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Zhang K, Zhang T, Lv QY, Han Y, Cai T, Gu FM, Gu ZX, Zhao JY, Liang JY, Gao M, Gao YF, Hu R, Cui D, Li B, Liu K. U-shaped association between serum calcium and in-hospital mortality in diabetes patients with congestive heart failure: a cohort study. Sci Rep 2024; 14:13412. [PMID: 38862553 PMCID: PMC11167038 DOI: 10.1038/s41598-024-63603-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/30/2024] [Indexed: 06/13/2024] Open
Abstract
Previous studies have reported that the significant association between serum calcium and mortality substantially in patients, especially among those with intensive care unit (ICU). And In diabetes mellitus, congestive heart failure (CHF) is a significant comorbidity. We aim to evaluate the association between serum calcium levels and in-hospital mortality among patients with diabetes and congestive heart failure. The participants in this study were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. To scrutinize potential associations between serum calcium levels and in-hospital mortality, a comprehensive analysis encompassing multivariate logistic regression, cubic spline function model, threshold effect analysis, and subgroup analysis was performed. This retrospective cohort study encompassed 7063 patients, among whom the in-hospital mortality stood at 12.2%. In the multivariate logistic regression, adjusted odds ratios (ORs) were contrasted with the reference category Q6 (8.8-9.1 mg/dL) for serum calcium levels and in-hospital mortality. The adjusted ORs for Q1 (≤ 7.7 mg/dL), Q2 (7.7-8 mg/dL), and Q7 (≥ 9.1 mg/dL) were 1.69 (95% CI 1.17-2.44, p = 0.005), 1.62 (95% CI 1.11-2.36, p = 0.013), and 1.57 (95% CI 1.1-2.24, p = 0.012) respectively. The dose-response analysis uncovered a U-shaped relationship between serum calcium levels and in-hospital mortality in diabetic patients with heart failure. Subgroup analyses confirmed result stability notwithstanding the influence of diverse factors. Our investigation revealed a U-shaped correlation between serum calcium levels and in-hospital mortality in diabetes patients with congestive heart failure, pinpointing a significant inflection point at 9.05 mg/dL.
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Affiliation(s)
- Kai Zhang
- Cardiovascular Surgery Department of Jilin University Second Hospital, No. 218, Ziqiang Street, Changchun, Jilin Province, China.
| | - Tianqi Zhang
- Cardiovascular Surgery Department of Jilin University Second Hospital, No. 218, Ziqiang Street, Changchun, Jilin Province, China
| | - Qian Yu Lv
- Cardiovascular Surgery Department of Jilin University Second Hospital, No. 218, Ziqiang Street, Changchun, Jilin Province, China
| | - Yu Han
- Department of Ophthalmology, First Hospital of Jilin University, Changchun, China
| | - Tianyi Cai
- Department of Ophthalmology, Second Hospital of Jilin University, Changchun, China
| | - Fang Ming Gu
- Cardiovascular Surgery Department of Jilin University Second Hospital, No. 218, Ziqiang Street, Changchun, Jilin Province, China
| | - Zhao Xuan Gu
- Cardiovascular Surgery Department of Jilin University Second Hospital, No. 218, Ziqiang Street, Changchun, Jilin Province, China
| | - Jia Yu Zhao
- Cardiovascular Surgery Department of Jilin University Second Hospital, No. 218, Ziqiang Street, Changchun, Jilin Province, China
| | - Jia Ying Liang
- Cardiovascular Surgery Department of Jilin University Second Hospital, No. 218, Ziqiang Street, Changchun, Jilin Province, China
| | - Min Gao
- Department of Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Ya Fang Gao
- Department of Ophthalmology, Second Hospital of Jilin University, Changchun, China
| | - Rui Hu
- Department of Ophthalmology, Second Hospital of Jilin University, Changchun, China
| | - Dan Cui
- Cardiovascular Surgery Department of Jilin University Second Hospital, No. 218, Ziqiang Street, Changchun, Jilin Province, China
| | - Bo Li
- Cardiovascular Surgery Department of Jilin University Second Hospital, No. 218, Ziqiang Street, Changchun, Jilin Province, China
| | - Kexiang Liu
- Cardiovascular Surgery Department of Jilin University Second Hospital, No. 218, Ziqiang Street, Changchun, Jilin Province, China.
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Ru X, Yang L, Shen G, Wang K, Xu Z, Bian W, Zhu W, Guo Y. Microelement strontium and human health: comprehensive analysis of the role in inflammation and non-communicable diseases (NCDs). Front Chem 2024; 12:1367395. [PMID: 38606081 PMCID: PMC11007224 DOI: 10.3389/fchem.2024.1367395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/08/2024] [Indexed: 04/13/2024] Open
Abstract
Strontium (Sr), a trace element with a long history and a significant presence in the Earth's crust, plays a critical yet often overlooked role in various biological processes affecting human health. This comprehensive review explores the multifaceted implications of Sr, especially in the context of non-communicable diseases (NCDs) such as cardiovascular diseases, osteoporosis, hypertension, and diabetes mellitus. Sr is predominantly acquired through diet and water and has shown promise as a clinical marker for calcium absorption studies. It contributes to the mitigation of several NCDs by inhibiting oxidative stress, showcasing antioxidant properties, and suppressing inflammatory cytokines. The review delves deep into the mechanisms through which Sr interacts with human physiology, emphasizing its uptake, metabolism, and potential to prevent chronic conditions. Despite its apparent benefits in managing bone fractures, hypertension, and diabetes, current research on Sr's role in human health is not exhaustive. The review underscores the need for more comprehensive studies to solidify Sr's beneficial associations and address the gaps in understanding Sr intake and its optimal levels for human health.
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Affiliation(s)
- Xin Ru
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Lida Yang
- College of Nursing, Mudanjiang Medical University, Mudanjiang, China
| | - Guohui Shen
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Kunzhen Wang
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Zihan Xu
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Wenbo Bian
- Zibo Agricultural Science Research Institute, Shandong, China
- Digital Agriculture and Rural Research Institute of CAAS (Zibo), Shandong, China
| | - Wenqi Zhu
- Agricultural Information Institute, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Yanzhi Guo
- Chinese Academy of Agricultural Sciences, Beijing, China
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Zhao R, Xiong C, Zhao Z, Zhang J, Huang Y, Xie Z, Qu X, Luo X, Li Z. Exploration of the Shared Hub Genes and Biological Mechanism in Osteoporosis and Type 2 Diabetes Mellitus based on Machine Learning. Biochem Genet 2023; 61:2531-2547. [PMID: 37140844 DOI: 10.1007/s10528-023-10390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 04/18/2023] [Indexed: 05/05/2023]
Abstract
A substantial amount of evidence suggests a close relationship between osteoporosis (OP) and Type 2 Diabetes Mellitus (T2DM), but the mechanisms involved remain unknown. Therefore, we conducted this study with the aim of screening for hub genes common to both diseases and conducting a preliminary exploration of common regulatory mechanisms. In the present study, we first screened genes significantly associated with OP and T2DM by the univariate logistic regression algorithm. And then, based on cross-analysis and random forest algorithm, we obtained three hub genes (ACAA2, GATAD2A, and VPS35) and validated the critical roles and predictive performance of the three genes in both diseases by differential expression analysis, receiver operating characteristic (ROC) curves, and genome wide association study (GWAS) analysis. Finally, based on gene set enrichment analysis (GSEA) and the construction of the miRNA-mRNA regulatory network, we conducted a preliminary exploration of the co-regulatory mechanisms of three hub genes in two diseases. In conclusion, this study provides promising biomarkers for predicting and treating both diseases and offers novel directions for exploring the common regulatory mechanisms of both diseases.
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Affiliation(s)
- Runhan Zhao
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
| | - Chuang Xiong
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
| | - Zenghui Zhao
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
| | - Jun Zhang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
| | - Yanran Huang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
| | - Zhou Xie
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
| | - Xiao Qu
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China
| | - Xiaoji Luo
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China.
- Orthopedic Laboratory of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China.
| | - Zefang Li
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400016, People's Republic of China.
- Department of Orthopedics, Qianjiang Central Hospital of Chongqing, Qianjiang, Chongqing, 409000, People's Republic of China.
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Barnett MJ. Association Between Primary Hyperparathyroidism and Secondary Diabetes Mellitus: Findings From a Scoping Review. Cureus 2023; 15:e40743. [PMID: 37350980 PMCID: PMC10284313 DOI: 10.7759/cureus.40743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 06/24/2023] Open
Abstract
An ill-defined association exists between diabetes mellitus (insulin resistance) and primary hyperparathyroidism. This article explores this phenomenon while providing an explanation for such a relationship and reviewing the evidence regarding the response to insulin sensitivity following a parathyroidectomy. Primary hyperparathyroidism may increase the risk of developing insulin resistance; peculiarly, this is not present in all patients. It is likely that both intracellular hypercalcemia and hypophosphatemia alter the insulin receptor expression and response; the contribution of parathyroid hormone is less clear. Following parathyroidectomy, patients may demonstrate improvement in their insulin sensitivity, while others have no response or a detrimental effect. A varied phenotype exists among patients, and furthermore, it is unclear why certain patients demonstrate improvement in insulin sensitivity following a parathyroidectomy, whereas others fail to do so. While this review provides a broad overview of the general endocrine community, it is imperative to note that clinical applicability is limited until further studies address these remaining uncertainties. Due to the lack of understanding regarding this endocrinological enigma, the presence of insulin resistance, at this present time, should not be a criterion for a parathyroidectomy.
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Affiliation(s)
- Maxim J Barnett
- Internal Medicine, Einstein Medical Center Philadelphia, Philadelphia, USA
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Bosman A, Koek WNH, Campos-Obando N, van der Eerden BCJ, Ikram MA, Uitterlinden AG, van Leeuwen JPTM, Zillikens MC. Sexual dimorphisms in serum calcium and phosphate concentrations in the Rotterdam Study. Sci Rep 2023; 13:8310. [PMID: 37221192 DOI: 10.1038/s41598-023-34800-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 05/08/2023] [Indexed: 05/25/2023] Open
Abstract
Sex differences in serum phosphate and calcium have been reported but the exact nature and underlying regulatory mechanisms remain unclear. We aimed to compare calcium and phosphate concentrations between sexes, and explore potential covariates to elucidate underlying mechanisms of sex differences in a prospective, population-based cohort study. Pooled data of subjects > 45 years from three independent cohorts of the Rotterdam Study (RS) were used: RS-I-3 (n = 3623), RS-II-1 (n = 2394), RS-III-1 (n = 3241), with separate analyses from an additional time point of the first cohort RS-I-1 (n = 2688). Compared to men, women had significantly higher total serum calcium and phosphate concentrations which was not explained by BMI, kidney function nor smoking. Adjustment for serum estradiol diminished sex differences in serum calcium while adjustment for serum testosterone diminished sex differences in serum phosphate. Adjustment for vitamin D and alkaline phosphatase did not change the association between sex and calcium or phosphate in RS-I-1. In the sex-combined group, both serum calcium and phosphate decreased with age with a significant interaction for sex differences for serum calcium but not phosphate. In sex-stratified analyses, serum estradiol but not testosterone was inversely associated with serum calcium in both sexes. Serum estradiol was inversely associated with serum phosphate in both sexes to a similar degree, while serum testosterone was inversely associated with serum phosphate in both sexes with an apparent stronger effect in men than in women. Premenopausal women had lower serum phosphate compared to postmenopausal women. Serum testosterone was inversely associated with serum phosphate in postmenopausal women only. In conclusion, women > 45 years have higher serum calcium and phosphate concentrations compared to men of similar age, not explained by vitamin D or alkaline phosphatase concentrations. Serum estradiol but not testosterone was inversely associated with serum calcium while serum testosterone was inversely associated with serum phosphate in both sexes. Serum testosterone may in part explain sex differences in serum phosphate while estradiol could partly explain sex differences in serum calcium.
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Affiliation(s)
- Ariadne Bosman
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - W Nadia H Koek
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Natalia Campos-Obando
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Bram C J van der Eerden
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Johannes P T M van Leeuwen
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M C Zillikens
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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Tanaka S, Kawamura H, Imoto Y, Urata Y, Hontama S, Oda M, Sakaue M, Ito M. Interaction between inorganic phosphate concentration and glucose metabolism in mild refeeding syndrome model. J Clin Biochem Nutr 2023; 72:126-131. [PMID: 36936877 PMCID: PMC10017325 DOI: 10.3164/jcbn.22-99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/06/2022] [Indexed: 02/10/2023] Open
Abstract
Refeeding syndrome is a major clinical problem that leads to fatal complications in patients suffering from malnutrition. Hypophosphatemia inevitably is observed at the onset of refeeding syndrome and therefore is monitored during refeeding; however, the causes of metabolic changes in phosphate concentration during refeeding remain poorly understood. In a previous study, we established a refeeding syndrome model employing total parenteral nutrition with insulin-induced hypophosphatemia, but the symptoms were severe and the metabolic mechanisms in this model may not have been representative of clinical conditions. Therefore, we established a new animal model of mild refeeding syndrome by using a shorter fasting period followed by a single refeeding. These mild refeeding syndrome-model rats exhibited hypophosphatemia without increases in urinary phosphate excretion. Interestingly, administration of the combination of phosphate and insulin during refeeding promoted insulin secretion during refeeding. This model implies that Pi may directly promote insulin secretion in pancreatic cells. These results clarify the interaction between phosphate and glucose metabolism pancreatic cells during refeeding syndrome in a mild refeeding syndrome model.
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Affiliation(s)
- Sarasa Tanaka
- Graduate School of Human Science and Environment, University of Hyogo, 1-1-12 Shinzaike-Honcho, Himeji, Hyogo 670-0092, Japan
- To whom correspondence should be addressed. E-mail:
| | - Hiromi Kawamura
- Graduate School of Human Science and Environment, University of Hyogo, 1-1-12 Shinzaike-Honcho, Himeji, Hyogo 670-0092, Japan
| | - Yumeno Imoto
- School of Human Science and Environment, University of Hyogo, 1-1-12 Shinzaike-Honcho, Himeji, Hyogo 670-0092, Japan
| | - Yuri Urata
- School of Human Science and Environment, University of Hyogo, 1-1-12 Shinzaike-Honcho, Himeji, Hyogo 670-0092, Japan
| | - Sayuka Hontama
- School of Human Science and Environment, University of Hyogo, 1-1-12 Shinzaike-Honcho, Himeji, Hyogo 670-0092, Japan
| | - Momoko Oda
- School of Human Science and Environment, University of Hyogo, 1-1-12 Shinzaike-Honcho, Himeji, Hyogo 670-0092, Japan
| | - Motoyoshi Sakaue
- Graduate School of Human Science and Environment, University of Hyogo, 1-1-12 Shinzaike-Honcho, Himeji, Hyogo 670-0092, Japan
| | - Mikiko Ito
- Graduate School of Human Science and Environment, University of Hyogo, 1-1-12 Shinzaike-Honcho, Himeji, Hyogo 670-0092, Japan
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The Association between Admission Serum Phosphorus and Preoperative Deep Venous Thrombosis in Geriatric Hip Fracture: A Retrospective Study. Diagnostics (Basel) 2023; 13:diagnostics13030545. [PMID: 36766651 PMCID: PMC9914597 DOI: 10.3390/diagnostics13030545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/30/2022] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the association between serum phosphorus level and preoperative deep vein thrombosis (DVT) in geriatric hip fractures. METHODS Older adults with hip fractures were screened between January 2015 and September 2019. Demographic and clinical characteristics of the patients were collected. Multivariate binary logistic regression and generalized additive models were used to identify the linear and nonlinear associations between serum phosphorus levels and preoperative DVT. Analyses were performed using Empower Stats and R software. RESULTS In this study, 1818 patients were included, with an average age of 79.39 ± 6.87. Of these, 30.25% were males, and 580 patients had DVT. The study found that when serum phosphorus was used as a continuous variable, there was a statistically significant difference in the relationship between blood phosphorus and the occurrence of DVT (p < 0.05). Furthermore, we also found curvilinear relationships. Serum phosphorus = 0.71 mmol/L was the inflection point in the curve. When serum phosphorus was <0.71 mmol/L, the serum phosphorus was associated with DVT (OR = 1.64; 95% CI: 1.04-2.59; p = 0.0333). With a 0.1 mmol/L increase, the DVT increased 0.64 times. When phosphorus was >0.71 mmol/L, there was no significant difference in the correlation between serum phosphorus levels and DVT (OR = 1.03; 95% CI: 0.98-1.09; p = 0.186). CONCLUSION Serum phosphorus was nonlinearly associated with preoperative DVT in geriatric patients with hip fractures, and serum phosphorus level could be considered a predictor of DVT risk.
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Wong SK. A Review of Current Evidence on the Relationship between Phosphate Metabolism and Metabolic Syndrome. Nutrients 2022; 14:4525. [PMID: 36364791 PMCID: PMC9656201 DOI: 10.3390/nu14214525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 07/30/2023] Open
Abstract
Phosphorus, present as phosphate in biological systems, is an essential mineral for various biological activities and biochemical processes. Numerous studies have indicated that disturbed phosphate balance may contribute to the development of metabolic syndrome (MetS). However, no consistent result was found on the association between phosphorus intake and serum phosphate concentration with MetS. It is believed that both positive and negative impacts of phosphorus/phosphate co-exist in parallel during MetS condition. Reduced phosphate level contributed to the development of obesity and hyperglycaemia. Low phosphate is believed to compromise energy production, reduce exercise capacity, increase food ingestion, and impair glucose metabolism. On the other hand, the effects of phosphorus/phosphate on hypertension are rather complex depending on the source of phosphorus and subjects' health conditions. Phosphorus excess activates sympathetic nervous system, renin-angiotensin-aldosterone system, and induces hormonal changes under pathological conditions, contributing to the blood pressure-rising effects. For lipid metabolism, adequate phosphate content ensures a balanced lipid profile through regulation of fatty acid biosynthesis, oxidation, and bile acid excretion. In conclusion, phosphate metabolism serves as a potential key feature for the development and progression of MetS. Dietary phosphorus and serum phosphate level should be under close monitoring for the management of MetS.
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Affiliation(s)
- Sok Kuan Wong
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
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Mironov N, Haque M, Atfi A, Razzaque MS. Phosphate Dysregulation and Metabolic Syndrome. Nutrients 2022; 14:4477. [PMID: 36364739 PMCID: PMC9658852 DOI: 10.3390/nu14214477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 10/05/2023] Open
Abstract
Phosphorus is one of the most abundant minerals in the human body. It is essential for almost all biochemical activities through ATP formation, intracellular signal transduction, cell membrane formation, bone mineralization, DNA and RNA synthesis, and inflammation modulation through various inflammatory cytokines. Phosphorus levels must be optimally regulated, as any deviations may lead to substantial derangements in glucose homeostasis. Clinical studies have reported that hyperphosphatemia can increase an individual's risk of developing metabolic syndrome. High phosphate burden has been shown to impair glucose metabolism by impairing pancreatic insulin secretion and increasing the risk of cardiometabolic disorders. Phosphate toxicity deserves more attention as metabolic syndrome is being seen more frequently worldwide and should be investigated further to determine the underlying mechanism of how phosphate burden may increase the cardiometabolic risk in the general population.
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Affiliation(s)
- Nikolay Mironov
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA 16509, USA
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defense Health, National Defense University of Malaysia, Kuala Lumpur 57000, Malaysia
| | - Azeddine Atfi
- Department of Pathology, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Mohammed S. Razzaque
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA 16509, USA
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Yin X, Chen JY, Huang XJ, Lai JH, Huang C, Yao W, Li NX, Huang WC, Guo XG. Association between vitamin D serum levels and insulin resistance assessed by HOMA-IR among non-diabetic adults in the United States: Results from NHANES 2007-2014. Front Nutr 2022; 9:883904. [PMID: 36313112 PMCID: PMC9614433 DOI: 10.3389/fnut.2022.883904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Insulin resistance, a pathological response to insulin hormone in insulin-dependent cells, is characterized by the presence of high glucose and insulin concentrations. The homeostasis model of insulin resistance (HOMA-IR) is one of the most used indexes to estimate insulin resistance by assessing the fasting glucose and insulin levels. An association was observed between vitamin D levels and insulin resistance, which varied in different ethnic groups, and there is some evidence that vitamin D supplementation could contribute to the improvement of insulin resistance. This study assessed the association between 25-hydroxyvitamin D (25[OH]D) concentration and HOMA-IR in American adults aged 20 years and older, without diabetes and other chronic diseases that can influence insulin resistance. The data from the National Health and Nutrition Examination Survey (NHANES) 2007–2014 were used by exploiting the free and publicly-accessible web datasets. Linear regression models were performed to evaluate the association between serum 25(OH)D concentration and HOMA-IR, and a negative association was observed, which remained significant following the adjustment for age, gender, race/ethnicity, education, body mass index (BMI), physical activity, the season of examination, current smoking, hypertension, the use of drugs which can influence insulin resistance, serum bicarbonates, triglycerides, and calcium and phosphorus levels. Only in non-Hispanic Blacks was this inverse association between vitamin D and HOMA-IR not observed in the fully adjusted model. Further studies are needed to explain the mechanisms of the observed ethnic/racial differences in the association of vitamin D levels with HOMA-IR.
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Affiliation(s)
- Xin Yin
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, China
| | - Jia-Yu Chen
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Xiang-Jie Huang
- School of Computer Science and Engineering, Central South University, Changsha, China
| | - Jia-Hong Lai
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Chang Huang
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Wang Yao
- Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Nan-Xi Li
- Department of Psychiatric Medicine, The Mental Health College of Guangzhou Medical University, Guangzhou, China
| | - Wei-Chao Huang
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Xu-Guang Guo
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China,Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, China,*Correspondence: Xu-Guang Guo
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11
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Al-Okbi S, Sabry S, Al-Siedy ESK, Elsayed S. Plasma Calcium and Phosphorus Levels and Cardiovascular Disease Risks in Egyptian Type 2 Diabetic Patients. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Cardiovascular complication of diabetes is considered an important issue that needs deep investigations. The levels of plasma calcium (Ca) and phosphorus (P) have been implicated as having an association to cardiovascular diseases.
AIM: The objective of the present research was to study the plasma levels of both Ca and P and their association to the atherogenic ratio; total cholesterol: high density lipoprotein-cholesterol and the plasma albumin in male and female patients with type 2-diabetes. The interrelation between anthropometric parameters represented by body mass index (BMI), waist circumference and waist/hip ratio with Ca and P were studied. Also, the association between plasma Ca and P with their dietary intake were investigated.
Subjects and METODS: Thirty-one type 2-diabetic male and female patients participated in the study, in addition of ten healthy subjects. Biochemical parameters, anthropometric measurements and nutrients′ intake were assessed. Biochemical parameters include plasma Ca, P, lipid profile, albumin, liver function tests and creatinine.
RESULTS: Plasma Ca levels of female patients of BMI> 30 kg/m2 demonstrated significant increase compared to the control group. All male and female patients showed significant increase in plasma P compared to the control group. Glycosylated hemoglobin of male and females showed significant high values compared to the control group except for diabetic male of BMI>30 kg/m2 that showed insignificant increase. No significant changes in plasma TG and LDL-C levels were noticed compared to the control. Plasma TC of patients showed significant high levels compared to the control group. The levels of HDL-C of patients were significantly lower than that of the control. The ratios of TC/HDL-C diabetic patients either male or female and whatever their BMI were significantly higher than that of the control. No significant changes in plasma activities of ALT and AST and bilirubin levels were observed among the different groups including the control. Plasma albumin levels demonstrated significant reduction compared to the control group whatever their sexes or BMI. Plasma creatinine levels of the different diabetic groups showed insignificant change from the control group except for the male group of BMI<30 kg/m2 that showed significant elevation. In male, plasma Ca showed significant negative correlation with albumin and positive correlation with creatinine and dietary vitamin D. In female, a significant positive correlation was noticed between plasma and dietary P while a negative correlation was observed between plasma Ca and dietary iron.
CONCLUSION: Elevated of plasma P together with reduced plasma albumin and elevated TC/HDL-C may reflect an association of plasma P to CVD in male and female diabetic subjects while high plasma Ca might predict CVD in only female diabetic patients of BMI > 30 kg/m2.
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Lan Q, Zhang Y, Lin F, Meng Q, Buys N, Fan H, Sun J. Sex-Specific Associations Between Serum Phosphate Concentration and Cardiometabolic Disease: A Cohort Study on the Community-Based Older Chinese Population. Diabetes Metab Syndr Obes 2022; 15:813-826. [PMID: 35313679 PMCID: PMC8934154 DOI: 10.2147/dmso.s354167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/08/2022] [Indexed: 04/20/2023] Open
Abstract
PURPOSE This study aimed to investigate the association between sex-specific baseline serum phosphate and the incidence of new-onset cardiometabolic disease in a cohort of Shanghai-based older Chinese individuals. PATIENTS AND METHODS A community cohort of 5000 disease-free Chinese men and women was recruited in 2013 and followed until 2017 for the development of cardiometabolic disease. Participants underwent index and follow-up health screens at the Tongji Medical School affiliated Shanghai East Hospital, including blood biochemistry analysis, anthropometric measurements, interview on health-related behaviors, and clinical evaluation. RESULTS Higher baseline serum phosphate (>1.25 mmol/L) was significantly associated with new-onset type-2 diabetes mellitus (HR 1.730, 95% CI 1.127-2.655) and metabolic syndrome (HR 0.640, 95% CI 1.085-2.155) in women. Baseline serum phosphate was associated with age, BMI, waist circumference, SBP, total calcium, bicarbonate, and total cholesterol in women. The estimated risk of developing diabetes mellitus in women with inorganic phosphate >1.25 mmol/L was 14.54%. Inorganic phosphate accounted for 9.2% of the variance explained in a total estimated 14.52% of variance attributed to BMI, total cholesterol, total calcium, waist circumference, and inorganic phosphate. CONCLUSION Serum phosphate concentration showed sex-specific associations with diabetes and metabolic syndrome. Higher inorganic phosphate was associated with increased risk of developing diabetes mellitus in women. These findings may be important in the assessment of individualized metabolic risk.
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Affiliation(s)
- Qin Lan
- Shanghai East Hospital, Tongji University, Shanghai, People's Republic of China
- School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Yuming Zhang
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Fang Lin
- Shanghai East Hospital, Tongji University, Shanghai, People's Republic of China
- School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Qingshu Meng
- Shanghai East Hospital, Tongji University, Shanghai, People's Republic of China
- School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Nicholas Buys
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Huimin Fan
- Shanghai East Hospital, Tongji University, Shanghai, People's Republic of China
- School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Jing Sun
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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Bu SY, Choi MJ, Choi DS, Jung YM, Jang IS, Yang N, Kim K, Park CY. Perspectives on the systematic review for the 2020 Dietary Reference Intakes for Koreans for calcium. Nutr Res Pract 2022; 16:S89-S112. [PMID: 35651839 PMCID: PMC9127516 DOI: 10.4162/nrp.2022.16.s1.s89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 11/15/2022] Open
Abstract
An accurate assessment of the recommended calcium (Ca) intake may contribute to reducing the risk of fractures and chronic diseases, ultimately improving quality of life. This review was performed to summarize key findings of Ca studies, investigate the effect of Ca intake on health outcomes, and determine the adequacy of evidence to revise the 2015 Dietary Reference Intakes for Koreans (KDRIs) for Ca in 2020. Databases were searched for intervention studies that assessed health outcomes by providing Ca in diets or as supplements. The framework of the systematic review comprised conducting literature searches, data extraction, quality assessment of the literature, and summarizing key findings relevant to set the Estimated Average Requirement (EAR) and Tolerable Upper Intake Level (UL) for Ca for the 2020 KDRI. The final search was performed in June 2019. A total of 13,309 studies were identified through databases and manual search. Sixtyfive studies were included in the final quality assessment and were summarized according to health indicators. As bone health was used as an indicator of the EAR for Ca, literature reports on bone health were further categorized by the life-cycle stage of the participants. This systematic review did not find new evidence that could be applied to the general Korean adult population, including postmenopausal women, for defining a new EAR for Ca in the 2020 KDRIs. Evidence in most of the reviewed literature was considered weak; however, some evidence was found that could improve the criteria on how the EAR for Ca was determined in children and adolescents. A review of the literature for the 2020 KDRIs for Ca did not find strong evidence in order to change the recommended values of the 2015 KDRIs. More clinical interventions are required among Koreans to strengthen the body of evidence to warrant the revision of the KDRIs.
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Affiliation(s)
- So Young Bu
- Department of Food and Nutrition, Daegu University, Gyeongsan 38453, Korea
| | - Mi Ja Choi
- Department of Food and Nutrition, Keimyung University, Daegu 42601, Korea
| | - Da Seul Choi
- Graduate School of Education, Chonnam National University, Gwangju 61186, Korea
| | - You-Mi Jung
- Department of Food and Nutrition, Keimyung University, Daegu 42601, Korea
| | - In-Sil Jang
- Department of Food and Nutrition, Keimyung University, Daegu 42601, Korea
| | - Narae Yang
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| | - Clara Yongjoo Park
- Department of Food and Nutrition, Chonnam National University, Gwangju 61186, Korea
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Giovenzana A, Carnovale D, Phillips B, Petrelli A, Giannoukakis N. Neutrophils and their role in the aetiopathogenesis of type 1 and type 2 diabetes. Diabetes Metab Res Rev 2022; 38:e3483. [PMID: 34245096 DOI: 10.1002/dmrr.3483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/12/2021] [Accepted: 06/19/2021] [Indexed: 12/25/2022]
Abstract
Multiple and complex aetiological processes underlie diabetes mellitus, which invariably result in the development of hyperglycaemia. Although there are two prevalent distinct forms of the disease, that is, type 1 and type 2 diabetes, accumulating evidence indicates that these syndromes share more aetiopathological mechanisms than originally thought. This compels a rethinking of the approaches to prevent and treat the different manifestations of what eventually becomes a hyperglycaemic state. This review aims to address the involvement of neutrophils, the most abundant type of granulocytes involved in the initiation of the acute phase of inflammation, in the aetiopathogenesis of diabetes mellitus, with a focus on type 1 and type 2 diabetes. We review the evidence that neutrophils are the first leucocytes to react to and accumulate inside target tissues of diabetes, such as the pancreas and insulin-sensitive tissues. We then review available data on the role of neutrophils and their functional alteration, with a focus on NETosis, in the progression towards clinical disease. Finally, we review potential approaches as secondary and adjunctive treatments to limit neutrophil-mediated damage in the prevention of the progression of subclinical disease to clinical hyperglycaemia.
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Affiliation(s)
- Anna Giovenzana
- San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
| | - Debora Carnovale
- San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
| | - Brett Phillips
- Institute of Cellular Therapeutics, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Alessandra Petrelli
- San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
| | - Nick Giannoukakis
- Institute of Cellular Therapeutics, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
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The Association between Branched-Chain Amino Acids (BCAAs) and Cardiometabolic Risk Factors in Middle-Aged Caucasian Women Stratified According to Glycemic Status. Nutrients 2021; 13:nu13103307. [PMID: 34684308 PMCID: PMC8538048 DOI: 10.3390/nu13103307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 02/07/2023] Open
Abstract
We examined the glycemic status-stratified relationships between total serum branched-chain amino acid (BCAA) concentrations and cardiometabolic risk factors in middle-aged Caucasian women. The study included 349 women divided into 2 subgroups: a normoglycemic group (NG, n = 184) and a dysglycemic group (DG, n = 165). Blood samples, anthropometric parameters, and blood pressure were measured. HOMA-IR, albumin-corrected calcium (CCa), and fatty liver index (FLI) were calculated. BCAA concentrations were higher in the women with dysglycemia. BCAAs moderately correlated with BMI and FLI in the NG group and with BMI, FLI, total calcium (TCa), CCa, HbA1c, TG/HDL-C, and HDL-C in the DG group. After adjusting for age and BMI, correlations for TCa, CCa, HbA1c, HDL-C, and TG/HDL-C remained significant. The coexistence of increased BCAAs with dysglycemic status was associated with markedly higher concentrations of TCa, CCa, HbA1c, and TG, which were not observed in the DG women with low level of BCAAs. Multiple regression showed that TCa or CCa, age and BCAAs were significantly associated with HbA1c independently of BMI only in the DG group. We conclude that dysglycemia in particular predisposes women to a significant relationship between total BCAAs and circulating calcium and HbA1c, and that these relationships are independent of BMI and may reflect the pathophysiological calcium-dependent mechanisms connecting BCAAs with metabolic disturbances.
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Lacerda-Abreu MA, Meyer-Fernandes JR. Extracellular Inorganic Phosphate-Induced Release of Reactive Oxygen Species: Roles in Physiological Processes and Disease Development. Int J Mol Sci 2021; 22:ijms22157768. [PMID: 34360534 PMCID: PMC8346167 DOI: 10.3390/ijms22157768] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/08/2021] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
Inorganic phosphate (Pi) is an essential nutrient for living organisms and is maintained in equilibrium in the range of 0.8-1.4 mM Pi. Pi is a source of organic constituents for DNA, RNA, and phospholipids and is essential for ATP formation mainly through energy metabolism or cellular signalling modulators. In mitochondria isolated from the brain, liver, and heart, Pi has been shown to induce mitochondrial reactive oxygen species (ROS) release. Therefore, the purpose of this review article was to gather relevant experimental records of the production of Pi-induced reactive species, mainly ROS, to examine their essential roles in physiological processes, such as the development of bone and cartilage and the development of diseases, such as cardiovascular disease, diabetes, muscle atrophy, and male reproductive system impairment. Interestingly, in the presence of different antioxidants or inhibitors of cytoplasmic and mitochondrial Pi transporters, Pi-induced ROS production can be reversed and may be a possible pharmacological target.
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Affiliation(s)
- Marco Antonio Lacerda-Abreu
- Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-901, RJ, Brazil
- Instituto Nacional de Ciência e Tecnologia em Biologia Estrutural e Bioimagem, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, RJ, Brazil
- Correspondence: (M.A.L.-A.); (J.R.M.-F.); Tel.: +55-21-3938-6781 (M.A.L.-A. & J.R.M.-F.); Fax: +55-21-2270-8647 (M.A.L.-A. & J.R.M.-F.)
| | - José Roberto Meyer-Fernandes
- Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-901, RJ, Brazil
- Instituto Nacional de Ciência e Tecnologia em Biologia Estrutural e Bioimagem, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, RJ, Brazil
- Correspondence: (M.A.L.-A.); (J.R.M.-F.); Tel.: +55-21-3938-6781 (M.A.L.-A. & J.R.M.-F.); Fax: +55-21-2270-8647 (M.A.L.-A. & J.R.M.-F.)
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Pathophysiological Implications of Imbalances in Fibroblast Growth Factor 23 in the Development of Diabetes. J Clin Med 2021; 10:jcm10122583. [PMID: 34208131 PMCID: PMC8230948 DOI: 10.3390/jcm10122583] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/24/2021] [Accepted: 06/08/2021] [Indexed: 12/18/2022] Open
Abstract
Observational studies have associated the increase in fibroblast growth factor (FGF) 23 levels, the main regulator of phosphate levels, with the onset of diabetes. These studies open the debate on the plausible existence of undescribed diabetogenic mechanisms derived from chronic supraphysiological levels of FGF23, a prevalent condition in chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. These maladaptive and diabetogenic responses to FGF23 may occur at different levels, including a direct effect on the pancreatic ß cells, and an indirect effect derived from the stimulation of the synthesis of pro-inflammatory factors. Both mechanisms could be mediated by the binding of FGF23 to noncanonical receptor complexes with the subsequent overactivation of signaling pathways that leads to harmful effects. The canonical binding of FGF23 to the receptor complex formed by the receptor FGFR1c and the coreceptor αKlotho activates Ras/MAPK/ERK signaling. However, supraphysiological concentrations of FGF23 favor non-αKlotho-dependent binding of this molecule to other FGFRs, which could generate an undesired overactivation of the PLCγ/CN/NFAT pathway, as observed in cardiomyocytes and hepatocytes. Moreover, the decrease in αKlotho expression may constitute a contributing factor to the appearance of these effects by promoting the nonspecific activation of the PLCγ/CN/NFAT to the detriment of the αKlotho-dependent Ras/MAPK/ERK pathway. The description of these mechanisms would allow the development of new therapeutic targets susceptible to be modified by dietary changes or by pharmacological intervention.
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Jaballah A, Soltani I, Bahia W, Dandana A, Hasni Y, Miled A, Ferchichi S. The Relationship Between Menopause and Metabolic Syndrome: Experimental and Bioinformatics Analysis. Biochem Genet 2021; 59:1558-1581. [PMID: 33973091 DOI: 10.1007/s10528-021-10066-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/06/2021] [Indexed: 11/27/2022]
Abstract
Menopausal hormonal changes have been associated with the emergence of the metabolic syndrome (MetS) and its consequences such as type 2 diabetes (T2D) and cardiovascular diseases (CVD). The common gene signature and the associated signaling pathways of MetS, T2D, CVD and menopause status have not been widely studied. We analyzed a total of 314 women aged between 35 and 75 years. The sample was divided into two groups: Group I, including women in the premenopausal period and Group II, comprising women in the post-menopausal period. The presence of MetS and its components were evaluated, as well as occurrence of T2D and CVD in both groups. We also exploited the translational bioinformatics approach to choose the common gene signatures for MetS, T2D, CVD and the menopause status. The frequency of the MetS was significantly higher in postmenopausal women than in premenopausal ones (67.1 vs. 27.2%, p < 0.001). Gene mining analysis revealed that a total of 47 genes were commonly associated with MetS, T2D, CVD and the menopausal changes. The gene enrichment analysis showed that these genes were markedly enriched in biological processes, including positive regulation of binding, positive regulation of leukocyte cell-cell adhesion, regulation of lipid localization. Furthermore, P53 signaling pathway, prolactin signaling pathway, parathyroid hormone synthesis, secretion and action were the top enriched pathways. Additionally, network analysis revealed TGFB1, SPP1, MMP2, MMP9, CCL2, IGF1, EGFR, ICAM1, TNF and IL6 as important hub genes with significant interacting partners. These hub genes identified in our study may play key role in menopausal changes and influence the risks of MetS, T2D and CVD.
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Affiliation(s)
- Abir Jaballah
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia.
| | - Ismael Soltani
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia
| | - Wael Bahia
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia
| | - Azza Dandana
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia
| | - Yosra Hasni
- Dept. Endocrinology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Abdelhedi Miled
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia.,Dept. Biochemistry, Farhat Hached University Hospital, Sousse, Tunisia
| | - Salima Ferchichi
- Research Unit of Clinical and Molecular Biology (UR17ES29), Department of Biochemistry, Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia.,Dept. Biochemistry, Farhat Hached University Hospital, Sousse, Tunisia
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Zhu H, Wang H, Jia Y, Cheng L, Cheng X. Increased serum calcium levels are associated with carotid atherosclerotic plaque in normocalcaemic individuals with type 2 diabetes. Ther Adv Endocrinol Metab 2021; 12:2042018821995369. [PMID: 33854752 PMCID: PMC8010831 DOI: 10.1177/2042018821995369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/22/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patients with type 2 diabetes mellitus (T2DM) have an elevated risk of atherosclerotic cardiovascular disease. Although previous data have suggested that serum calcium levels could be involved in T2DM and cardiovascular disease, whether this applies in T2DM patients with atherosclerosis remains unclear. This study therefore aimed to investigate the relationship between serum calcium levels within the physiological ranges and carotid atherosclerotic plaque in T2DM patients. METHODS A total of 594 normocalcaemic in-patients with T2DM were recruited, of whom 231 had carotid atherosclerotic plaque. Serum calcium levels were measured and carotid ultrasonography was performed. RESULTS Patients with plaque had significantly higher serum albumin-corrected calcium than those without plaque [9.02 (8.78-9.34) mg/dL versus 8.86 (8.66-9.06) mg/dL, p < 0.001]. As serum albumin-corrected calcium levels increased across tertiles, the percentage of plaque increased (27.6%, 35.5%, and 55.7%; p < 0.001). Logistic regression showed that serum albumin-corrected calcium levels were independently and positively correlated with the presence of plaque, but not parathyroid hormone levels. Compared with patients in the lowest serum calcium tertiles, the odds ratio for plaque in patients in the upper quartile was 2.47 (95% confidence interval 1.51-4.03, p < 0.001) after adjustment for potential confounders. CONCLUSION Serum albumin-corrected calcium levels are elevated in patients with T2DM and carotid atherosclerotic plaques.
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Affiliation(s)
- Huijing Zhu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Endocrinology & Metabolism, Heze Municipal Hospital, Heze, Shandong, China
| | - Huili Wang
- Department of Endocrinology & Metabolism, Heze Municipal Hospital, Heze, Shandong, China
| | | | - Lin Cheng
- Department of Endocrinology & Metabolism, Heze Municipal Hospital, Heze, Shandong, China
| | - Xingbo Cheng
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, Jiangsu 215006, China
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Akter S, Eguchi M, Kochi T, Kabe I, Nanri A, Mizoue T. Association of Serum Calcium and Phosphate Concentrations with Glucose Metabolism Markers: The Furukawa Nutrition and Health Study. Nutrients 2020; 12:nu12082344. [PMID: 32764504 PMCID: PMC7468836 DOI: 10.3390/nu12082344] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 08/03/2020] [Indexed: 01/03/2023] Open
Abstract
Calcium and phosphate may play an important role in cardio-metabolic abnormalities, including type 2 diabetes; however, epidemiological evidence of the association of calcium and phosphate status with glucose metabolism among Asians is limited. In the current study, we performed a cross-sectional analysis of the association of serum calcium, phosphate, and calcium–phosphate product concentrations with glucose metabolism markers among Japanese individuals. Overall, 1701 workers (aged 18–78 years) who participated in a health survey were enrolled in this study. Multivariable linear regression models were used to estimate means of homeostatic model assessment of insulin resistance (HOMA-IR), homeostatic model assessment of β-cell function (HOMA-β), and glycated hemoglobin (HbA1c). Serum calcium concentration was positively associated with HOMA-IR and HbA1c (p for trend < 0.01). Multivariable-adjusted means (95% confidence interval (CI)) of HOMA-IR for the lowest and highest quartiles of serum calcium were 0.78 (0.75–0.82) and 1.01 (0.96–1.07), respectively. The corresponding values for HbA1c were 5.24 (5.22–5.27) and 5.29 (5.26–5.32), respectively. Serum phosphate and calcium–phosphate product concentrations were inversely associated with HOMA-IR (p for trend < 0.01). Multivariable-adjusted means (95% CI) of HOMA-IR for the lowest and highest quartiles of serum phosphate were 1.04 (0.99–1.09) and 0.72 (0.69–0.76), respectively. The corresponding values for calcium–phosphate product were 1.04 (0.99–1.09) and 0.73 (0.69–0.77), respectively. The current findings suggest that higher serum calcium and lower serum phosphate concentrations are associated with IR among apparently healthy adults.
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Affiliation(s)
- Shamima Akter
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (A.N.); (T.M.)
- Correspondence: ; Tel.: +81-3-3202-7181; Fax: +81-3-3202-7364
| | - Masafumi Eguchi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo 100-8322, Japan; (M.E.); (T.K.); (I.K.)
| | - Takeshi Kochi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo 100-8322, Japan; (M.E.); (T.K.); (I.K.)
| | - Isamu Kabe
- Department of Health Administration, Furukawa Electric Corporation, Tokyo 100-8322, Japan; (M.E.); (T.K.); (I.K.)
| | - Akiko Nanri
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (A.N.); (T.M.)
- Department of Food and Health Sciences, Fukuoka Women’s University, Fukuoka 813-8529, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (A.N.); (T.M.)
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Chen L, Guo Q, Wang Q, Luo C, Chen S, Wen S, Tan A, Yang W, Bao W, Hu FB, Liu L. Association between plasma strontium, a bone-seeking element, and type 2 diabetes mellitus. Clin Nutr 2020; 39:2151-2157. [DOI: 10.1016/j.clnu.2019.08.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/14/2019] [Accepted: 08/29/2019] [Indexed: 01/23/2023]
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Circulating calcium levels and the risk of type 2 diabetes: a systematic review and meta-analysis. Br J Nutr 2020; 122:376-387. [PMID: 31208474 DOI: 10.1017/s0007114519001430] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Abnormal Ca homeostasis has been associated with impaired glucose metabolism. However, the epidemiological evidence is controversial. We aimed to assess the association between circulating Ca levels and the risk of type 2 diabetes mellitus (T2DM) or abnormal glucose homeostasis through conducting a systematic review and meta-analysis. Eligible studies were identified by searching electronic database (PubMed, Embase and Google Scholar) and related references with de novo results from primary studies up to December 2018. A random-effects meta-analysis was performed to estimate the weighted relative risks (RR) and 95 % CI for the associations. The search yielded twenty eligible publications with eight cohort studies identified for the meta-analysis, which included a total of 89 165 participants. Comparing the highest with the lowest category of albumin-adjusted serum Ca, the pooled RR was 1·14 (95 % CI 1·05, 1·24) for T2DM (n 51 489). Similarly, serum total Ca was associated with incident T2DM (RR 1·25; 95 % CI 1·10, 1·42) (n 64 502). Additionally, the adjusted RR for 1 mg/dl increments in albumin-adjusted serum Ca or serum total Ca levels was 1·16 (95 % CI 1·07, 1·27) and 1·19 (95 % CI 1·11, 1·28), respectively. The observed associations remained with the inclusion of a cohort study with ionised Ca as the exposure. However, data pooled from neither case-control (n 4) nor cross-sectional (n 8) studies manifested a significant correlation between circulating Ca and glucose homeostasis. In conclusion, accumulated data from the cohort studies suggest that higher circulating Ca levels are associated with an augmented risk of T2DM.
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Andretta A, Schieferdecker MEM, Petterle RR, Dos Santos Paiva E, Boguszewski CL. Relations between serum magnesium and calcium levels and body composition and metabolic parameters in women with fibromyalgia. Adv Rheumatol 2020; 60:18. [PMID: 32171334 DOI: 10.1186/s42358-020-0122-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 02/17/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Correlate serum magnesium (Mg) and Calcium (Ca) levels with body composition and metabolic parameters in women with fibromyalgia (FM). PATIENTS AND METHODS Cross-sectional study compared with a control group paired by age and body mass index (BMI) of adult women diagnosed with fibromyalgia. All participants went through assessment of their body composition through dual-energy X-ray absorptiometry (DXA) and had blood samples collected for dosing of Mg, Ca, C-reactive Protein (CRP), lipidogram and glycemia. RESULTS 53 women with FM (average age 48.1 ± 8.2 years, average BMI 26.6 ± 4.5 kg/m2) and 50 control women (average age 47.1 ± 9.9 years, average BMI 25.6 ± 3.6 kg/m2) participated in the study. Serum levels turned out to have inverse correlation with CRP in the FM group (r = - 0.29, p = 0.03) and with BMI and glycemia in the control group (r = 0.31; p = 0.02 and r = 0.48; p = 0.0004 respectively). Serum levels of calcium correlated with triglycerides (r = 0.29; p = 0.03) in the FM group and with glycemia in the control group (r = 0.64; p = 0.0001). CONCLUSIONS In patients with FM, magnesemia turned out to have inverse correlation with CRP and calcemia had positive association with triglycerides.
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Affiliation(s)
- Aline Andretta
- Department of Internal Medicine, Federal University of Parana (UFPR), Curitiba, PR, Brazil. Rua General Carneiro, 181, Curitiba, PR, 80060-900, Brazil.
| | | | | | | | - César Luiz Boguszewski
- Endocrine Division (SEMPR), Department of Internal Medicine, Federal University of Parana (UFPR), Curitiba, PR, Brazil
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Guo W, Zhou Q, Jia Y, Xu J. Cluster and Factor Analysis of Elements in Serum and Urine of Diabetic Patients with Peripheral Neuropathy and Healthy People. Biol Trace Elem Res 2020; 194:48-57. [PMID: 31140035 PMCID: PMC6987062 DOI: 10.1007/s12011-019-01747-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 05/03/2019] [Indexed: 12/27/2022]
Abstract
Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus, presented as a major teratogenic cause worldwide. This study discussed alternation and correlation of magnesium (Mg), calcium (Ca), copper (Cu), zinc (Zn), iron (Fe), chromium (Cr), and selenium (Se) among DPN patients and healthy people using multivariate statistical analysis. Fifty patients with DPN were recruited from endocrinology department, First Hospital of Jilin University between January 2010 and October 2011 and also 50 healthy subjects were enrolled at the same time. Inductively coupled plasma mass spectrometry (ICP-MS) was used to assay elements in serum and urine. Cluster analysis was used to clarify alternation of elements' homogeneity. Factor analysis was performed to evaluate the most informative kinds of elements. Mg, Ca, Zn, and Cr in DPN patients were significantly lower in serum whereas significantly higher in urine. Elements were clustered into 4 or 5 clusters based on internal association using between-groups linkage algorithm. Serum Cr, Se, and Fe were grouped, and Mg related to Ca more closely in both serum and urine in DPN. Factor analysis revealed discrepancies of elements' contribution. Cr, Se, and Fe appeared to be the most crucial factors contributing to DPN. Mg, Ca, Zn, and Cu were more influential, whereas Cr became less potent to disease. Contributed value of elements could be determined and specified using loadings in scree plot. Future studies and delicate statistical models should be applied.
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Affiliation(s)
- Wenjia Guo
- Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, China
| | - Qi Zhou
- Department of Pediatrics, First Hospital of Jilin University, Changchun, China
| | - Yanan Jia
- Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, China
| | - Jiancheng Xu
- Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, China.
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Brown RB. Diabetes, Diabetic Complications, and Phosphate Toxicity: A Scoping Review. Curr Diabetes Rev 2020; 16:674-689. [PMID: 31686640 DOI: 10.2174/1573399815666191104113236] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/09/2019] [Accepted: 10/28/2019] [Indexed: 02/06/2023]
Abstract
This article presents a scoping review and synthesis of research findings investigating the toxic cellular accumulation of dysregulated inorganic phosphate-phosphate toxicity-as a pathophysiological determinant of diabetes and diabetic complications. Phosphorus, an essential micronutrient, is closely linked to the cellular metabolism of glucose for energy production, and serum inorganic phosphate is often transported into cells along with glucose during insulin therapy. Mitochondrial dysfunction and apoptosis, endoplasmic reticulum stress, neuronal degeneration, and pancreatic cancer are associated with dysregulated levels of phosphate in diabetes. Ectopic calcification involving deposition of calcium-phosphate crystals is prevalent throughout diabetic complications, including vascular calcification, nephropathy, retinopathy, and bone disorders. A low-glycemic, low-phosphate dietary intervention is proposed for further investigations in the treatment and prevention of diabetes and related diabetic pathologies.
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Affiliation(s)
- Ronald B Brown
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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Sobczak AIS, Stewart AJ. Coagulatory Defects in Type-1 and Type-2 Diabetes. Int J Mol Sci 2019; 20:E6345. [PMID: 31888259 PMCID: PMC6940903 DOI: 10.3390/ijms20246345] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/06/2019] [Accepted: 12/12/2019] [Indexed: 12/16/2022] Open
Abstract
Diabetes (both type-1 and type-2) affects millions of individuals worldwide. A major cause of death for individuals with diabetes is cardiovascular diseases, in part since both types of diabetes lead to physiological changes that affect haemostasis. Those changes include altered concentrations of coagulatory proteins, hyper-activation of platelets, changes in metal ion homeostasis, alterations in lipid metabolism (leading to lipotoxicity in the heart and atherosclerosis), the presence of pro-coagulatory microparticles and endothelial dysfunction. In this review, we explore the different mechanisms by which diabetes leads to an increased risk of developing coagulatory disorders and how this differs between type-1 and type-2 diabetes.
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Affiliation(s)
| | - Alan J. Stewart
- Medical and Biological Sciences Building, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK;
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Thongprayoon C, Cheungpasitporn W, Mao MA, Erickson SB. Calcium‐phosphate product and its impact on mortality in hospitalized patients. Nephrology (Carlton) 2019; 25:22-28. [DOI: 10.1111/nep.13603] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Charat Thongprayoon
- Division of Nephrology and Hypertension, Department of MedicineMayo Clinic Rochester Minnesota USA
| | - Wisit Cheungpasitporn
- Division of Nephrology, Department of MedicineUniversity of Mississippi Medical Center Jackson Mississippi USA
| | - Michael A Mao
- Division of Nephrology and Hypertension, Department of MedicineMayo Clinic Rochester Minnesota USA
| | - Stephen B Erickson
- Division of Nephrology and Hypertension, Department of MedicineMayo Clinic Rochester Minnesota USA
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Wu F, Juonala M, Pahkala K, Buscot MJ, Sabin MA, Pitkänen N, Rönnemaa T, Jula A, Lehtimäki T, Hutri-Kähönen N, Kähönen M, Laitinen T, Viikari JSA, Raitakari OT, Magnussen CG. Youth and Long-Term Dietary Calcium Intake With Risk of Impaired Glucose Metabolism and Type 2 Diabetes in Adulthood. J Clin Endocrinol Metab 2019; 104:2067-2074. [PMID: 30629189 DOI: 10.1210/jc.2018-02321] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 01/03/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT To the best of our knowledge, no previous studies have examined the role of youth calcium intake in the development of impaired glucose metabolism, especially those with long-term high calcium intake. OBJECTIVES To examine whether youth and long-term (between youth and adulthood) dietary calcium intake is associated with adult impaired glucose metabolism and type 2 diabetes (T2D). DESIGN, SETTING, AND PARTICIPANTS The Cardiovascular Risk in Young Finns Study is a 31-year prospective cohort study (n = 1134; age, 3 to 18 years at baseline). EXPOSURES Dietary calcium intake was assessed at baseline (1980) and adult follow-up visits (2001, 2007, and 2011). Long-term (mean between youth and adulthood) dietary calcium intake was calculated. MAIN OUTCOME MEASURES Adult impaired fasting glucose (IFG) and T2D. RESULTS We found no evidence for nonlinear associations between calcium intake and IFG or T2D among females and males (all P for nonlinearity > 0.05). Higher youth and long-term dietary calcium intake was not associated with the risk of IFG or T2D among females or males after adjustment for confounders, including youth and adult body mass index. CONCLUSIONS Youth or long-term dietary calcium intake is not associated with adult risk of developing impaired glucose metabolism or T2D.
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Affiliation(s)
- Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Marie-Jeanne Buscot
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Matthew A Sabin
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | | | - Antti Jula
- Department of Health, National Institute for Health and Welfare, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center - Tampere, Tampere University, Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | | | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Shridhar K, Kinra S, Gupta R, Khandelwal S, D P, Cox SE, Dhillon PK. Serum Calcium Concentrations, Chronic Inflammation and Glucose Metabolism: A Cross-Sectional Analysis in the Andhra Pradesh Children and Parents Study (APCaPS). Curr Dev Nutr 2019; 3:nzy085. [PMID: 30891537 PMCID: PMC6416530 DOI: 10.1093/cdn/nzy085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/06/2018] [Accepted: 10/23/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Evidence suggests a role for elevated serum calcium in dysregulated glucose metabolism, linked through low-level chronic inflammation. OBJECTIVES We investigated the association of elevated serum calcium concentrations (corrected for albumin) with markers of dysregulated glucose metabolism and type II diabetes and tested if these associations were accounted for by chronic inflammation in a rural Indian population. METHODS A cross-sectional analysis of participants aged 40-84 y from the Andhra Pradesh Children and Parents Study (APCaPS; n = 2699, 52.2% women) was conducted. Comprehensive information on household, sociodemographic, and lifestyle factors; medical and family history; physical measurements; blood measurements including fasting plasma glucose (FPG), fasting insulin (FI), serum calcium, albumin, phosphorous, vitamin D (in a subset), and creatinine were analyzed. Additionally, in a random sample of healthy participants (n = 1000), inflammatory biomarkers (interleukins 6 and 18, soluble intercellular adhesion molecule 1, adiponectin, and high-sensitivity C-reactive protein) were measured and an inflammatory score (IScore) calculated. RESULTS After adjustments for sociodemographics, lifestyle factors, and anthropometry the highest calcium quartile (Q4 compared with Q1) was associated with FI (β = 1.4 µU/ml; 95% CI: 1.2, 1.5 µU/ml; P-trend < 0.001), the homeostasis model assessment for insulin resistance (HOMA-IR) (β = 1.4; 95% CI: 1.2, 1.5; P-trend < 0.001), and was modestly associated with FPG (β = 2.1 mg/dL; 95% CI: -0.9, 5.2 mg/dL; P-trend = 0.058) and prevalent type II diabetes (OR = 1.6; 95% CI: 1.0, 2.6; P-trend= 0.020). In the healthy subgroup, the association of the highest calcium quartile was similar for FI and HOMA-IR. Additional adjustment with IScore did not alter the associations. Further, in a subset, all these associations were independent of endogenous regulators of calcium metabolism (serum vitamin D, phosphorus, and creatinine). Independently, after accounting for potential confounders, the highest IScore quartile (Q4 compared with Q1) was positively associated with FPG, FI, HOMA-IR, and prevalent prediabetes, and also with serum calcium concentrations in men. CONCLUSIONS Elevated serum calcium was positively associated with markers of dysregulated glucose metabolism and prevalent type II diabetes in a rural Indian population. Chronic inflammation did not mediate this association but was independently associated with markers of dysregulated glucose metabolism. Inflammation might be responsible for elevated serum calcium concentrations in men.
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Affiliation(s)
- Krithiga Shridhar
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
| | - Sanjay Kinra
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ruby Gupta
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
| | | | - Prabhakaran D
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
- London School of Hygiene and Tropical Medicine, London, UK
- Centre for Chronic Disease Control, Haryana, India
| | - Sharon E Cox
- London School of Hygiene and Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Preet K Dhillon
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
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Zhang Q, Ji L, Zheng H, Li Q, Xiong Q, Sun W, Zhu X, Li Y, Lu B, Liu X, Zhang S. Low serum phosphate and magnesium levels are associated with peripheral neuropathy in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract 2018; 146:1-7. [PMID: 30273706 DOI: 10.1016/j.diabres.2018.09.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 08/31/2018] [Accepted: 09/25/2018] [Indexed: 01/19/2023]
Abstract
AIMS To determine the relationship of serum phosphate, serum magnesium and peripheral nerve function in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 254 patients diagnosed with T2DM were included. Peripheral nerve function was evaluated by nerve conduction study with the use of electromyography. Composite z scores of conduction velocity, latency, and amplitude were constructed, respectively. Demographic, medical and laboratory data including serum phosphate and magnesium were collected. RESULTS Serum phosphate and serum magnesium levels were significantly lower in patients with diabetic peripheral neuropathy (DPN) (P < 0.01). And the percentages of DPN patients were lower in high tertile of serum phosphate and serum magnesium (P < 0.05). Furthermore, composite z score of conduction velocity (CV) (P = 0.012) were positively associated with serum phosphate levels and the composite z score of amplitude (P < 0.001) and CV (P = 0.041) were positively associated with serum magnesium levels. After adjusting potential related factors (age, gender, smoking, diabetes duration, body mass index, systolic blood pressure, glycated hemoglobin, total cholesterol, estimated glomerular filtration rate), serum levels of phosphate and magnesium were still related to status of DPN in logistic regression (P < 0.05). CONCLUSION Lower serum phosphate and magnesium significantly correlated with parameters of nerve conduction in T2DM patients. Serum phosphate and magnesium might underlie the pathophysiologic features of DPN.
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Affiliation(s)
- Qi Zhang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Lijin Ji
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Hangping Zheng
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qingchun Li
- Jing'an District Center Hospital of Shanghai, Fudan University, Shanghai 200040, China
| | - Qian Xiong
- Jing'an District Center Hospital of Shanghai, Fudan University, Shanghai 200040, China
| | - Wanwan Sun
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiaoming Zhu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yiming Li
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Bin Lu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiaoxia Liu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Shuo Zhang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China.
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Brey CW, Akbari-Alavijeh S, Ling J, Sheagley J, Shaikh B, Al-Mohanna F, Wang Y, Gaugler R, Hashmi S. Salts and energy balance: A special role for dietary salts in metabolic syndrome. Clin Nutr 2018; 38:1971-1985. [PMID: 30446179 DOI: 10.1016/j.clnu.2018.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/20/2018] [Accepted: 10/28/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Dietary salts sodium (Na+), potassium (K+), magnesium (Mg2+), and calcium (Ca2+) are important in metabolic diseases. Yet, we do not have sufficient understanding on the salts global molecular network in these diseases. In this systematic review we have pooled information to identify the general effect of salts on obesity, insulin resistance and hypertension. AIMS To assess the roles of salts in metabolic disorders by focusing on their individual effect and the network effect among these salts. METHODS We searched articles in PubMed, EMBASE and Google Scholar. We selected original laboratory research, systematic reviews, clinical trials, observational studies and epidemiological data that focused on dietary salts and followed the preferred reporting items for systematic review in designing the present systematic review. RESULTS From the initial search of 2898 studies we selected a total of 199 articles that met our inclusion criteria and data extraction. Alterations in metabolic pathways associated with the sensitivity of sodium, potassium, magnesium and calcium may lead to obesity, hypertension, and insulin resistance. We found that the results of most laboratory research, animal studies and clinical trials are coherent but some research outcome are either inconsistent or inconclusive. CONCLUSION Important of salts in metabolic disorder is evident. In order to assess the effects of dietary salts in metablic diseases, environmental factors, dietary habits, physical activity, and the microbiome, should be considered in any study. Although interest in this area of research continues to grow, the challenge is to integrate the action of these salts in metabolic syndrom.
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Affiliation(s)
| | - Safoura Akbari-Alavijeh
- Laboratory of Developmental Biology, Center for Vector Biology, Rutgers University, 180 Jones Avenue, New Brunswick, NJ, 08901, USA
| | - Jun Ling
- Department of Basic Sciences, Geisinger Commonwealth School of Medicine, 525 Pine Street, Scranton, PA, 18509, USA
| | - Jordan Sheagley
- Department of Basic Sciences, Geisinger Commonwealth School of Medicine, 525 Pine Street, Scranton, PA, 18509, USA
| | - Bilal Shaikh
- Laboratory of Developmental Biology, Center for Vector Biology, Rutgers University, 180 Jones Avenue, New Brunswick, NJ, 08901, USA
| | | | - Yi Wang
- Laboratory of Developmental Biology, Center for Vector Biology, Rutgers University, 180 Jones Avenue, New Brunswick, NJ, 08901, USA
| | - Randy Gaugler
- Laboratory of Developmental Biology, Center for Vector Biology, Rutgers University, 180 Jones Avenue, New Brunswick, NJ, 08901, USA
| | - Sarwar Hashmi
- Laboratory of Developmental Biology, Center for Vector Biology, Rutgers University, 180 Jones Avenue, New Brunswick, NJ, 08901, USA; Rutgers Center for Lipid Research, New Jersey Institute for Food, Nutrition, & Health, Rutgers University, USA.
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Al-Anazi A, Parhar R, Saleh S, Al-Hijailan R, Inglis A, Al-Jufan M, Bazzi M, Hashmi S, Conca W, Collison K, Al-Mohanna F. Intracellular calcium and NF- kB regulate hypoxia-induced leptin, VEGF, IL-6 and adiponectin secretion in human adipocytes. Life Sci 2018; 212:275-284. [PMID: 30308181 DOI: 10.1016/j.lfs.2018.10.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/19/2018] [Accepted: 10/06/2018] [Indexed: 11/26/2022]
Abstract
AIMS Hypoxia-induced adipokine release has been attributed mainly to HIF-1α. Here we investigate the role of intracellular calcium and NF-kB in the hypoxia-dependent release of leptin, VEGF, IL-6 and the hypoxia-induced inhibition of adiponectin release in human adipocytes. MAIN METHODS We used intracellular calcium imaging to compare calcium status in preadipocytes and in adipocytes. We subjected both cell types to hypoxic conditions and measured the release of adipokines induced by hypoxia in the presence and absence of HIF-1α inhibitor YC-1, NF-κB inhibitor SN50 and intracellular calcium chelator BAPTA-AM. KEY FINDINGS We demonstrate reduced intracellular calcium oscillations and increased oxidative stress as the cells transitioned from preadipocytes to adipocytes. We show that differentiation of preadipocytes to adipocytes is associated with distinct morphological changes in the mitochondria. We also show that hypoxia-induced secretion of leptin, VEGF, IL-6 and hypoxia-induced inhibition of adiponectin secretion are independent of HIF-1α expression. The hypoxia-induced leptin, VEGF and IL-6 release are [Ca++]i dependent whereas adiponectin is NF-kB dependent. SIGNIFICANCE Our work suggests a major role for [Ca++]i in preadipocyte differentiation to adipocytes and that changes in mitochondrial morphology in the adipocytes might underlie the reduced calcium oscillations observed in the adipocytes. It also demonstrates that multiple signaling pathways are associated with the hypoxia-induced adipokine secretion.
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Affiliation(s)
- Azizah Al-Anazi
- Department of Cell Biology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Ranjit Parhar
- Department of Cell Biology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Soad Saleh
- Department of Cell Biology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Reem Al-Hijailan
- Department of Cell Biology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Angela Inglis
- Department of Cell Biology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Mansour Al-Jufan
- Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Mohammed Bazzi
- Department of Biochemistry, College of Science, King Saud University, Riyadh 12372, Saudi Arabia
| | - Sarwar Hashmi
- Developmental Biology, Center for Vector Biology, Rutgers University, New Brunswick, NJ 08901, United States
| | - Walter Conca
- Department of Cell Biology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh 11211, Saudi Arabia
| | - Kate Collison
- Department of Cell Biology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Futwan Al-Mohanna
- Department of Cell Biology, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh 11211, Saudi Arabia.
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Dazini PO, Lanna CMM, Moreira APB. Relação entre vitamina D e cálcio no desenvolvimento do Diabetes Mellitus tipo 1 e 2 - Uma revisão de literatura. HU REVISTA 2018. [DOI: 10.34019/1982-8047.2017.v43.2663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A prevalência de obesidade, associada a hábitos alimentares inadequados e sedentarismo tem aumentado a ocorrência Diabetes Mellitus, tornando-se um problema de saúde pública. Perspectivas imediatas na mudança do ambiente para reverter o aumento dos níveis de obesidade não são promissores, e existe uma necessidade de considerar outras opções para prevenir o diabetes. Tem sido apontada uma associação inversa entre os baixos níveis da vitamina D e cálcio com a incidencia do Diabetes Mellitus. Desse modo, a vitamina D e o cálcio têm sido propostos como um possível agente terapêutico para a prevenção e tratamento da doença. O objetivo do estudo foi realizar uma revisão de literatura sobre a influência da vitamina D e do cálcio na fisiopatologia do diabetes mellitus, assim como no controle glicêmico. Estudos têm mostrado que a vitamina D em conjunto com o cálcio são capazes de reduzirem o risco do desenvolvimento do diabetes mellitus tipo 2, enquanto que a insuficiência de vitamina D e de cálcio pode influenciar negativamente a glicemia. Além disso, nível plasmático de 25(OH)D, tem sido correlacionado com o diagnóstico de Diabetes Mellitus tipo 1. Evidências recentes demonstram que a concentração sérica de vitamina D e do cálcio podem estar relacionados ao diabetes. Entretanto, estudos prospectivos e de intervenção em humanos que comprovem a efetividade de ambos, tanto na prevenção como no tratamento dessa doença, ainda são necessários.
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Li Z, Wang C, Li L, Shao M, Wang L, Lv X, Gao C, Niu H, Li B. The Study on the Correlation Between Six Kinds of Mineral Elements and Diabetes. Biol Trace Elem Res 2018; 183:226-232. [PMID: 28884459 DOI: 10.1007/s12011-017-1136-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 08/16/2017] [Indexed: 12/18/2022]
Abstract
The study aimed to explore the relationship of six kinds of mineral elements and diabetes among adults in northeast China. A cross-sectional survey was conducted in Jilin Province, northeast China. A total of 366 males and 204 females aged 18 ~ 77 years from Jingyu town, Dongliao town, and Changling town were included using a multistage stratified random cluster sampling design. Data was obtained from face to face interview, physical examination, and laboratory measurement. We defined the normal people (3.9 ~ 6.0 mmol/L), impaired fasting glucose (IFG) individuals (6.1 ~ 6.9 mmol/L), and diabetes mellitus (DM) (> 7.0 mmol/L) according to the WHO diagnostic criteria. Kruskal-Wallis test, Spearman rank correlation, as well as binary logistic regression were used to analyze influencing factors. lg(Cu/Zn)was correlated with DM (OR 8.390; 95% CI of OR 1.272-55.347). The specific mineral elements such as Zn, Ca, as well as Cu/Zn ratio may be the potential risk factors for diabetes. So, the supplement or reduction of these elements is supposed to be told to IFG to prevent or delay the occurrence of diabetes or DM to avoid its complication.
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Affiliation(s)
- Zhuo Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Changcong Wang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Lu Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Mengyun Shao
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Linbo Wang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Xin Lv
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Chunshi Gao
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Huikun Niu
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China.
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Kim KN, Oh SY, Hong YC. Associations of serum calcium levels and dietary calcium intake with incident type 2 diabetes over 10 years: the Korean Genome and Epidemiology Study (KoGES). Diabetol Metab Syndr 2018; 10:50. [PMID: 29946367 PMCID: PMC6006916 DOI: 10.1186/s13098-018-0349-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 06/02/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous evidence regarding the associations between serum calcium concentrations, dietary calcium intake, and type 2 diabetes (T2D) is limited. We investigated the longitudinal associations of serum calcium levels and dietary calcium intake with T2D development. METHODS This study used data from the Ansung-Ansan cohort, a community-based, prospective cohort that was followed up for 10 years. Cox regression models adjusted for potential confounders were used to evaluate the associations of serum calcium levels (mean, 9.41 mg/dL) and dietary calcium intake (median, 389.59 mg/day) with T2D incidence. Association between dietary calcium intake and serum calcium levels was assessed using linear regression models. RESULTS Albumin-adjusted serum calcium levels were not associated with T2D risk (hazard ratio [HR] = 1.07, 95% confidence interval [CI] 0.96, 1.19, p-value = 0.2333). A one-unit increase in log-transformed, energy-adjusted dietary calcium intake was associated with a decreased risk of T2D (HR = 0.88, 95% CI 0.77, 1.00, p-value = 0.0460) and lower albumin-adjusted serum calcium levels (β = - 0.04, 95% CI - 0.07, - 0.02, p-value = 0.0014). The associations did not differ according to sex (all p-values for interaction > 0.10). CONCLUSIONS Serum calcium levels were not associated with T2D risk, while higher dietary calcium intake was associated with a decreased risk of T2D development. These results have public health implications for predicting and preventing T2D development, as well as providing guidelines for diet and calcium supplementation.
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Affiliation(s)
- Kyoung-Nam Kim
- Division of Public Health and Preventive Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, Republic of Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-799 Republic of Korea
| | - Se-Young Oh
- Department of Food and Nutrition, Research Center for Human Ecology, College of Human Ecology, Kyung Hee University, 26 Kyungheedae-Ro Dongdaemun-Gu, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-799 Republic of Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, 103 Daehak-Ro Jongno-Gu, Seoul, Republic of Korea
- Environmental Health Center, Seoul National University College of Medicine, 103 Daehak-Ro Jongno-Gu, Seoul, Republic of Korea
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Kim JH, Lee SH, Park SJ, Yeum KJ, Choi B, Joo NS. Dietary Calcium Intake May Contribute to the HOMA-IR Score in Korean Females with Vitamin D Deficiency (2008-2012 Korea National Health and Nutrition Examination Survey). J Obes Metab Syndr 2017; 26:274-280. [PMID: 31089530 PMCID: PMC6489473 DOI: 10.7570/jomes.2017.26.4.274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/09/2017] [Accepted: 11/29/2017] [Indexed: 01/04/2023] Open
Abstract
Background Vitamin D and calcium are important factors involved in the regulation of blood glucose and insulin secretion. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score is a useful variable for evaluating insulin resistance, and therefore we cross-sectionally compared HOMA-IR scores according to serum vitamin D levels and dietary calcium intake. Methods We selected data from healthy males (n=5,163) and females (n=7,506) analyzed over 5 years (2008–2012) via the Korea National Health and Nutrition Examination Survey (KNHANES). We calculated HOMA-IR scores and compared them according to serum 25-hydroxyvitamin D (25(OH)D) concentration classification (<20, 20–30, >30 ng/mL) and dietary calcium quintile after adjustment for relevant variables using complex sample analysis. Comparisons were done after data weighting. Results The mean dietary calcium intake in males and females was 558.1 mg/day and 445.9 mg/day, respectively. The mean serum 25(OH)D concentration in males and females was 19.4 ng/mL and 16.8 ng/mL, respectively. After adjustment for relevant variables, HOMA-IR score was significantly correlated with serum 25(OH)D concentration and dietary calcium intake in females, whereas it was only correlated with serum 25(OH)D concentration in males. HOMA-IR was significantly lower in the top quintile of dietary calcium intake (mean, 866 mg/day) within females with vitamin D deficiency (P=0.047). Conclusion Adequate dietary calcium intake may be important for normal HOMA-IR in females with vitamin D deficiency.
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Affiliation(s)
- Jin-Ho Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Seok-Hoon Lee
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Soo-Jung Park
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Kyung-Jin Yeum
- College of Biomedical and Health Sciences, Konkuk University, Chungju, Korea
| | - Beomhee Choi
- CHA Anti-aging Institute, CHA University, Seoul, Korea
| | - Nam-Seok Joo
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
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Suh S, Bae JC, Jin SM, Jee JH, Park MK, Kim DK, Kim JH. Serum calcium changes and risk of type 2 diabetes mellitus in Asian population. Diabetes Res Clin Pract 2017; 133:109-114. [PMID: 28934667 DOI: 10.1016/j.diabres.2017.08.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 08/09/2017] [Accepted: 08/30/2017] [Indexed: 10/18/2022]
Abstract
AIMS We examined the association between changes in serum calcium levels with the incidence of type 2 diabetes mellitus (T2DM) in apparently healthy South Korean subjects. METHODS A retrospective longitudinal analysis was conducted with subjects who had participated in comprehensive health check-ups at least four times over a 7-year period (between 2006 and 2012). In total, 23,121 subjects were categorized into tertiles based on changes in their albumin-adjusted serum calcium levels. Multivariate Cox regression models were fitted to assess the association between changes in serum calcium levels during follow-up and the relative risk of diabetes incidence. RESULTS After a median follow-up of 57.4months, 1,929 (8.3%) new cases of T2DM occurred. Simple linear regression analysis showed serum calcium level changes correlated positively with changes in HbA1c and fasting plasma glucose (FPG) levels (B=5.72, p<0.001 for FPG; B=0.13, p<0.001 for HbA1c). An increase in albumin-adjusted serum calcium levels during follow-up was related to an increased risk of T2DM. After adjustment for potential confounders, the risk of T2DM was 1.6 times greater for subjects whose albumin-adjusted serum calcium levels were in the highest change tertile during follow-up than for subjects whose levels were in the lowest tertile (HR 1.65, 95% CI 1.44-1.88, P<0.001). CONCLUSIONS The elevation of albumin-adjusted serum calcium levels was associated with an increased risk of T2DM, independent of baseline glycemic status.
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Affiliation(s)
- Sunghwan Suh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Busan, Republic of Korea
| | - Ji Cheol Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Gyeongsangnamdo, Republic of Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Hwan Jee
- Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Mi Kyoung Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Busan, Republic of Korea
| | - Duk Kyu Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Busan, Republic of Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Cooke A. Dietary Food-Additive Phosphate and Human Health Outcomes. Compr Rev Food Sci Food Saf 2017; 16:906-1021. [PMID: 33371609 DOI: 10.1111/1541-4337.12275] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/12/2017] [Accepted: 05/17/2017] [Indexed: 01/19/2023]
Abstract
Dietary intake of phosphorus is required for human health, and dietary reference intakes for phosphorus have been established. Food-grade phosphates are used as additives to provide a wide range of technical functions in food production. Phosphates are often the most efficient ingredients to provide the required functionality in many applications, and in some cases, there are not effective and approved alternatives. However, many investigators have expressed concern about the quantities of phosphorus and food-additive phosphate present in the diets of many populations. This paper presents the outcome of an extensive review of 110 primary research articles focused on identifying evidence that substantiates or refutes associations of total dietary phosphorus and food-additive phosphate intake with health and disease in humans. The lack of conclusive evidence prevented the drawing of firm conclusions about the safety and possible risks of food-additive phosphate in the general population, which is consonant with the overall assessments of authoritative institutions who have concluded that available data are insufficient to make the required determinations. Despite the inadequacy of the evidence currently available, many of the authors of the publications reviewed for this paper expressed concerns about the quantities of phosphorus and food-additive phosphate in the diets of the populations and subpopulations they studied. At the same time, most of these authors offered only qualified conclusions and expressed themselves tentatively. In addition, authors of primary research publications, authors of review articles, and authoritative institutions have called for the conduct of further research.
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Affiliation(s)
- Allison Cooke
- Intl. Food Additives Council, 529 14th St. NW, Suite 750, Washington, DC, 20045, U.S.A
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Skalnaya MG, Skalny AV, Yurasov VV, Demidov VA, Grabeklis AR, Radysh IV, Tinkov AA. Serum Trace Elements and Electrolytes Are Associated with Fasting Plasma Glucose and HbA 1c in Postmenopausal Women with Type 2 Diabetes Mellitus. Biol Trace Elem Res 2017; 177:25-32. [PMID: 27752920 DOI: 10.1007/s12011-016-0868-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/07/2016] [Indexed: 02/06/2023]
Abstract
The primary aim of the research was to assess the level of trace elements and electrolytes in serum of postmenopausal diabetic women. Sixty-four postmenopausal women with type 2 diabetes mellitus (DM2) and 64 age- and body mass index-matched controls were examined. Serum trace elements were assessed using inductively coupled plasma dynamic reaction cell mass spectrometry (ICP-DRC-MS). Fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) levels were evaluated using Randox kits. The obtained data demonstrate that DM2 patients were characterized by 42 and 34 % higher FPG and HbA1c levels, respectively (p < 0.001). The level of Cu and Se in diabetic postmenopausal women was increased by 10 and 15 % in comparison to the respective control values (p = 0.002 and <0.001). Serum Mn, Zn, and Ni concentrations were lower than the control ones by 32 % (p = 0.003), 8 % (p = 0.003), and 23 % (p = 0.046), respectively. FPG and HbA1c levels directly correlated with serum Se (p < 0.001) and Cu (p = 0.014 and p = 0.028) concentrations and inversely related to Zn (p < 0.001) and Tl (p = 0.023 and p = 0.029) levels. Multiple regression analysis demonstrated a significant association between serum Zn and Se and FPG and HbA1c levels. It is proposed that Zn and Se play an important role in DM2 pathogenesis. Further studies are required to assess the intimate mechanisms of the observed differences.
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Affiliation(s)
- Margarita G Skalnaya
- RUDN University, Moscow, Russia
- Russian Society of Trace Elements in Medicine, ANO "Center for Biotic Medicine", Moscow, Russia
| | - Anatoly V Skalny
- RUDN University, Moscow, Russia
- Russian Society of Trace Elements in Medicine, ANO "Center for Biotic Medicine", Moscow, Russia
- Orenburg State University, Orenburg, Russia
- Yaroslavl State University, Yaroslavl, Russia
- All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia
| | | | - Vasily A Demidov
- Russian Society of Trace Elements in Medicine, ANO "Center for Biotic Medicine", Moscow, Russia
| | - Andrei R Grabeklis
- Russian Society of Trace Elements in Medicine, ANO "Center for Biotic Medicine", Moscow, Russia
- Yaroslavl State University, Yaroslavl, Russia
| | | | - Alexey A Tinkov
- RUDN University, Moscow, Russia.
- Orenburg State University, Orenburg, Russia.
- Yaroslavl State University, Yaroslavl, Russia.
- Orenburg State Medical University, Orenburg, Russia.
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Zhang N, Du SM, Ma GS. Current lifestyle factors that increase risk of T2DM in China. Eur J Clin Nutr 2017; 71:832-838. [DOI: 10.1038/ejcn.2017.41] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/21/2017] [Accepted: 02/25/2017] [Indexed: 01/04/2023]
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Baek JH, Jin SM, Bae JC, Jee JH, Yu TY, Kim SK, Hur KY, Lee MK, Kim JH. Serum Calcium and the Risk of Incident Metabolic Syndrome: A 4.3-Year Retrospective Longitudinal Study. Diabetes Metab J 2017; 41:60-68. [PMID: 28029017 PMCID: PMC5328697 DOI: 10.4093/dmj.2017.41.1.60] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/17/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND An association between serum calcium level and risk of metabolic syndrome (MetS) has been suggested in cross-sectional studies. This study aimed to evaluate the association between baseline serum calcium level and risk of incident MetS in a longitudinal study. METHODS We conducted a retrospective longitudinal study of 12,706 participants without MetS who participated in a health screening program, had normal range serum calcium level at baseline (mean age, 51 years), and were followed up for 4.3 years (18,925 person-years). The risk of developing MetS was analyzed according to the baseline serum calcium levels. RESULTS A total of 3,448 incident cases (27.1%) of MetS developed during the follow-up period. The hazard ratio (HR) for incident MetS did not increase with increasing tertile of serum calcium level in an age- and sex-matched model (P for trend=0.915). The HRs (95% confidence interval [CI]) for incident MetS comparing the second and the third tertiles to the first tertile of baseline serum calcium level were 0.91 (95% CI, 0.84 to 0.99) and 0.85 (95% CI, 0.78 to 0.92) in a fully adjusted model, respectively (P for trend=0.001). A decreased risk of incident MetS in higher tertiles of serum calcium level was observed in subjects with central obesity and/or a metabolically unhealthy state at baseline. CONCLUSION There was no positive correlation between baseline serum calcium levels and incident risk of MetS in this longitudinal study. There was an association between higher serum calcium levels and decreased incident MetS in individuals with central obesity or two components of MetS at baseline.
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Affiliation(s)
- Jong Ha Baek
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Sang Man Jin
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Cheol Bae
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Jae Hwan Jee
- Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Yang Yu
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Kyoung Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Kyu Yeon Hur
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon Kyu Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Li J, Wu N, Dai W, Jiang L, Li Y, Li S, Wen Z. Association of serum calcium and heart failure with preserved ejection fraction in patients with type 2 diabetes. Cardiovasc Diabetol 2016; 15:140. [PMID: 27716206 PMCID: PMC5048602 DOI: 10.1186/s12933-016-0458-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 09/24/2016] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a recognized trigger factor for heart failure with preserved ejection fraction (HFpEF). Recent studies show that higher serum calcium level is associated with greater risk of both T2DM and heart failure. We speculate that increased serum calcium is related to HFpEF prevalence in patients with T2DM. METHODS In this cross-sectional echocardiographic study, 807 normocalcemia and normophosphatemia patients with T2DM participated, of whom 106 had HFpEF. Multinomial logistic regression was carried out to determine the variables associated with HFpEF. The associations between serum calcium and metabolic parameters, as well as the rate of HFpEF were examined using bivariate linear correlation and binary logistic regression, respectively. The predictive performance of serum calcium for HFpEF was evaluated using the area under the receiver operating characteristic curve (AUC). RESULTS Patients with HFpEF have significantly higher serum calcium than those without HFpEF. Serum calcium was positively associated with total cholesterol, triglycerides, low-density lipoprotein cholesterol, serum uric acid, HOMA-IR and fasting plasma glucose. Compared with patients in the lowest serum calcium quartile, the odds ratio (OR) for HFpEF in patients in the highest quartile was 2.331 (95 % CI 1.088-4.994, p = 0.029). When calcium was analyzed as a continuous variable, per 1 mg/dL increase, the OR (95 % CI) for HFpEF was [2.712 (1.471-5.002), p = 0.001]. Serum calcium can predict HFpEF [AUC = 0.673, 95 % CI (0.620-0.726), p < 0.001]. CONCLUSIONS An increase in serum calcium level is associated with an increased risk of HFpEF in patients with T2DM.
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Affiliation(s)
- Junfeng Li
- Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Nan Wu
- Department of Geriatrics, Zhongshan Hospital of Fudan University, Shanghai, 200032, China
| | - Wenling Dai
- Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Liu Jiang
- Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yintao Li
- Department of Medical Oncology, Shandong Cancer Hospital and Institute, Shandong University School of Medicine, Jinan, 250012, China
| | - Shibao Li
- Department of Medical Laboratory, The Affiliated Hospital of Xuzhou Medical College, No. 99 Huaihai West Road, Xuzhou, 221000, China.
| | - Zhongyuan Wen
- Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Rooney MR, Pankow JS, Sibley SD, Selvin E, Reis JP, Michos ED, Lutsey PL. Serum calcium and incident type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) study. Am J Clin Nutr 2016; 104:1023-1029. [PMID: 27510541 PMCID: PMC5039808 DOI: 10.3945/ajcn.115.130021] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 07/06/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Elevated serum calcium has been associated with a variety of metabolic abnormalities and may be associated with a greater risk of diabetes. OBJECTIVE The purpose of this study was to test the hypothesis that serum calcium concentration is positively and independently associated with the incidence of diabetes and to evaluate the association of calcium-sensing receptor (CaSR) gene single nucleotide polymorphism (SNP) rs1801725 with incident diabetes. DESIGN Atherosclerosis Risk in Communities study participants free of diabetes at baseline (n = 12,800; mean age: 53.9 y; 22.6% black) were studied for incident diabetes. Serum calcium was measured at baseline and corrected for serum albumin. Diabetes was defined by use of glucose concentrations, self-report, or medication use. Cox proportional hazards regression was used. RESULTS During a mean 8.8 y of follow-up, 1516 cases of diabetes were reported. Participants in the highest compared with lowest calcium quintile were at greater risk of incident diabetes after adjustment for demographic and lifestyle factors [HR (95% CI): 1.34 (1.14, 1.57); P-trend across quintiles <0.0001] and with further adjustment for waist circumference and body mass index [1.26 (1.07, 1.48); P-trend = 0.004]. Additional adjustment for biomarkers on the metabolic pathway (e.g., 25-hydroxyvitamin D, parathyroid hormone, phosphorus) had little impact. The calcium-diabetes association was statistically significant in blacks [1.48 (1.11, 1.98); P-trend = 0.002] but not whites [1.17 (0.96, 1.43); P-trend = 0.17] after adjustment for adiposity. In whites, CaSR gene SNP rs1801725 was associated with serum calcium but not with risk of diabetes. CONCLUSIONS Consistent with 3 previous cohort studies, elevated serum calcium was found to be associated with a greater risk of type 2 diabetes. Further research is needed to understand the role, if any, that calcium plays in the pathogenesis of diabetes.
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Affiliation(s)
| | | | | | - Elizabeth Selvin
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, and
| | - Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Erin D Michos
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, and Division of Cardiology, Johns Hopkins University, Baltimore, MD; and
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Nguyen TT, Quan X, Xu S, Das R, Cha SK, Kong ID, Shong M, Wollheim CB, Park KS. Intracellular alkalinization by phosphate uptake via type III sodium-phosphate cotransporter participates in high-phosphate-induced mitochondrial oxidative stress and defective insulin secretion. FASEB J 2016; 30:3979-3988. [PMID: 27565711 DOI: 10.1096/fj.201600455rr] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 08/08/2016] [Indexed: 01/20/2023]
Abstract
Elevated plasma levels of inorganic phosphate (Pi) are harmful, causing, among other complications, vascular calcification and defective insulin secretion. The underlying molecular mechanisms of these complications remain poorly understood. We demonstrated the role of Pi transport across the plasmalemma on Pi toxicity in INS-1E rat clonal β cells and rat pancreatic islet cells. Type III sodium-phosphate cotransporters (NaPis) are the predominant Pi transporters expressed in insulin-secreting cells. Transcript and protein levels of sodium-dependent phosphate transporter 1 and 2 (PiT-1 and -2), isotypes of type III NaPi, were up-regulated by high-Pi incubation. In patch-clamp experiments, extracellular Pi elicited a Na+-dependent, inwardly rectifying current, which was markedly reduced under acidic extracellular conditions. Cellular uptake of Pi elicited cytosolic alkalinization; intriguingly, this pH change facilitated Pi transport into the mitochondrial matrix. Increased mitochondrial Pi uptake accelerated superoxide generation, mitochondrial permeability transition (mPT), and endoplasmic reticulum stress-mediated translational attenuation, leading to reduced insulin content and impaired glucose-stimulated insulin secretion. Silencing of PiT-1/2 prevented Pi-induced superoxide generation and mPT, and restored insulin secretion. We propose that Pi transport across the plasma membrane and consequent cytosolic alkalinization could be a therapeutic target for protection from Pi toxicity in insulin-secreting cells, as well as in other cell types.-Nguyen, T. T., Quan, X., Xu, S., Das, R., Cha, S.-K., Kong, I. D., Shong, M., Wollheim, C. B., Park, K.-S. Intracellular alkalinization by phosphate uptake via type III sodium-phosphate cotransporter participates in high-phosphate-induced mitochondrial oxidative stress and defective insulin secretion.
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Affiliation(s)
- Tuyet Thi Nguyen
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Korea.,Department of Physiology, Tan-Tao University College of Medicine, Long An, Vietnam
| | - Xianglan Quan
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Shanhua Xu
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Ranjan Das
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung-Kuy Cha
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Korea.,Mitohormesis Translational Research Center, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - In Deok Kong
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Minho Shong
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Korea; and
| | - Claes B Wollheim
- Department of Cell Physiology and Metabolism, University of Geneva, Geneva, Switzerland
| | - Kyu-Sang Park
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Korea; .,Mitohormesis Translational Research Center, Wonju College of Medicine, Yonsei University, Wonju, Korea
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46
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Cho HS, Lee SW, Shin J, Moon SD, Han JH, Cha BY, Kim ES. Association of serum calcium concentrations with fibrinogen and homocysteine in nondiabetic Korean subjects. Medicine (Baltimore) 2016; 95:e3899. [PMID: 27310988 PMCID: PMC4998474 DOI: 10.1097/md.0000000000003899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Considerable evidence shows that increased serum calcium levels are associated with metabolic disorders, cardiovascular disease, and increased mortality. This study investigated whether serum calcium, within a normal range, is significantly associated with serum fibrinogen and homocysteine, markers of increased cardiovascular disease risk in nondiabetic Korean subjects.A cross-sectional analysis was performed on 1096 subjects (mean age, 55.1 ± 11.1 years; 36.1% women) undergoing a general health checkup. Serum biochemistry was analyzed including serum albumin-corrected calcium (Cac), insulin resistance (IR, using homeostasis model assessment [HOMA]), fibrinogen, and homocysteine.Compared with patients within the lowest Cac quartile, those with higher Cac levels had increased fibrinogen and homocysteine levels as well as an increased proportion of smoking, dyslipidemia, and HOMA-IR. Correlation analyses revealed linear relationships for Cac with fibrinogen and homocysteine in both genders. After adjustment for confounding factors, serum Cac was significantly associated with high fibrinogen (odds ratio [OR] for the highest vs the lowest quartile = 1.76, 95% confidence interval [CI] = 1.09-2.83, P = 0.02) and homocysteine (OR = 1.83, 95% CI = 1.07-3.11, P = 0.027). Multivariate regression models showed that Cac was linearly associated with fibrinogen (standardized β = 0.14, P < 0.001) and homocysteine (standardized β = 0.07, P = 0.009).High normal calcium concentrations were independently associated with increased levels of fibrinogen and homocysteine. Further investigation is needed to validate whether slightly increased calcium levels within the normal range indicate a higher risk of cardiovascular disease.
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Affiliation(s)
- Hyun Sun Cho
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Health Promotion Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Won Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Juyoung Shin
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Health Promotion Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Dae Moon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Je Ho Han
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bong Yun Cha
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Sook Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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47
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Reid IR, Gamble GD, Bolland MJ. Circulating calcium concentrations, vascular disease and mortality: a systematic review. J Intern Med 2016; 279:524-40. [PMID: 26749423 DOI: 10.1111/joim.12464] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Associations between serum calcium and vascular disease have been reported, but the consistency of these findings is unknown. We conducted a systematic review to determine whether circulating calcium concentrations are associated with risks of cardiovascular disease and death in normocalcaemic populations. We conducted PubMed searches up to 18 December 2014 and scrutinized reference lists of papers. Eligible studies related serum calcium to mortality or cardiovascular events in humans. A follow-up of at least one year was required for longitudinal studies. Studies in populations selected on the basis of renal disease or abnormal serum calcium were excluded. Two investigators performed independent data extraction. The results were tabulated and, where possible, meta-analysed. Five of 11 studies reported a statistically significant positive association between serum calcium and mortality. Meta-analysis of eight of these studies showed a hazard ratio of death of 1.13 (1.09, 1.18) per standard deviation of serum calcium. Eight of 13 studies reported a statistically significant positive association between serum calcium and cardiovascular disease. Meta-analysis of eight studies showed a hazard ratio of cardiovascular disease of 1.08 (1.04, 1.13) per standard deviation of serum calcium. For two studies reporting odds ratios, the pooled odds ratio per standard deviation was 1.22 (1.11, 1.32). When hazard ratios adjusted for cardiovascular risk factors were meta-analysed, the pooled hazard ratio was 1.04 (1.01, 1.08). Other studies demonstrated associations between serum calcium and stroke and between serum calcium and direct measurements of arterial disease and calcification. These observational data indicate that serum calcium is associated with vascular disease and death, but they cannot determine causality.
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Affiliation(s)
- I R Reid
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Endocrinology, Auckland District Health Board, Auckland, New Zealand
| | - G D Gamble
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - M J Bolland
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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48
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Sing CW, Cheng VKF, Ho DKC, Kung AWC, Cheung BMY, Wong ICK, Tan KCB, Salas-Salvadó J, Becerra-Tomas N, Cheung CL. Serum calcium and incident diabetes: an observational study and meta-analysis. Osteoporos Int 2016; 27:1747-54. [PMID: 26659066 DOI: 10.1007/s00198-015-3444-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 11/26/2015] [Indexed: 01/11/2023]
Abstract
UNLABELLED The study aimed to prospectively evaluate if serum calcium is related to diabetes incidence in Hong Kong Chinese. The results showed that serum calcium has a significant association with increased risk of diabetes. The result of meta-analysis reinforced our findings. INTRODUCTION This study aimed to evaluate the association of serum calcium, including serum total calcium and albumin-corrected calcium, with incident diabetes in Hong Kong Chinese. METHODS We conducted a retrospective cohort study in 6096 participants aged 20 or above and free of diabetes at baseline. Serum calcium was measured at baseline. Incident diabetes was determined from several electronic databases. We also searched relevant databases for studies on serum calcium and incident diabetes and conducted a meta-analysis using fixed-effect modeling. RESULTS During 59,130.9 person-years of follow-up, 631 participants developed diabetes. Serum total calcium and albumin-corrected calcium were associated with incident diabetes in the unadjusted model. After adjusting for demographic and clinical variables, the association remained significant only for serum total calcium (hazard ratio (HR), 1.32 (95 % confidence interval (CI), 1.02-1.70), highest vs. lowest quartile). In a meta-analysis of four studies including the current study, both serum total calcium (pooled risk ratio (RR), 1.38 (95 % CI, 1.15-1.65); I (2) = 5 %, comparing extreme quantiles) and albumin-corrected calcium (pooled RR, 1.29 (95 % CI, 1.03-1.61); I (2) = 0 %, comparing extreme quantiles) were associated with incident diabetes. Penalized regression splines showed that the association of incident diabetes with serum total calcium and albumin-correlated calcium was non-linear and linear, respectively. CONCLUSIONS Elevated serum calcium concentration is associated with incident diabetes. The mechanism underlying this association warrants further investigation.
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Affiliation(s)
- C W Sing
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - V K F Cheng
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - D K C Ho
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - A W C Kung
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - B M Y Cheung
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- The State Key Laboratory of Pharmaceutical Biotechnology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - I C K Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- The State Key Laboratory of Pharmaceutical Biotechnology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
| | - K C B Tan
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - J Salas-Salvadó
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigacio Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - N Becerra-Tomas
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigacio Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - C L Cheung
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China.
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China.
- Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China.
- The State Key Laboratory of Pharmaceutical Biotechnology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China.
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Nguyen TT, Quan X, Hwang KH, Xu S, Das R, Choi SK, Wiederkehr A, Wollheim CB, Cha SK, Park KS. Mitochondrial oxidative stress mediates high-phosphate-induced secretory defects and apoptosis in insulin-secreting cells. Am J Physiol Endocrinol Metab 2015; 308:E933-41. [PMID: 25852001 DOI: 10.1152/ajpendo.00009.2015] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 03/31/2015] [Indexed: 02/06/2023]
Abstract
Inorganic phosphate (Pi) plays an important role in cell signaling and energy metabolism. In insulin-releasing cells, Pi transport into mitochondria is essential for the generation of ATP, a signaling factor in metabolism-secretion coupling. Elevated Pi concentrations, however, can have toxic effects in various cell types. The underlying molecular mechanisms are poorly understood. Here, we have investigated the effect of Pi on secretory function and apoptosis in INS-1E clonal β-cells and rat pancreatic islets. Elevated extracellular Pi (1~5 mM) increased the mitochondrial membrane potential (ΔΨm), superoxide generation, caspase activation, and cell death. Depolarization of the ΔΨm abolished Pi-induced superoxide generation. Butylmalonate, a nonselective blocker of mitochondrial phosphate transporters, prevented ΔΨm hyperpolarization, superoxide generation, and cytotoxicity caused by Pi. High Pi also promoted the opening of the mitochondrial permeability transition (PT) pore, leading to apoptosis, which was also prevented by butylmalonate. The mitochondrial antioxidants mitoTEMPO or MnTBAP prevented Pi-triggered PT pore opening and cytotoxicity. Elevated extracellular Pi diminished ATP synthesis, cytosolic Ca(2+) oscillations, and insulin content and secretion in INS-1E cells as well as in dispersed islet cells. These parameters were restored following preincubation with mitochondrial antioxidants. This treatment also prevented high-Pi-induced phosphorylation of ER stress proteins. We propose that elevated extracellular Pi causes mitochondrial oxidative stress linked to mitochondrial hyperpolarization. Such stress results in reduced insulin content and defective insulin secretion and cytotoxicity. Our data explain the decreased insulin content and secretion observed under hyperphosphatemic states.
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Affiliation(s)
- Tuyet Thi Nguyen
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Xianglan Quan
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Kyu-Hee Hwang
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Shanhua Xu
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Ranjan Das
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Seong-Kyung Choi
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | | | - Claes B Wollheim
- Department of Cell Physiology and Metabolism, University of Geneva, Geneva, Switzerland
| | - Seung-Kuy Cha
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Kyu-Sang Park
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea;
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50
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Zaccardi F, Webb DR, Carter P, Pitocco D, Khunti K, Davies MJ, Kurl S, Laukkanen JA. Association between direct measurement of active serum calcium and risk of type 2 diabetes mellitus: A prospective study. Nutr Metab Cardiovasc Dis 2015; 25:562-568. [PMID: 25933474 DOI: 10.1016/j.numecd.2015.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 01/27/2015] [Accepted: 02/24/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Previous prospective studies showing a positive association between serum calcium and incidence of type 2 diabetes mellitus (T2DM) have relied on total calcium or an indirect estimate of active, ionized calcium (iCa). We aimed to assess this relationship using a direct measurement of iCa. METHODS AND RESULTS iCa and cardiometabolic risk factors were measured in a population-based sample of 2350 men without a known history of T2DM at baseline. Associations between iCa levels and incident cases of T2DM (self-reported, ascertained with a glucose tolerance test, or determined by record linkage to national registers) were estimated using Cox regression analyses adjusted for potential confounders. At baseline, mean (standard deviation) age was 53 (5) years and mean iCa 1.18 (0.05) mmol/L. During a median follow-up of 23.1 years, 140 new cases of T2DM were recorded. In a multivariable analysis adjusted for age, body mass index, systolic blood pressure, serum HDL-cholesterol, and family history of T2DM, there was no association comparing second (hazard ratio 0.84; 95% confidence interval 0.59-1.18), third (0.77; 0.52-1.14), or fourth (0.98; 0.69-1.39) vs first quartile of iCa (p for trend 0.538); further adjustment for C-reactive protein, physical activity level, and triglycerides did not change the estimates (p for trend 0.389). CONCLUSION In this study, we did not find evidence of an association between direct measurement of active calcium and risk of T2DM. Further studies are needed to confirm our findings and define the relationship between factors influencing indirect calcium estimation and incident T2DM.
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Affiliation(s)
- F Zaccardi
- Diabetes Research Centre, University of Leicester, Leicester, UK.
| | - D R Webb
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - P Carter
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - D Pitocco
- Diabetes Research Unit, Catholic University School of Medicine, Rome, Italy
| | - K Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - M J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - S Kurl
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - J A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Lapland Central Hospital, Department of Internal Medicine, Rovaniemi, Finland
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