Calcium-phosphate levels and cardiovascular disease in community-dwelling adults: The Atherosclerosis Risk in Communities (ARIC) Study
Calcium-phosphate levels and cardiovascular disease in community-dwelling adults: The Atherosclerosis Risk in Communities (ARIC) Study
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DOI：
10.1016/j.ahj.2008.05.016
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发表时间：
2008-09-01
影响因子：
4.8
通讯作者：
Kalra, Philip A.
中科院分区：
文献类型：
--
作者：
Foley, Robert N.;Collins, Allan J.;Kalra, Philip A.
背景 钙磷酸盐水平与慢性肾病血管功能障碍相关，可能代表社区居住成年人冠心病、中风和死亡的新危险因素。方法我们在基于社区的前瞻性动脉粥样硬化风险社区研究 (n = 15,732) 中经过 12.6 年的随访检验了这一假设。结果 基线时，平均值 (SD) 值为 9.8 (0.4) mg/dL 血清钙，3.4 (0.5) mg/dL 血清磷酸盐，33.6 (5.3) mg(2)/dL(2) 磷酸钙产品，年龄 54.2 (5.7) 岁，肾小球滤过率 (GFR) 93.1 (21.5) mL/min 每 1.73 m(2)。钙、磷酸盐和磷酸钙产品的共同关联包括年龄、女性、非裔美国人种族、吸烟年数、当前吸烟、低体重指数、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、低血清白蛋白、低GFR、低热量摄入和磷摄入。调整年龄、人口特征、合并症、白蛋白和 GFR 后，冠心病、中风和死亡的钙相关风险比分别为 1.01（95% 置信区间 0.96-1.06）、1.16（1.07-1.26，P = 0.0005）和 1.03（0.98-1.08）；与磷酸盐相关的危害比分别为 1.03 (0.98-1.08)、1.11 (1.02-1.21，P = .0219) 和 1.14 (1.09-1.20，P < .0001)；磷酸钙产品相关风险比分别为 1.03 (0.98-1.08)、1.15 (1.05-1.26，P = .0017) 和 1.15 (1.09-1.20，P < .0001)。 结论 虽然钙、磷酸盐和磷酸钙产品水平与传统心血管危险因素和结果表现出复杂的关联，但它们可能是潜在的可改变风险 社区居住成年人中风和死亡的因素。
Background Calcium-phosphate levels, linked to vascular dysfunction in chronic kidney disease, may represent novel risk factors for coronary heart disease, stroke, and death in community-dwelling adults.Methods We tested this hypothesis over 12.6 years of follow-up in the prospective, community-based Atherosclerosis Risk in Communities Study (n = 15,732).Results At baseline, mean (SD) values were 9.8 (0.4) mg/dL for serum calcium, 3.4 (0.5) mg/dL for serum phosphate, 33.6 (5.3) mg(2)/dL(2) for calcium-phosphate product, 54.2 (5.7) years for age, and 93.1 (21.5) mL/min per 1.73 m(2) for glomerular filtration rate (GFR). Shared associations of calcium, phosphate, and calcium-phosphate product included older age, female sex, African American race, cigarette-years, current cigarette smoking, low body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, low serum albumin, low GFR, low caloric intake, and phosphorus intake. With adjustment for age, demographic characteristics, comorbid conditions, albumin, and GFR, calcium-associated hazards ratios for coronary heart disease, stroke, and death were, respectively, 1.01 (95% confidence interval 0.96-1.06), 1.16 (1.07-1.26, P = .0005), and 1.03 (0.98-1.08); phosphate-associated hazards ratios were 1.03 (0.98-1.08), 1.11 (1.02-1.21, P = .0219), and 1.14 (1.09-1.20, P < .0001); calcium-phosphate product-associated hazards ratios were 1.03 (0.98-1.08), 1.15 (1.05-1.26, P = .0017), and 1.15 (1.09-1.20, P < .0001).Conclusions Although calcium, phosphate, and calcium-phosphate product levels exhibit complex associations with traditional cardiovascular risk factors and outcomes, they may be potentially modifiable risk factors for stroke and death in community-dwelling adults.