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Title: Increased serum calcium levels and risk of type 2 diabetes in individuals at high cardiovascular risk
Authors: Becerra-Tomás, Nerea
Estruch, Ramón
Bulló, Mònica
Casas, Rosa
Díaz-López, Andrés
Basora, Josep
Fitó, Montserrat
Serra-Majem, Lluis 
Salas-Salvadó, Jordi
Keywords: Fasting Plasma-Glucose
Mellitus, et al
Issue Date: 2014
Publisher: 0149-5992
Journal: Diabetes Care 
Abstract: OBJECTIVEInsulin 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 METHODSProspective 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.RESULTSAfter 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.CONCLUSIONSAn increase in serum calcium concentrations is associated with an increased risk of type 2 diabetes in individuals at high cardiovascular risk.
ISSN: 0149-5992
DOI: 10.2337/dc14-0898
Source: Diabetes Care[ISSN 0149-5992],v. 37, p. 3084-3091
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