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Cousineau CM, Loftus K, Churchill GA, Bridges D. Cross-sectional association between blood cholesterol and calcium levels in genetically diverse strains of mice. FEBS Open Bio 2024; 14:426-433. [PMID: 38129969 PMCID: PMC10909986 DOI: 10.1002/2211-5463.13757] [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: 08/30/2023] [Revised: 11/13/2023] [Accepted: 12/20/2023] [Indexed: 12/23/2023] Open
Abstract
Genetically diverse outbred mice allow for the study of genetic variation in the context of high dietary and environmental control. Using a machine learning approach, we investigated clinical and morphometric factors that associate with serum cholesterol levels in 840 genetically unique Diversity Outbred mice of both sexes (n = 417 male and 423 female), and on both a control chow (% kcals in diet: protein 22%, carbohydrate 62%, fat 16%, no cholesterol) and high fat high sucrose (% kcals in diet: protein 15%, carbohydrate 41%, fat 45%, 0.05% cholesterol). We find expected elevations of cholesterol in male mice, as well as in mice with elevated serum triglycerides and/or fed a high fat high sucrose diet. The third strongest predictor was serum calcium which correlated with serum cholesterol across both diets and sexes (r = 0.39-0.48) in both Diversity Outbred (P = 3.0 × 10-43 ) and BXD (P = 0.005) mice. This is in-line with several human cohort studies which show associations between calcium and cholesterol, and calcium as an independent predictor of cardiovascular events.
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Affiliation(s)
- Cody M. Cousineau
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMIUSA
| | - Kaelin Loftus
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMIUSA
| | | | - Dave Bridges
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMIUSA
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2
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Jin X, Meng L, Zhang R, Tong M, Qi Z, Mi L. Effects of essential mineral elements deficiency and supplementation on serum mineral elements concentration and biochemical parameters in grazing Mongolian sheep. Front Vet Sci 2023; 10:1214346. [PMID: 37559889 PMCID: PMC10407109 DOI: 10.3389/fvets.2023.1214346] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
Traditional sheep grazing is the pillar industry and the main source of income for local herders in the Inner Mongolia Autonomous Region of China. However, grazing sheep often suffer from mineral deficiency. In the present study, the feeding experiment was performed on 84 grazing Wu Ranke sheep. After being divided into calcium (Ca), zinc (Zn), copper (Cu), cobalt (Co), manganese (Mn), and selenium (Se) treatment groups, they were fed with a mineral deficient diet for 60 days and then a mineral supplement diet for 41 days. Serum samples were collected three times, 10 concentrations of essential mineral elements and 15 concentrations/activity of biochemical parameters were measured to assess the effects of mineral deficiency and supplementation on the physical health of sheep. The results revealed that the sheep showed mineral Ca, Cu, Co, Mn, and Se deficiencies after feeding their respective mineral deficient diet. Deficiency in dietary Ca, Zn, Cu, Co, Mn, and Se may adversely affect the liver, myocardium and pancreas of sheep. The prompt supplementation of dietary Zn, Cu, Co, Mn, and Se may alleviate the damage caused to the liver, myocardium and pancreas, while that of dietary Ca improved energy generation. In conclusion, the adequate supplementation of dietary Ca, Zn, Cu, Co, Mn, and Se is essential for avoiding the impairment caused to the liver, myocardium and pancreas function of sheep by the deficiency in essential dietary minerals.
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Affiliation(s)
| | | | | | | | - Zhi Qi
- State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot, China
| | - Lan Mi
- State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot, China
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Shen Z, Wang R, He P, Zhang Z, Dai Y, Li M, Liu Z, Yang H, Guan S, Sun J. Association between urinary metal concentrations and abnormal estimated glomerular filtration rate in Chinese community-dwelling elderly: Exploring the mediating effect of triglycerides. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 259:114966. [PMID: 37182299 DOI: 10.1016/j.ecoenv.2023.114966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Environmental metal exposure is associated with elevated triglycerides (TG) and the development of chronic kidney disease (CKD). However, the relationship between metal exposure and glomerular filtration rate (GFR) remains uncertain, and the mediating effect of TG between the two is unclear. METHODS This study measured the concentrations of 14 metals in urine samples from 3752 elderly people in the community. The most relevant metals were screened by least absolute shrinkage and selection operator (LASSO) regression. The relationship between combined exposure to multiple metals and abnormal estimated glomerular filtration rate (eGFR) was explored using multivariate logistic regression analysis and Bayesian kernel machine regression (BKMR) analysis. Generalized linear regression models and the Karlson-Holm-Green (KHB) method were used to assess the mediating effects of TG. RESULTS In the single-metal model, calcium (Ca), iron (Fe), selenium (Se), strontium (Sr), and thallium (Tl) showed significant negative correlations with the prevalence of abnormal eGFR (all P < 0.05). In the multi-metals model, Ca, Se, and Tl continued to show significant negative correlations, while vanadium (V) and zinc (Zn) showed significant positive correlations with abnormal eGFR (all P < 0.05). The BKMR model showed a negative joint effect of the mixture of Ca, V, Zn, Se, and Tl on the prevalence of abnormal eGFR. The generalized linear regression model showed a significant positive correlation between the concentrations of Ca (β = 0.07), Zn (β = 0.07), Se (β = 0.09), and TG levels (all P < 0.05). In the mediation analysis, TG masked a 4.30% and 5.21% correlation between Ca and Se and the prevalence of eGFR abnormalities, respectively. CONCLUSIONS Urinary concentration of multiple metals is significantly associated with eGFR abnormalities, and Ca, and Se may be among the potential protective factors. TG masked some of the protective effects of Ca and Se.
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Affiliation(s)
- Zhuoheng Shen
- School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China
| | - Rui Wang
- School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China
| | - Pei He
- School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China
| | - Zhongyuan Zhang
- School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China
| | - Yuqing Dai
- School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China
| | - Meiyan Li
- School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China
| | - Zhihong Liu
- School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China
| | - Huifang Yang
- School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China
| | - Suzhen Guan
- School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China.
| | - Jian Sun
- School of Public Health, Ningxia Medical University, Yinchuan Ningxia 750004, P.R. China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan Ningxia 750004, P.R. China.
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Cousineau CM, Loftus K, Churchill GA, Bridges D. Cross-sectional association between blood cholesterol and calcium levels in genetically diverse strains of mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.08.527123. [PMID: 36798159 PMCID: PMC9934644 DOI: 10.1101/2023.02.08.527123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Genetically diverse outbred mice allow for the study of genetic variation in the context of high dietary and environmental control. Using a machine learning approach we investigated clinical and morphometric factors that associate with serum cholesterol levels in 840 genetically unique mice of both sexes, and on both a control chow and high fat high sucrose diet. We find expected elevations of cholesterol in male mice, those with elevated serum triglycerides and/or fed a high fat high sucrose diet. The third strongest predictor was serum calcium which correlated with serum cholesterol across both diets and sexes (r=0.39-0.48). This is in-line with several human cohort studies which show associations between calcium and cholesterol, and calcium as an independent predictor of cardiovascular events.
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Affiliation(s)
- Cody M. Cousineau
- Department of Nutritional Sciences, University of Michigan School of Public Health
| | - Kaelin Loftus
- Department of Nutritional Sciences, University of Michigan School of Public Health
| | | | - Dave Bridges
- Department of Nutritional Sciences, University of Michigan School of Public Health
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5
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Meng X, Han T, Jiang W, Dong F, Sun H, Wei W, Yan Y. Temporal Relationship Between Changes in Serum Calcium and Hypercholesteremia and Its Impact on Future Brachial-Ankle Pulse Wave Velocity Levels. Front Nutr 2021; 8:754358. [PMID: 34869527 PMCID: PMC8635801 DOI: 10.3389/fnut.2021.754358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The high levels of serum calcium and cholesterol are the important risk factors of cardiovascular disease (CVD), which frequently influence each other during the development of CVD. However, few studies have examined their temporal relationship to confirm the precursor, and it is still largely unknown whether and how their temporal relationship would influence the development of CVD. This study aimed to establish the temporal relationship between the changes in serum calcium and cholesterol using the longitudinal cohort data, and examine whether this temporal relationship influenced the arterial elasticity indicated by brachial-ankle pulse wave velocity (baPWV). Methods: This is a cohort study with a sample of 3,292 Chinese participants (aged 20-74 years) with 5.7 years follow-up. Serum calcium and cholesterol were measured at baseline and follow-up survey. The cross-lagged path analysis was used to examine their temporal relationship, and mediation analysis was performed to evaluate the potential mediating effect. Results: The cross-lagged path coefficients (β2 values) from baseline serum calcium to follow-up cholesterol was significantly greater than the path coefficients (β1 values) from baseline cholesterol to follow-up serum calcium (β2 = 0.110 vs. β1 = 0.047; P = 0.010) after adjusting for the multiple covariates. The path coefficients from baseline serum calcium to follow-up cholesterol in the participants with high baPWV was significantly greater than the participants with low baPWV (β2 = 0.155 for high baPWV and β2 = 0.077 for low baPWV, P = 0.028 for the difference between the β2 values). Moreover, cholesterol partially mediated the association between the higher serum calcium and greater subsequent baPWV values, the percentage of the total effect mediated by cholesterol was estimated at 21.7%. Conclusion: Our findings indicate that increased serum calcium precedes increased in serum cholesterol, and this temporal relationship may contribute to the development of higher baPWV levels.
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Affiliation(s)
- Xing Meng
- Division of Clinical Nutrition, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tianshu Han
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Wenbo Jiang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Fengli Dong
- Division of Clinical Nutrition, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongxue Sun
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Wei
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Yageng Yan
- Division of Clinical Nutrition, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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Wen S, Sha Y, Li Y, Rui Z, Si C, Zhou Y, Yan F, Wang B, Hu J, Han X, Shi D. Serum Iron and Ferritin Levels Are Correlated with Complement C3. Biol Trace Elem Res 2021; 199:2482-2488. [PMID: 32935207 DOI: 10.1007/s12011-020-02379-2] [Citation(s) in RCA: 3] [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: 04/10/2020] [Accepted: 09/07/2020] [Indexed: 02/08/2023]
Abstract
Iron is one of the most important trace elements in the body, and its homeostasis is essential to the normal function of the immune system. Complement component C3, which is the converging of three main pathways of complement system activation, plays a key role in the innate immunity. However, the relationship between iron homeostasis and complement C3 remains unknown. The aim of our study was to analyze the relationship between serum iron and ferritin level and complement C3 and C4. A total of 590 healthy individuals were recruited in our study. Higher serum complement C3 level (p < 0.001) was found in individuals with higher serum ferritin level (> 104.0 μg/L). Moreover, serum iron level and serum ferritin level were positively correlated with complement C3 (r = 0.133, p = 0.001; r = 0.221, p < 0.001) and complement C4 (r = 0.117, p = 0.004; r = 0.123, p = 0.003). The linear regression analysis displayed that both serum iron level and serum ferritin level were linearly correlated with serum complement C3 level (adjusted beta: 2.382, 95% CI: 0.841-3.923; adjusted beta: 42.911, 95% CI: 29.070-56.751). To explore the relationship between iron homeostasis and complement C3 further, the serum samples from C3-/- mice and the wild-type (WT) control mice were obtained. Significantly lower serum iron level and higher ferritin level were found in C3-/- mice than those in WT mice (p < 0.001; p < 0.001), indicating that complement C3 might influence iron distribution and utilization. Overall, these data suggested that serum iron and ferritin levels were correlated with complement C3. The deficiency of complement C3 may disrupt the regular iron metabolism in the body.
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Affiliation(s)
- Shuang Wen
- Department of Immunology, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yeqin Sha
- Department of Immunology, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yinling Li
- Department of Immunology, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Zhilian Rui
- Department of Laboratory Medicine, Liyang People's Hospital, Liyang, 213300, Jiangsu, China
| | - Chenhong Si
- Department of Pediatrics, Liyang Women and Children Health Hospital, Liyang, 213000, Jiangsu, China
| | - Yuning Zhou
- Department of Immunology, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Fengfeng Yan
- Department of Immunology, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Bicheng Wang
- Department of Immunology, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Jingming Hu
- Department of Immunology, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Xu Han
- Department of Immunology, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Dongyan Shi
- Department of Immunology, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
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Sha Y, Rui Z, Dong Y, Wei X, Zhou Y, Ye X, He L, Shi D. Total Serum Calcium Level Is Negatively Correlated With Systemic Lupus Erythematosus Activity. Dose Response 2020; 18:1559325820926764. [PMID: 32435164 PMCID: PMC7223868 DOI: 10.1177/1559325820926764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/04/2020] [Accepted: 04/09/2020] [Indexed: 01/04/2023] Open
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and hypocomplementemia signifies disease activity. Several studies have shown that calcium may help maintain optimum function of immune system and metabolism in SLE. The aim of our study was to analyze the relationship between total serum calcium level and SLE activity. A total of 66 patients with SLE and 214 healthy controls were included in this study. Our results showed lower serum levels of calcium (P < .001), complement C3 (P < .001), complement C4 (P < .001), and albumin (P < .001) in patients with SLE. A negative correlation was found between serum calcium level and systemic lupus erythematosus disease activity index (SLEDAI) rating (r = -0.394, P = .001). Additionally, serum level of calcium was positively correlated with serum complement C3 level (r = 0.366, P = .003) in patients with SLE, while no such correlation was found between serum calcium level and complement C4 (r = -0.190, P = .126). Likewise, patients with SLE with normal serum calcium level showed higher complement C3 level (P < .01) than that of patients with low serum calcium level. Overall, the results displayed that patients with SLE have lower serum calcium level compared to healthy controls, and the serum calcium level is positively correlated with SLEDAI rating and serum complement C3 level in patients with SLE. In conclusion, the total serum calcium level is negatively correlated with SLE disease activity.
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Affiliation(s)
- Yeqin Sha
- Department of Immunology, Nanjing Medical University, Nanjing, China
| | - Zhilian Rui
- Department of Laboratory Medicine, Liyang People's Hospital, Liyang, China
| | - Yuxiang Dong
- Department of Immunology, Nanjing Medical University, Nanjing, China
| | - Xiyi Wei
- Department of Immunology, Nanjing Medical University, Nanjing, China
| | - Yuning Zhou
- Department of Immunology, Nanjing Medical University, Nanjing, China
| | - Xiaoxue Ye
- Department of Immunology, Nanjing Medical University, Nanjing, China
| | - Lianping He
- Department of Immunology, Nanjing Medical University, Nanjing, China
- College of Experience Industry, Anhui Polytechnic University, Wuhu, China
| | - Dongyan Shi
- Department of Immunology, Nanjing Medical University, Nanjing, China
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Ozsezen OS, Meral I. Effect of diet with carbohydrate but without daily energy restriction on serum glucose, lactate, and selected mineral and lipid levels in streptozotocin-induced experimental diabetic rats. Arch Physiol Biochem 2019; 125:351-356. [PMID: 29681164 DOI: 10.1080/13813455.2018.1465099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective: Type I diabetes is a disease characterised by an extreme reduction in serum insulin levels. Diet and exercise have gained considerable attention in the treatment of diabetes. Therefore, this study was carried out to investigate the effect of diet with carbohydrate but without daily energy restriction on various metabolites (glucose, triglycerides, cholesterol, lactate), some electrolytes (Ca, Mg, Na, K, P, Cl) and essential metals (Mn, Co, Cu, Se, Zn, Fe) in the blood of rats with streptozotocin-induced diabetes. Materials and methods: Thirty-three male rats were divided into four groups of standard rat diet (SR)-fed control, SR-diet fed diabetics, low carbohydrate-standard protein-high fat (LCSPHF) diet-fed diabetics, and very low carbohydrate-high protein-high fat (VLCHPHF) diet-fed diabetics. Diabetes was induced by an i.p. injection of 50 mg/kg streptozotocin. The rats were fed with the specially prepared diets for 28 days. Results: The decreased-serum Cl and the increased-serum glucose levels were only the difference between the controls and SR diet-fed diabetic rats regarding to measured parameters. Lowering carbohydrate and increasing fat ratio in diet caused an increase in serum cholesterol and triglyceride levels leading to an increased-serum Fe and Ca, and decreased-serum Na and Cu levels in diabetic rats. Conclusion: The serum mineral changes should be taken into consideration together with the changes in serum glucose, cholesterol, and triglyceride levels for the secondary complications of diabetes mellitus.
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Affiliation(s)
| | - Ismail Meral
- b Department of Physiology, School of Medicine, Bezmialem Vakif University , Istanbul , Turkey
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Gallo L, Faniello MC, Canino G, Tripolino C, Gnasso A, Cuda G, Costanzo FS, Irace C. Serum Calcium Increase Correlates With Worsening of Lipid Profile: An Observational Study on a Large Cohort From South Italy. Medicine (Baltimore) 2016; 95:e2774. [PMID: 26937904 PMCID: PMC4779001 DOI: 10.1097/md.0000000000002774] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Despite the well-documented role of calcium in cell metabolism, its role in the development of cardiovascular disease is still under heavy debate. Several studies suggest that calcium supplementation might be associated with an increased risk of coronary heart disease, whereas others underline a significant effect on lowering high blood pressure and hyperlipidemia. The purpose of this study was to investigate, in a large nonselected cohort from South Italy, if serum calcium levels correlate with lipid values and can therefore be linked to higher individual cardiovascular risk.Eight-thousand-six-hundred-ten outpatients addressed to the Laboratory of Clinical Biochemistry, University of Magna Græcia, Catanzaro, Italy from January 2012 to December 2013 for routine blood tests, were enrolled in the study. Total HDL-, LDL- and non-HDL colesterol, triglycerides, and calcium were determined with standard methods.We observed a significant association between total cholesterol, LDL-cholesterol, HDL-cholesterol, non-HDL cholesterol, triglycerides, and serum calcium in men and postmenopause women. Interestingly, in premenopause women, we only found a direct correlation between serum calcium, total cholesterol, and HDL-cholesterol. Calcium significantly increased while increasing total cholesterol and triglycerides in men and postmenopause women.Our results confirm that progressive increase of serum calcium level correlates with worsening of lipid profile in our study population. Therefore, we suggest that a greater caution should be used in calcium supplement prescription particularly in men and women undergoing menopause, in which an increase of serum lipids is already known to be associated with a higher cardiovascular risk.
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Affiliation(s)
- Luigia Gallo
- From the Department of Experimental and Clinical Medicine (LG, MCF, CT, AG, Giovanni Cuda, FSC); Department of Medical and Surgical Sciences (Giovanni Canino); and Department of Health Science (CI), Magna Græcia University of Catanzaro, Catanzaro, Italy
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Becerra-Tomás N, Estruch R, Bulló M, Casas R, Díaz-López A, Basora J, Fitó M, Serra-Majem L, Salas-Salvadó J. Increased serum calcium levels and risk of type 2 diabetes in individuals at high cardiovascular risk. Diabetes Care 2014; 37:3084-91. [PMID: 25139884 DOI: 10.2337/dc14-0898] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Insulin resistance and secretion depend on calcium homeostasis. Cross-sectional studies have associated elevated serum calcium levels with markers of impaired glucose metabolism. However, only one prospective cohort study has demonstrated an increased risk of diabetes in individuals with increased serum calcium concentrations. The aim of the current study was to prospectively investigate the association between albumin-adjusted serum calcium concentrations and type 2 diabetes in subjects at high cardiovascular risk. RESEARCH DESIGN AND METHODS Prospective assessment of participants from two Spanish PREDIMED study centers where serum calcium levels were measured at baseline and yearly during follow-up. Multivariate-adjusted Cox regression models were fitted to assess associations between baseline and changes during follow-up in serum calcium levels and relative risk of diabetes incidence. RESULTS After a median follow-up of 4.78 years, 77 new cases of type 2 diabetes occurred. An increase in serum calcium levels during follow-up was related to an increased risk of diabetes. In comparison with individuals in the lowest tertile (-0.78 ± 0.29 mg/dL), the hazard ratio (HR) and 95% CI for diabetes incidence in individuals in the higher tertile of change (0.52 ± 0.13 mg/dL) during follow-up was 3.48 (95% CI 1.48-8.17; P for trend = 0.01). When albumin-adjusted serum calcium was analyzed as a continuous variable, per 1 mg/dL increase, the HR of diabetes incidence was 2.87 (95% CI 1.18-6.96; P value = 0.02). These associations remained significant after individuals taking calcium supplements or having calcium levels out of normal range had been excluded. CONCLUSIONS An increase in serum calcium concentrations is associated with an increased risk of type 2 diabetes in individuals at high cardiovascular risk.
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Affiliation(s)
- Nerea Becerra-Tomás
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Ramón Estruch
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain Department of Internal Medicine, August Pi i Sunyer Institute of Biomedical Research, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Mònica Bulló
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Rosa Casas
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain Department of Internal Medicine, August Pi i Sunyer Institute of Biomedical Research, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Andrés Díaz-López
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Josep Basora
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Montserrat Fitó
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain Cardiovascular Risk and Nutrition (Regicor Study Group), Hospital del Mar Medical Research Institute, Barcelona Biomedical Research Park, Barcelona, Spain
| | - Lluis Serra-Majem
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
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