Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA.
Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Nutr Metab Cardiovasc Dis. 2020 May 7;30(5):758-767. doi: 10.1016/j.numecd.2020.01.003. Epub 2020 Jan 21.
Elevated serum calcium and phosphorus have been associated with increased risk of cardiovascular disorders. We evaluated whether abnormal calcium and high serum phosphorus are associated cross-sectionally with echocardiographic measures of left ventricular (LV) structure and function, as doing so may provide insight into the etiology of cardiac disorders.
Included in the analysis were 5213 Atherosclerosis Risk in Communities Study (ARIC) participants who in 2011-2013 had echocardiography and serum calcium and phosphorus measurements. We evaluated the association of serum calcium (corrected for albumin) and phosphorus quintiles with measures of LV structure and function, after adjusting for other cardiovascular risk factors. Participants were on average 75.3 years old; 59.1% were female and 19.8% were African American. Mean (±SD) concentrations of calcium and phosphorus were 9.33 ± 0.38 and 3.46 ± 0.45 mg/dL, respectively. Higher calcium was associated with lower LV end-diastolic diameter (LVEDD) but greater prevalence of concentric remodeling (p-trend: 0.005 and 0.004 respectively). We observed association between high phosphorus and high septal E/e' (p-trend: 0.02). Likewise, higher serum phosphorus was associated with higher left atrial volume index (p-trend: 0.001) and LV hypertrophy prevalence (p-trend: 0.04).
In conclusion, higher calcium was associated with more concentric remodeling but lower LVEDD, suggesting complex associations between calcium and cardiac function. Serum phosphorus was related to worse indices of LV diastolic function and LV hypertrophy, but not to LV systolic function. However, the magnitudes of association were modest, so clinical implications of these findings may be limited.
血清钙和磷升高与心血管疾病风险增加有关。我们评估了血清钙和磷异常升高是否与左心室（LV）结构和功能的超声心动图测量值存在横断面相关性，因为这可能有助于深入了解心脏疾病的发病机制。
纳入分析的有 5213 名动脉粥样硬化风险社区研究（ARIC）参与者，他们在 2011-2013 年进行了超声心动图检查和血清钙、磷测量。我们评估了血清钙（校正白蛋白）和磷五分位数与 LV 结构和功能测量值的相关性，调整了其他心血管危险因素。参与者的平均年龄为 75.3 岁；59.1%为女性，19.8%为非裔美国人。钙和磷的平均（±SD）浓度分别为 9.33 ± 0.38 和 3.46 ± 0.45 mg/dL。较高的钙与较低的 LV 舒张末期直径（LVEDD）相关，但与同心性重构的发生率较高相关（趋势 p 值：0.005 和 0.004）。我们观察到磷与高间隔 E/e'之间存在相关性（趋势 p 值：0.02）。同样，较高的血清磷与较高的左心房容积指数（趋势 p 值：0.001）和 LV 肥厚的发生率相关（趋势 p 值：0.04）。
总之，钙较高与更严重的同心性重构但 LVEDD 较低相关，提示钙与心脏功能之间存在复杂的关联。血清磷与 LV 舒张功能和 LV 肥厚的指标较差相关，但与 LV 收缩功能无关。然而，关联的幅度较小，因此这些发现的临床意义可能有限。
