Jung Eujene, Kim Dong Ki, Ryu Seok Jin, Ryu Hyun Ho
Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, South Korea.
Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, South Korea.
Biol Res Nurs. 2025 Apr;27(2):246-254. doi: 10.1177/10998004241295360. Epub 2024 Nov 7.
This study aims to investigate the association between serum calcium levels and acute coronary syndrome (ACS) risk, examining whether this relationship differs by sex, given the known differences in calcium metabolism and hormonal influences between males and females. Utilizing the Korean Genome Epidemiology Study (KoGES) prospective cohort data, our primary exposure variables were serum calcium level and sex. The incidence of ACS served as the main outcome of interest. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression analysis. An interaction analysis was conducted to assess the interaction effect of calcium level and sex on ACS incidence. After adjusting for confounding variables, high calcium intake did not significantly increase ACS incidence, with a hazard ratio (HR) of 1.07 (95% CI: 0.90-1.26). There was also no significant difference in ACS risk between females and males (HR: 0.81, 95% CI: 0.61-1.04). However, interaction effect analysis revealed that higher calcium levels were associated with an increased risk of ACS only in females (HR: 1.24, 95% CI: 1.07-1.58), whereas the association in males was not statistically significant (HR: 0.90, 95% CI: 0.71-1.15). Our study results indicate that elevated serum calcium levels alone did not independently increase the risk of ACS; however, high serum calcium levels were associated with an increased risk of ACS in females but not in males, underscoring the importance of sex-specific factors in assessing and managing ACS risk and highlighting the necessity for personalized medical approaches to improve cardiovascular health outcomes for women.
本研究旨在探讨血清钙水平与急性冠状动脉综合征（ACS）风险之间的关联，鉴于已知男性和女性在钙代谢及激素影响方面存在差异，研究这种关系是否因性别而异。利用韩国基因组流行病学研究（KoGES）前瞻性队列数据，我们的主要暴露变量为血清钙水平和性别。ACS的发病率作为主要关注结果。使用Cox回归分析估计风险比（HRs）和95%置信区间（CIs）。进行交互分析以评估钙水平和性别对ACS发病率的交互作用。在调整混杂变量后，高钙摄入量并未显著增加ACS发病率，风险比（HR）为1.07（95%CI：0.90 - 1.26）。女性和男性之间的ACS风险也没有显著差异（HR：0.81，95%CI：0.61 - 1.04）。然而，交互作用分析显示，仅在女性中，较高的钙水平与ACS风险增加相关（HR：1.24，95%CI：1.07 - 1.58），而在男性中的关联无统计学意义（HR：0.90，95%CI：0.71 - 1.15）。我们的研究结果表明，仅血清钙水平升高并不会独立增加ACS风险；然而，高血清钙水平与女性而非男性的ACS风险增加相关，这凸显了性别特异性因素在评估和管理ACS风险中的重要性，并强调了采用个性化医疗方法改善女性心血管健康结局的必要性。
