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Diabetologia
Published in: Diabetologia 2/2007

01-02-2007 | Article

Serum calcium is independently associated with insulin sensitivity measured with euglycaemic–hyperinsulinaemic clamp in a community-based cohort

Authors: E. Hagström, P. Hellman, E. Lundgren, L. Lind, J. Ärnlöv

Published in: Diabetologia | Issue 2/2007

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Abstract

Aims/hypothesis

Diabetes mellitus type 2 is associated with altered calcium metabolism. Moreover, in diseases with supranormal serum calcium levels, such as primary hyperparathyroidism, the prevalence of diabetes is increased. Relatively little is known about the relationship between serum calcium concentration and the underlying causes of diabetes—insulin resistance and defective insulin secretion—in the normocalcaemic general population.

Materials and methods

We investigated associations between serum calcium concentration and insulin sensitivity and secretion in a population-based cohort of elderly men (Uppsala Longitudinal Study of Adult Men, n = 961). Insulin sensitivity index (M/I; glucose disposal rate [M] divided by mean insulin concentration [I]) was assessed using euglycaemic–hyperinsulinaemic clamp, and insulin secretion was estimated from the early insulin response (EIR) during an OGTT.

Results

In a multivariable linear regression model adjusting for BMI, physical activity, smoking, consumption of tea, alcohol, coffee and dietary calcium, serum phosphate and serum creatinine, 1 SD increase in serum calcium was associated with 0.17 mg kg−1 min−1 (mU/l)−1 × 100 (0.024 mg kg−1 min−1 [pmol/l]−1 × 100) decrease in M/I (p = 0.01). The results remained robust in individuals with normal fasting glucose, normal glucose tolerance and serum calcium within the normal range (n = 413, regression coefficient for 1 SD increase −0.45, p = 0.001). Serum calcium was not associated with EIR. Dietary intake of calcium was not independently associated with insulin sensitivity or EIR.

Conclusion/interpretation

Our data support the notion that endogenous calcium may be involved early in the development of diabetes and that this effect is mediated mainly through effects on insulin sensitivity rather than defective insulin secretion. Dietary intake of calcium does not seem to influence insulin sensitivity.
Appendix
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Metadata
Title
Serum calcium is independently associated with insulin sensitivity measured with euglycaemic–hyperinsulinaemic clamp in a community-based cohort
Authors
E. Hagström
P. Hellman
E. Lundgren
L. Lind
J. Ärnlöv
Publication date
01-02-2007
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 2/2007
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-006-0532-9

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