Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults: 10-Year Follow-up of the Multi-Ethnic Study of Atherosclerosis (MESA).
Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults: 10-Year Follow-up of the Multi-Ethnic Study of Atherosclerosis (MESA).
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DOI：
10.1161/jaha.116.003815
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发表时间：
2016-10-11
影响因子：
5.4
通讯作者：
Michos ED
中科院分区：
文献类型：
--
作者：
Anderson JJ;Kruszka B;Delaney JA;He K;Burke GL;Alonso A;Bild DE;Budoff M;Michos ED
最近的随机数据表明，钙补充剂可能与心血管疾病（CVD）事件的风险增加有关。通过一项纵向队列研究，我们评估了从食物和补充剂中摄入钙与冠状动脉钙化（CAC）测量的动脉粥样硬化之间的关系。我们研究了来自多种族动脉粥样硬化研究的5448名无临床诊断CVD的成年人（52%女性;年龄45-84岁）。从饮食（使用食物频率问卷）和钙补充剂（通过药物清单）评估基线总钙摄入量，并将其分为五分位数。通过计算机断层扫描测量基线CAC，10年后在2742名参与者中重复CAC测量。基线时，五分位数的平均钙摄入量分别为313.3、540.3、783.0、1168.9和2157.4 mg/天。女性的钙摄入量高于男性。校正潜在混杂因素后，在1567名基线无CAC的参与者中，按钙摄入量的五分位数1 - 5，10年内发生CAC事件的相对风险（RR）为1（参考）、0.95（0.79-1.14）、1.02（0.85-1.23）、0.86（0.69-1.05）和0.73（0.57-0.93）。在考虑总钙摄入量后，钙补充剂的使用与CAC事件风险增加相关（RR=1.22 [1.07-1.39]）。在基线CAC >0的受试者中，基线钙摄入量与对数转换CAC的10年变化之间没有关系。在长期随访中，高总钙摄入量与动脉粥样硬化事件风险降低相关，特别是在不使用补充剂的情况下。然而，钙补充剂的使用可能会增加发生CAC的风险。
Recent randomized data suggest that calcium supplements may be associated with increased risk of cardiovascular disease (CVD) events. Using a longitudinal cohort study, we assessed the association between calcium intake, from both foods and supplements, and atherosclerosis, as measured by coronary artery calcification (CAC). We studied 5448 adults free of clinically diagnosed CVD (52% female; aged 45–84 years) from the Multi‐Ethnic Study of Atherosclerosis. Baseline total calcium intake was assessed from diet (using a food frequency questionnaire) and calcium supplements (by a medication inventory) and categorized into quintiles. Baseline CAC was measured by computed tomography, and CAC measurements were repeated in 2742 participants ≈10 years later. At baseline, mean calcium intakes across quintiles were 313.3, 540.3, 783.0, 1168.9, and 2157.4 mg/day. Women had higher calcium intakes than men. After adjustment for potential confounders, among 1567 participants without baseline CAC, the relative risk (RR) of developing incident CAC over 10 years, by quintile 1 to 5 of calcium intake, were 1 (reference), 0.95 (0.79–1.14), 1.02 (0.85–1.23), 0.86 (0.69–1.05), and 0.73 (0.57–0.93). After accounting for total calcium intake, calcium supplement use was associated with increased risk for incident CAC (RR=1.22 [1.07–1.39]). No relation was found between baseline calcium intake and 10‐year changes in log‐transformed CAC among those participants with baseline CAC >0. High total calcium intake was associated with a decreased risk of incident atherosclerosis over long‐term follow‐up, particularly if achieved without supplement use. However, calcium supplement use may increase the risk for incident CAC.