Prediction of all-cause mortality in a patient population with hypertension and type 2 DM by using traditional risk factors and serum-phosphate,-calcium and-magnesium

Håglin, Lena; Törnkvist, Birgitta; Backman, L

doi:10.1007/s00592-007-0254-6

Cited by 34 publications

(29 citation statements)

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“…An association of elevated calcium levels and mortality, as observed in the current cohort of acute stroke patients, was observed among patients with hypertension and diabetes as well as among dialysis patients [17,18]. Possible mechanisms may be related to accelerated atherosclerosis, vascular calcification and plaque rupture which are associated with elevated calcium levels as well as with other metabolic risk factors [19,20,21], yet the reasons underlying the interaction with gender are not clear.…”

Section: Discussionmentioning

confidence: 99%

Serum Calcium Levels and Long-Term Mortality in Patients with Acute Stroke

et al. 2010

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Background: Calcium concentrations in serum are maintained within an exquisitely narrow range. Our aim was to examine the association between serum calcium and albumin-adjusted calcium (calcium_adj) levels and stroke outcome in a cohort of unselected patients with acute stroke. Methods: Consecutive patients hospitalized due to acute stroke (ischemic or intracerebral hemorrhage) throughout a large medical center were systematically assessed and followed for 1 year. Baseline total calcium and calcium_adj levels were collapsed into groups of low (<8.6 mg/dl), normal (8.7–9.9 mg/dl) and high (>10 mg/dl) levels and linear and quadratic relations with outcome were examined. Result: Among 784 patients (mean age 70.7 ± 12.5 years, 42.5% females), the mean ± SD total calcium level was 9.3 ± 0.6 mg/dl. For total calcium, the adjusted hazard ratio (HR) for all-cause death over 1 year was 1.83 [95% confidence interval (CI) 1.22–2.75] among patients with low versus normal levels. For calcium_adj, the adjusted HR for all-cause death among women was over 3-fold higher among patients with high calcium_adj levels versus those with normal levels (3.31; 95% CI 1.70–6.46), while no such associations were observed among men. In models developed to estimate the linear and quadratic relations, each unit increment in total calcium squared was associated with an increased adjusted HR of all-cause death over 1 year (p = 0.02) confirming nonlinear associations, and each unit increment in calcium_adj squared was associated with an increased adjusted HR of all-cause death over 1 year among women (p < 0.001) but not among men (p = 0.70). Conclusions: Serum calcium concentrations are a marker of mortality in acute stroke patients, but the associations are not linear, increasing at both extremes of calcium levels. Our findings suggest that long-term survival is optimal in a distinct range of serum calcium levels.

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Section: Discussionmentioning

confidence: 99%

Serum Calcium Levels and Long-Term Mortality in Patients with Acute Stroke

et al. 2010

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“…Inclusion of the serum calcium level increased the predictive value of the traditional risk factors, which suggested an independent mediating mechanism (8).…”

Section: Introductionmentioning

confidence: 98%

Serum calcium level is associated with metabolic syndrome in the general population: FIN-D2D study

Saltevo

Niskanen

Kautiainen

et al. 2011

European Journal of Endocrinology

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Background: The aim of this cross-sectional study was to examine the association between serum calcium and the components of metabolic syndrome (MetS). Methods: As a part of the national prevention program of diabetes in Finland (FIN-D2D), a randomly selected study population of 4500 middle-aged men and women were recruited from three central hospital district areas. Anthropometric measurements were performed by a trained nurse. An oral glucose tolerance test was performed and serum calcium and lipids were measured. We assessed current medications, physical activity, smoking, alcohol consumption, calcium intake, and vitamin D intake. The MetS was defined according to the criteria of the updated National Education Program. The study population consisted of 2896 individuals: 1396 men (62% of invited individuals) and 1500 women (66.7% of invited individuals). Results: The mean age was 60.3G8.3 years in men and 59.8G8.5 years in women. The prevalence of MetS was 50.7% in women and 55.8% in men. The prevalence of MetS and its components, except high-density lipoprotein (HDL)-cholesterol, increased linearly with increasing serum calcium (P!0.001), even after adjustment for age, physical activity, alcohol, vitamin D intake, calcium intake, and smoking. The threshold value for serum calcium for MetS was 2.50 mmol/l in this population. The association of MetS with total serum calcium was similar even after exclusion of patients treated with hypertensive drugs. The drug treatments for hypertension, dyslipidemia, and diabetes increased in a similar pattern. Conclusions: Serum calcium level is associated with MetS and its components, except HDL-cholesterol.

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“…Patients with insulin resistant conditions like type-2 diabetes and obesity have lower circulating magnesium concentrations than healthy subjects [5,6]. Recently, a low serum magnesium concentration was shown to increase the risk of all-cause mortality when added to the conventional CVD risk factors and was significantly associated with all-cause mortality in type 2 diabetes patients [7]. A previous weight-reducing surgical method, the jejunoileal bypass (JIB) was associated with an increased risk of magnesium depletion [8].…”

Section: Introductionmentioning

confidence: 99%