From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
Arterioscler Thromb Vasc Biol. 2014 Aug;34(8):1763-9. doi: 10.1161/ATVBAHA.114.303440. Epub 2014 Jun 12.
The current data regarding the association between calcium and phosphorus and cardiovascular disease are lacking. The aim of this study was to explore whether dietary calcium and phosphorus intake and their serum levels are associated with the prevalence of coronary artery calcification (CAC) using cardiac computed tomography in asymptomatic participants without a history of chronic kidney disease or cardiovascular disease.
A cross-sectional study was performed in 23 652 Korean participants (40.8±7.3 years, male 83.5%) without chronic kidney disease (estimated glomerular filtration rate≥60 mL/min per 1.73 m(2)) or clinically overt cardiovascular disease, who underwent cardiac computed tomographic estimation of CAC scores as part of a general health checkup in addition to completing a self-administered food frequency questionnaire. We assessed the relationship of dietary calcium and phosphorus intake and serum levels with CAC scores using both multivariate-adjusted Tobit models and multinomial logistic regression models. Neither dietary calcium nor phosphorus intake was consistently associated with CAC scores. However, the serum calcium, phosphorus, and calcium-phosphorus product levels were significantly associated with the CAC score ratios. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest quartiles of serum calcium, phosphorus, and calcium-phosphorus product levels to the lowest quartiles were 1.89 (1.36-2.64), 3.33 (2.55-4.35), and 3.98 (3.00-5.28), respectively (P for trend <0.001).
Elevated serum levels of calcium, phosphorus, and calcium-phosphorus product, but not dietary consumption, are associated with increased CAC scores. Our findings should be explored in further research.
目前有关钙和磷与心血管疾病之间关联的数据尚缺乏。本研究旨在探讨在无慢性肾脏病或心血管疾病病史的无症状参与者中，使用心脏计算机断层扫描（CT）检查时，膳食钙和磷摄入量及其血清水平是否与冠状动脉钙化（CAC）的发生率相关。
在 23652 名韩国参与者（40.8±7.3 岁，男性 83.5%）中进行了一项横断面研究，这些参与者无慢性肾脏病（估计肾小球滤过率≥60 mL/min/1.73 m²）或临床明显的心血管疾病，他们除了接受一般健康检查的心脏 CT 估计 CAC 评分外，还完成了一份自我管理的食物频率问卷。我们使用多元调整 Tobit 模型和多项逻辑回归模型来评估膳食钙和磷摄入量及血清水平与 CAC 评分之间的关系。膳食钙和磷的摄入量均与 CAC 评分无一致性关联。然而，血清钙、磷和钙磷乘积水平与 CAC 评分比值显著相关。在多变量调整模型中，与血清钙、磷和钙磷乘积水平最低四分位数相比，最高四分位数的 CAC 评分比值（95%置信区间）分别为 1.89（1.36-2.64）、3.33（2.55-4.35）和 3.98（3.00-5.28）（趋势 P<0.001）。
血清钙、磷和钙磷乘积水平升高，但膳食摄入量不升高，与 CAC 评分增加相关。我们的发现应在进一步的研究中进行探索。
