Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg)
Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg)
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DOI：
10.1136/heartjnl-2011-301345
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发表时间：
2012-06-01
期刊：
影响因子：
5.7
通讯作者：
Rohrmann, Sabine
中科院分区：
文献类型：
--
作者：
Li, Kuanrong;Kaaks, Rudolf;Rohrmann, Sabine
研究背景：高钙摄入量可能有利于改善心血管危险因素。然而，最终降低心血管疾病（CVD）风险的研究结果有限。相反，最近的证据警告说，服用钙补充剂可能会增加心肌梗死（MI）的风险。目的前瞻性地评估膳食钙摄入量和钙补充剂与MI和卒中风险以及总体CVD死亡率的关系。方法来自欧洲癌症与营养前瞻性调查研究的23 980名海德堡队列参与者的数据，年龄35-64岁，招募时无重大CVD事件。多变量考克斯回归模型被用来估计HR和95%CIs.Results后，平均随访时间为11年，354 MI和260中风病例和267 CVD死亡记录。与最低四分位数相比，总膳食和乳制品钙摄入量的第三四分位数显著降低了MI风险，HR分别为0.69（95%CI 0.50至0.94）和0.68（95%CI 0.50至0.93）。卒中风险与CVD死亡率之间的相关性总体上为零。与不服用任何补充剂的人相比，服用钙补充剂的人患心肌梗死的风险在统计学上显著增加（HR=1.86; 95% CI 1.17 - 2.96），仅补充钙的使用者更明显（HR=2.39; 95%CI 1.12至5.12）。结论增加饮食中的钙摄入量可能不会带来显着的心血管益处，而钙补充剂，这可能会增加心肌梗死的风险，应谨慎对待。
Background It has been suggested that a higher calcium intake might favourably modify cardiovascular risk factors. However, findings of an ultimately decreased risk of cardiovascular disease (CVD) are limited. Instead, recent evidence warns that taking calcium supplements might increase myocardial infarction (MI) risk.Objective To prospectively evaluate the associations of dietary calcium intake and calcium supplementation with MI and stroke risk and overall CVD mortality.Methods Data from 23 980 Heidelberg cohort participants of the European Prospective Investigation into Cancer and Nutrition study, aged 35-64 years and free of major CVD events at recruitment, were analysed. Multivariate Cox regression models were used to estimate HRs and 95% CIs.Results After an average follow-up time of 11 years, 354 MI and 260 stroke cases and 267 CVD deaths were documented. Compared with the lowest quartile, the third quartile of total dietary and dairy calcium intake had a significantly reduced MI risk, with a HR of 0.69 (95% CI 0.50 to 0.94) and 0.68 (95% CI 0.50 to 0.93), respectively. Associations for stroke risk and CVD mortality were overall null. In comparison with non-users of any supplements, users of calcium supplements had a statistically significantly increased MI risk (HR=1.86; 95% CI 1.17 to 2.96), which was more pronounced for calcium supplement only users (HR=2.39; 95% CI 1.12 to 5.12).Conclusions Increasing calcium intake from diet might not confer significant cardiovascular benefits, while calcium supplements, which might raise MI risk, should be taken with caution.