Associations between calcium-phosphate metabolism and coronary artery calcification; a cross sectional study of a middle-aged general population

Grønhøj, Mette Hjortdal; Gerke, Oke; Mickley, Hans; Steffensen, Flemming Hald; Lambrechtsen, Jess; Sand, Niels Peter Rønnow; Rasmussen, Lars Melholt; Olsen, Michael Hecht; Diederichsen, Axel Cosmus Pyndt

doi:10.1016/j.atherosclerosis.2016.06.001

Cited by 20 publications

(18 citation statements)

References 38 publications

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“…The mechanism as to how vitamin D is related to ischemic stroke is unclear. Mineral metabolism has been suggested to play a role in cardiovascular and stroke risk (34)(35)(36).…”

Section: Discussionmentioning

confidence: 99%

Serum 25-hydroxyvitamin D and the risk of stroke in Hong Kong Chinese

Leung¹,

Han²,

Sing³

et al. 2017

Thromb Haemost

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Low vitamin D levels have been associated with various cardiovascular diseases; however, whether it is associated with stroke remains inconclusive. We aimed to evaluate the association between serum 25-hydroxyvitamin D and risk of stroke. We conducted a cohort study consisting of 3,458 participants from the Hong Kong Osteoporosis Study aged ≥45 at baseline, examined between 1995 and 2010 and followed up using electronic medical records. Ischaemic and haemorrhagic stroke were defined using the ICD-9 code. In multivariable Cox-proportional hazard regression, quintiles 1 and 4 were significantly associated with increased risk of stroke when compared to the highest quintile (Quintile 1: HR, 1.78; 95 % CI, 1.16-2.74 and quintile 4: HR, 1.61; 95 % CI, 1.07-2.43). A similar association was observed in both men and women. In subgroup analysis, the association was specifically observed for ischaemic stroke, but not haemorrhagic stroke. Using a penalized regression spline, the association between vitamin D and risk of stroke was in a reverse J-shape, with the lowest risk of stroke being observed at 25(OH)D levels between 70 and 80 nmol/l. In conclusion, a low vitamin D level is associated with increased risk of ischaemic stroke; however, whether high vitamin D level is also associated with increased risk of stroke requires further study.

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“…The mechanism as to how vitamin D is related to ischemic stroke is unclear. Mineral metabolism has been suggested to play a role in cardiovascular and stroke risk (34)(35)(36).…”

Section: Discussionmentioning

confidence: 99%

Serum 25-hydroxyvitamin D and the risk of stroke in Hong Kong Chinese

Leung¹,

Han²,

Sing³

et al. 2017

Thromb Haemost

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“…Thus there was a weak positive cross-sectional association between calcium x phosphorus product and coronary artery calcification score (by CT), amongst 384 patients with metabolic syndrome (although apparently not amongst 1672 patients without metabolic syndrome[78]. In a larger cross-sectional study of 1088 middle-aged men and women, serum total calcium concentrations were again positively associated with coronary artery calcification score, but only amongst men and not women[79]. This sex discordance is the opposite of the findings from Rohrmann et al in relation to incident ischaemic cardiovascular events in a large prospective database study of 441,738 participants, in which serum calcium concentrations (corrected for albumin concentrations) were positively related to risk of incident myocardial infarction, non-fatal cardiovascular disease, and stroke during a median follow-up time of 21 years[77].…”

Section: Mechanistic Considerationsmentioning

confidence: 99%

The role of calcium supplementation in healthy musculoskeletal ageing

et al. 2016

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The place of calcium supplementation, with or without concomitant vitamin D supplementation, has been much debated in terms of both efficacy and safety. There have been numerous trials and meta-analyses of supplementation for fracture reduction, and associations with risk of myocardial infarction have been suggested in recent years. In this report, the product of an expert consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF), we review the evidence for the value of calcium supplementation, with or without vitamin D supplementation, for healthy musculoskeletal ageing. We conclude that (1) calcium and vitamin D supplementation leads to a modest reduction in fracture risk, although population-level intervention has not been shown to be an effective public health strategy; (2) supplementation with calcium alone for fracture reduction is not supported by the literature; (3) side effects of calcium supplementation include renal stones and gastrointestinal symptoms; (4) vitamin D supplementation, rather than calcium supplementation, may reduce falls risk; and (5) assertions of increased cardiovascular risk consequent to calcium supplementation are not convincingly supported by current evidence. In conclusion, we recommend, on the basis of the current evidence, that calcium supplementation, with concomitant vitamin D supplementation, is supported for patients at high risk of calcium and vitamin D insufficiency, and in those who are receiving treatment for osteoporosis.

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“…Accumulating evidence indicated the association of abnormal calcium-phosphate metabolism with cardiovascular disease in the general population. Intact PTH levels were associated with hypertension [20] and abnormal calcium-phosphate metabolism was associated with coronary artery calcification [21]. The prevalence ratio of intact PTH among participants of the US National Health and Nutrition Examination Survey showed a stepwise increment of 2.30 and 4.69 for individuals with an eGFR of 45 to 59 and 30 to 44 mL/min/1.73 m 2 compared with those people having eGFR > or = 60 mL/min/1.73 m 2 [22].…”

Section: Introductionmentioning

confidence: 99%

Association between Parathyroid Hormone, 25 (OH) Vitamin D, and Chronic Kidney Disease: A Population-Based Study

Wang

Chen

Lee

et al. 2017

BioMed Research International

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Identification of the accurate risk factor for CKD remains mandatory to combat the high prevalence of diseases. Growing evidence suggests the association of serum vitamin D with diverse health conditions. However, the relationship between vitamin D, intact parathyroid hormone (PTH), and calcium-phosphate metabolism and development of CKD remains controversial. We conduct this cross-sectional observational study to investigate the association between serum 25 (OH) vitamin D, intact PTH, and calcium and phosphate levels with eGFR and albuminuria, as a surrogate marker of CKD, in a community population. A total of 4080 participants were recruited. The mean age was 58.4 ± 13.3 years and 1480 (36.3%) were men. The mean eGFR was 94.1 ± 26.3 mL/min/1.73 m2. The prevalence of CKD was 19.8%. Serum 25 (OH) vitamin D and log intact PTH levels were inversely correlated with eGFR but positively correlated with log albuminuria. Logistic regression analysis identified the log intact PTH as an independent factor associated with eGFR ≤ 60 mL/min/1.73 m2 and proteinuria. This association was consistent when serum intact PTH was analyzed as continuous as well as categorical variables (as hyperparathyroidism). The relationship remains significant using resampling subset analysis with comparable baseline characteristics and adjustment for 25 (OH) vitamin D, calcium, and phosphate levels. This finding warranted further research to clarify the causal relationship of PTH/25 (OH) vitamin D with the risk of CKD in the general population.

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Associations between calcium-phosphate metabolism and coronary artery calcification; a cross sectional study of a middle-aged general population

Cited by 20 publications

References 38 publications

Serum 25-hydroxyvitamin D and the risk of stroke in Hong Kong Chinese

Serum 25-hydroxyvitamin D and the risk of stroke in Hong Kong Chinese

The role of calcium supplementation in healthy musculoskeletal ageing

Association between Parathyroid Hormone, 25 (OH) Vitamin D, and Chronic Kidney Disease: A Population-Based Study

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