Association between Serum Calcium and Risk of Cardiometabolic Disease among Community-dwelling Adults in Taiwan.

Serum calcium, although only comprising 1% of total body calcium, is involved in intracellular signal pathways, vascular dilatation/constriction, and muscle contraction, which are crucial for insulin secretion, cholesterol catabolism, and blood pressure regulation. As far as we know, research on the relationship between serum calcium level and metabolic syndrome (MetS), diabetes, and hypertension in one longitudinal study is rare. Owing to the crucial role of serum calcium in human cardiometabolic physiology and lack of related study so far, this study aims to describe the relationship between serum calcium level and the incidence of MetS, diabetes, and hypertension. During the period 2010-2016, there are two parts to our study: cross-sectional analysis and longitudinal analysis. Logistic regression was applied for cross-sectional analysis of the association between serum calcium level or albumin-corrected calcium (ACCA) and the prevalence of MetS, diabetes, or hypertension. Receiver operating characteristic (ROC) curve analysis was used for calculating of optimal cut-off value of serum calcium and ACCA. Cox proportional regression for development of MetS, diabetes, and hypertension according to different cut-off values of serum calcium level and ACCA were conducted. At baseline, there were 27,364 participants in our study. Serum calcium level had positive association with diabetes in the total population, male, and female. ACCA level had positive association with diabetes in the total population, male, and female. In unadjusted and multivariate Cox proportional hazard models, serum calcium level was associated with increased risk of incident MetS in the total population and male. ACCA was associated with increased risk of incident MetS in the total population and male. ACCA was associated with increased risk of incident diabetes in the total population and male participants. This study describes the relationship between serum calcium level and the incidence of MetS, diabetes, and hypertension. Higher serum calcium level is associated with increased risk of MetS, diabetes, and hypertension.