Li Junfeng, Wu Nan, Li Yintao, Ye Kuanping, He Min, Hu Renming
The Institute of Endocrinology and Diabetology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Middle Wulumuqi Road, Shanghai, 200040, China.
Department of Medical Oncology, Shandong Cancer Hospital and Institute, Shandong Academy of Medical Sciences, Jinan, 250117, China.
Cardiovasc Diabetol. 2015 Apr 29;14:43. doi: 10.1186/s12933-015-0200-9.
Left ventricular hypertrophy (LVH) is prevalent in patients with type 2 diabetes mellitus (T2DM). Recent studies show that an increase in albumin-adjusted serum calcium level is associated with an elevated risk of T2DM. We speculate that increased serum calcium levels in T2DM patients are related to LVH prevalence.
In this echocardiographic study, 833 normocalcemia and normophosphatemia patients with T2DM were enrolled. The associations between serum calcium and metabolic parameters, left ventricular mass index (LVMI), as well as the rate of LVH were examined using bivariate linear correlation, multivariate linear regression and logistic regression, respectively. The predictive performance of serum calcium for LVH was evaluated using the area under the receiver operating characteristic curve (AUC).
Patients with LVH have significantly higher serum calcium than those without LVH. Serum calcium was positively associated with total cholesterol, triglycerides, low-density lipoprotein cholesterol, serum uric acid, HOMA-IR and fasting plasma glucose. Multivariate linear regression analysis demonstrated that serum calcium was independently associated with LVMI (p < 0.001). In comparison with patients in the lowest serum calcium quartile, the odds ratio (OR) for LVH in patients in the highest quartile was 2.909 (95% CI 1.792-4.720; p < 0.001). When serum calcium was analyzed as a continuous variable, per 1 mg/dl increase, the OR (95% CI) for LVH was [2.400 (1.552-3.713); p < 0.001]. Serum calcium can predict LVH (AUC = 0.617; 95% CI (0.577-0.656); p < 0.001).
Albumin-adjusted serum calcium is associated with an increased risk of LVH in patients with T2DM.
左心室肥厚（LVH）在2型糖尿病（T2DM）患者中很常见。最近的研究表明，白蛋白校正血清钙水平升高与T2DM风险增加有关。我们推测T2DM患者血清钙水平升高与LVH患病率有关。
在这项超声心动图研究中，纳入了833名血钙和血磷正常的T2DM患者。分别使用双变量线性相关、多元线性回归和逻辑回归来研究血清钙与代谢参数、左心室质量指数（LVMI）以及LVH发生率之间的关联。使用受试者操作特征曲线下面积（AUC）评估血清钙对LVH的预测性能。
LVH患者的血清钙水平显著高于无LVH患者。血清钙与总胆固醇、甘油三酯、低密度脂蛋白胆固醇、血清尿酸、HOMA-IR和空腹血糖呈正相关。多元线性回归分析表明，血清钙与LVMI独立相关（p<0.001）。与血清钙最低四分位数的患者相比，最高四分位数患者发生LVH的比值比（OR）为2.909（95%CI 1.792-4.720；p<0.001）。当将血清钙作为连续变量分析时，每增加1mg/dl，LVH的OR（95%CI）为[2.400（1.552-3.713）；p<0.001]。血清钙可以预测LVH（AUC=0.617；95%CI（0.577-0.656）；p<0.001）。
白蛋白校正血清钙与T2DM患者LVH风险增加有关。
