium and/or phosphate concentrations have been associated with increased carotid artery plaque thickness (1) and increased incidence of cardiovascular events and death in large retrospective (3,4) and prospective cohorts (2,41) in the general population. Primary hyperparathyroidism is another condition with increased serum calcium concentrations and has been associated with increased risk of cardiovascular events and death, (5,6) although evidence for increased vascular calcification is inconsistent.…”

Section: Discussionmentioning

confidence: 99%

“…Serum calcium concentrations are positively associated with increased carotid artery plaque thickness (1) and with increased incidence of myocardial infarction (MI) and death. (2)(3)(4) An increased risk of cardiovascular events and death also has been reported in primary hyperparathyroidism, a condition in which serum calcium is elevated. (5,6) In patients with renal failure, calcium supplements accelerate vascular calcification and increase mortality in both dialysis and predialysis populations.…”

Section: Introductionmentioning

confidence: 99%

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Relationships between vascular calcification, calcium metabolism, bone density, and fractures

Wang

Bolland

Pelt

et al. 2010

Journal of Bone and Mineral Research

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Factors involved with calcium metabolism, such as serum calcium and phosphate and calcium intake, have been associated with vascular disease in different populations. We investigated whether this association is mediated via increased vascular calcification by assessing relationships between these factors and abdominal aortic calcification (AAC) and coronary artery calcification (CAC). A total of 1471 healthy postmenopausal women participated in a 5-year randomized, placebo-controlled trial of calcium 1 g/day, and 323 healthy middle-aged and older men participated in a 2-year randomized, placebo-controlled trial of calcium 600 or 1200 mg/day. AAC was assessed on vertebral morphometric images at baseline and follow-up. Based on computed tomography, 163 men had CAC assessed, on average, 1.5 years after study completion. In elderly women, AAC was positively related to serum calcium (p < .001), phosphate (p ¼ .04), and the calcium-phosphate product (p ¼ .003), but changes in AAC over time and incidence of cardiovascular events were not related to these variables. In middle-aged men, AAC and CAC were not consistently related to these variables. Neither dietary calcium intake nor calcium supplementation was associated with changes in the prevalence of AAC over time, and calcium supplementation also was not related to CAC scores in men. After adjusting for age, AAC was not associated with low bone mineral density (BMD) at baseline, changes in BMD over time, or fracture incidence. CAC also was not related to baseline BMD. In summary, serum calcium and phosphate are associated with AAC in older women, but dietary calcium intake and calcium supplementation were not associated with changes in AAC over 2 to 5 years. ß

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relationships between vascular calcification, calcium metabolism, bone density, and fractures

Wang

Bolland

Pelt

et al. 2010

Journal of Bone and Mineral Research

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“…Intracellular calcium disturbances have been suggested as the factor linking the wide range of abnormalities of the metabolic syndrome, such as hypertension, insulin resistance and obesity [8,9]. A few previous epidemiological investigations have explored the associations between extracellular serum levels of calcium, insulin sensitivity and secretion [10][11][12][13]. However, previous studies have been limited by the use of surrogate markers of insulin sensitivity and secretion [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…A few previous epidemiological investigations have explored the associations between extracellular serum levels of calcium, insulin sensitivity and secretion [10][11][12][13]. However, previous studies have been limited by the use of surrogate markers of insulin sensitivity and secretion [10][11][12][13]. All previous epidemiological studies have included subjects with diabetes or IFG and IGT [10][11][12][13], making it difficult to evaluate the independent relationship of serum calcium with the underlying causes of pathologically increased levels of glucose.…”

Section: Introductionmentioning

confidence: 99%

“…All previous epidemiological studies have included subjects with diabetes or IFG and IGT [10][11][12][13], making it difficult to evaluate the independent relationship of serum calcium with the underlying causes of pathologically increased levels of glucose. Furthermore, all previous studies have included individuals with supra-and subnormal levels of calcium [10][11][12][13] and our knowledge of the relationship between serum calcium within the normal range and insulin sensitivity and secretion is limited.…”

Section: Introductionmentioning

confidence: 99%

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Serum calcium is independently associated with insulin sensitivity measured with euglycaemic–hyperinsulinaemic clamp in a community-based cohort

et al. 2006

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Aims/hypothesis Diabetes mellitus type 2 is associated with altered calcium metabolism. Moreover, in diseases with supranormal serum calcium levels, such as primary hyperparathyroidism, the prevalence of diabetes is increased. Relatively little is known about the relationship between serum calcium concentration and the underlying causes of diabetes-insulin resistance and defective insulin secretionin the normocalcaemic general population. Materials and methods We investigated associations between serum calcium concentration and insulin sensitivity and secretion in a population-based cohort of elderly men (Uppsala Longitudinal Study of Adult Men, n=961). Insulin sensitivity index (M/I; glucose disposal rate [M] divided by mean insulin concentration [I]) was assessed using euglycaemic-hyperinsulinaemic clamp, and insulin secretion was estimated from the early insulin response (EIR) during an OGTT.Results In a multivariable linear regression model adjusting for BMI, physical activity, smoking, consumption of tea, alcohol, coffee and dietary calcium, serum phosphate and serum creatinine, 1 SD increase in serum calcium was associated with 0.17 mg kg −1 min −1 (mU/l) −1 × 100 (0.024 mg kg −1 min −1 [pmol/l] −1 ×100) decrease in M/I (p=0.01). The results remained robust in individuals with normal fasting glucose, normal glucose tolerance and serum calcium within the normal range (n=413, regression coefficient for 1 SD increase −0.45, p=0.001). Serum calcium was not associated with EIR. Dietary intake of calcium was not independently associated with insulin sensitivity or EIR. Conclusion/interpretation Our data support the notion that endogenous calcium may be involved early in the development of diabetes and that this effect is mediated mainly through effects on insulin sensitivity rather than defective insulin secretion. Dietary intake of calcium does not seem to influence insulin sensitivity.

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Cross‐sectional association between blood cholesterol and calcium levels in genetically diverse strains of mice

Cousineau,

Loftus,

Churchill

et al. 2024

FEBS Open Bio

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Genetically diverse outbred mice allow for the study of genetic variation in the context of high dietary and environmental control. Using a machine learning approach, we investigated clinical and morphometric factors that associate with serum cholesterol levels in 840 genetically unique Diversity Outbred mice of both sexes (n=417 male and 423 female), and on both a control chow (% kcals in diet: protein 22%, carbohydrate 62%, fat 16%, no cholesterol) and high fat high sucrose (% kcals in diet: protein 15%, carbohydrate 41%, fat 45%, 0.05% cholesterol). We find expected elevations of cholesterol in male mice, as well as in mice with elevated serum triglycerides and/or fed a high fat high sucrose diet. The third strongest predictor was serum calcium which correlated with serum cholesterol across both diets and sexes (r=0.39‐0.48) in both Diversity Outbred (p=3.0 x 10‐43) and BXD (p=0.005) mice. This is in‐line with several human cohort studies which show associations between calcium and cholesterol, and calcium as an independent predictor of cardiovascular events.

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Serum calcium: A new, independent, prospective risk factor for myocardial infarction in middle-aged men followed for 18 years

Cited by 153 publications

References 28 publications

Relationships between vascular calcification, calcium metabolism, bone density, and fractures

Relationships between vascular calcification, calcium metabolism, bone density, and fractures

Serum calcium is independently associated with insulin sensitivity measured with euglycaemic–hyperinsulinaemic clamp in a community-based cohort

Cross‐sectional association between blood cholesterol and calcium levels in genetically diverse strains of mice

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