Zhu Huijing, Wang Huili, Jia Yuqing, Cheng Lin, Cheng Xingbo
Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Endocrinology & Metabolism, Heze Municipal Hospital, Heze, Shandong, China.
Ther Adv Endocrinol Metab. 2021 Mar 29;12:2042018821995369. doi: 10.1177/2042018821995369. eCollection 2021.
Patients with type 2 diabetes mellitus (T2DM) have an elevated risk of atherosclerotic cardiovascular disease. Although previous data have suggested that serum calcium levels could be involved in T2DM and cardiovascular disease, whether this applies in T2DM patients with atherosclerosis remains unclear. This study therefore aimed to investigate the relationship between serum calcium levels within the physiological ranges and carotid atherosclerotic plaque in T2DM patients.
A total of 594 normocalcaemic in-patients with T2DM were recruited, of whom 231 had carotid atherosclerotic plaque. Serum calcium levels were measured and carotid ultrasonography was performed.
Patients with plaque had significantly higher serum albumin-corrected calcium than those without plaque [9.02 (8.78-9.34) mg/dL 8.86 (8.66-9.06) mg/dL, < 0.001]. As serum albumin-corrected calcium levels increased across tertiles, the percentage of plaque increased (27.6%, 35.5%, and 55.7%; < 0.001). Logistic regression showed that serum albumin-corrected calcium levels were independently and positively correlated with the presence of plaque, but not parathyroid hormone levels. Compared with patients in the lowest serum calcium tertiles, the odds ratio for plaque in patients in the upper quartile was 2.47 (95% confidence interval 1.51-4.03, < 0.001) after adjustment for potential confounders.
Serum albumin-corrected calcium levels are elevated in patients with T2DM and carotid atherosclerotic plaques.
2型糖尿病（T2DM）患者发生动脉粥样硬化性心血管疾病的风险升高。尽管先前的数据表明血清钙水平可能与T2DM和心血管疾病有关，但这是否适用于患有动脉粥样硬化的T2DM患者仍不清楚。因此，本研究旨在探讨生理范围内的血清钙水平与T2DM患者颈动脉粥样硬化斑块之间的关系。
共招募了594例血钙正常的T2DM住院患者，其中231例有颈动脉粥样硬化斑块。测量血清钙水平并进行颈动脉超声检查。
有斑块的患者血清白蛋白校正钙水平显著高于无斑块的患者[9.02（8.78 - 9.34）mg/dL对8.86（8.66 - 9.06）mg/dL，P < 0.001]。随着血清白蛋白校正钙水平按三分位数增加，斑块百分比增加（27.6%、35.5%和55.7%；P < 0.001）。逻辑回归显示，血清白蛋白校正钙水平与斑块的存在独立正相关，但与甲状旁腺激素水平无关。在调整潜在混杂因素后，与血清钙最低三分位数的患者相比，上四分位数患者有斑块的比值比为2.47（95%置信区间1.51 - 4.03，P < 0.001）。
T2DM和颈动脉粥样硬化斑块患者的血清白蛋白校正钙水平升高。
