Ding Congcong, Bi Chonglei, Lin Tengfei, Liu Lishun, Song Yun, Wang Binyan, Wang Ping, Fang Chongqian, Ma Hai, Huang Xiao, Xu Xiping, Zhang Hao, Hu Lihua, Huo Yong, Wang Xiaobin, Bao Huihui, Cheng Xiaoshu
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Front Neurol. 2022 Aug 5;13:938794. doi: 10.3389/fneur.2022.938794. eCollection 2022.
Evidence from epidemiologic studies has been limited and inconsistent regarding the role of serum calcium in stroke incidence risk. We aimed to evaluate the association between serum albumin-corrected calcium and the risk of the first stroke in the Chinese community-dwelling population.
The study sample population was drawn from the "H-type Hypertension and Stroke Prevention and Control Project." Using a nested case-control study, a total of 1,255 first-stroke cases and 1,255 controls matched for age, sex, and village were included in the final data analysis. We measured the serum calcium by inductively coupled plasma mass spectrometry and assessed the associations between serum albumin-corrected calcium and first stroke using conditional logistic regression.
The overall mean (SD) serum albumin-corrected calcium was 8.9 (0.6) mg/dl. Compared with the middle tertile (8.7-9.1 mg/dl), the multivariate-adjusted odds ratios (95% CIs) of first total stroke associated with the lowest tertile and the highest tertile of serum albumin-corrected calcium were 1.37 (1.10, 1.70) and 1.30 (1.04, 1.62), respectively. Similar trends were observed for the first ischemic stroke. Consistently, restricted cubic spline showed a U-shaped association between serum albumin-corrected calcium and risk of total stroke and ischemic stroke. However, serum albumin-corrected calcium had no significant effect on first hemorrhagic stroke. No significant effect modification was observed in the subgroup analysis.
Our results suggested a U-shaped association between serum calcium and first stroke; both low and high serum calcium levels were associated with an increased risk of the first stroke in the Chinese population.
关于血清钙在中风发病风险中的作用，流行病学研究的证据有限且不一致。我们旨在评估血清白蛋白校正钙与中国社区居住人群首次中风风险之间的关联。
研究样本人群来自“H型高血压与中风预防控制项目”。采用巢式病例对照研究，最终数据分析纳入了1255例首次中风病例和1255例年龄、性别和村庄匹配的对照。我们通过电感耦合等离子体质谱法测量血清钙，并使用条件逻辑回归评估血清白蛋白校正钙与首次中风之间的关联。
血清白蛋白校正钙的总体平均（标准差）为8.9（0.6）mg/dl。与中间三分位数（8.7 - 9.1mg/dl）相比，血清白蛋白校正钙最低三分位数和最高三分位数相关的首次全中风的多变量调整优势比（95%置信区间）分别为1.37（1.10，1.70）和1.30（1.04，1.62）。首次缺血性中风也观察到类似趋势。一致地，受限立方样条显示血清白蛋白校正钙与全中风和缺血性中风风险之间呈U形关联。然而，血清白蛋白校正钙对首次出血性中风没有显著影响。亚组分析未观察到显著的效应修饰。
我们的结果表明血清钙与首次中风之间呈U形关联；在中国人群中，低血清钙水平和高血清钙水平均与首次中风风险增加相关。
