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Published in: Journal of Translational Medicine 1/2012

Open Access 01-12-2012 | Research

Serum calcium level is related to both intima-media thickness and carotid atherosclerosis: a neglect risk factor in obese/overweight subjects

Authors: Tiziana Montalcini, Gaetano Gorgone, Arturo Pujia

Published in: Journal of Translational Medicine | Issue 1/2012

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Abstract

Background

Experimental studies suggested that high serum calcium may be important in the pathogenesis of vascular diseases. Since calcium seems to affect specifically the cerebrovascular district, aim of this study was to determine the relation between serum calcium levels, within normal range, and subclinical atherosclerosis in the carotid arteries, in a population of obese/overweight subjects.

Methods

In our retrospective study we included 472 subjects (59% female) with body mass index equal to or more than 25 kg/m2. They underwent a physical examination, a biochemical assessment (including calcium evaluation) and a B-mode ultrasonography of the extracranial carotid arteries to detect carotid atherosclerosis presence and to measure intima-media thickness.

Results

Mean age of the population was 50 ±12 years. Prevalence of the Carotid atherosclerosis was 40%. Mean carotid intima-media thickness was 0,66 ± 0,18 mm. The univariate and multivariate analysis showed an association between calcium and carotid intima-media thickness (p = 0,035). We divided the population in serum calcium tertiles. We found an higher carotid atherosclerosis prevalence in the III tertile in comparison to that of the I tertile (p = 0,039).

Conclusions

In this study we found a positive relation between serum calcium levels, within normal range, and subclinical atherosclerosis in the carotid arteries, in a population of obese/overweight subjects. It is important to consider the impact of the serum calcium levels in the overall risk assessment of patients, at least in obese subjects.
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Literature
1.
go back to reference Palmér M, Adami HO, Bergström R, Akerström G, Ljunghall S: Mortality after surgery for primary hyperparathyroidism: a follow-up of 441 patients operated on from 1956 to 1979. Surgery. 1987, 102: 1-7.PubMed Palmér M, Adami HO, Bergström R, Akerström G, Ljunghall S: Mortality after surgery for primary hyperparathyroidism: a follow-up of 441 patients operated on from 1956 to 1979. Surgery. 1987, 102: 1-7.PubMed
2.
go back to reference Hedback G, Oden A, Tisell LE: The influence of surgery on the risk of death in patients with primary hyperparathyroidism. World J Surg. 1991, 15: 399-405. 10.1007/BF01658740.CrossRefPubMed Hedback G, Oden A, Tisell LE: The influence of surgery on the risk of death in patients with primary hyperparathyroidism. World J Surg. 1991, 15: 399-405. 10.1007/BF01658740.CrossRefPubMed
3.
go back to reference Hedback G, Tisell LE, Bengtsson BA, Hedman I, Oden A: Premature death in patients operated on for primary hyperparathyroidism. World J Surg. 1990, 14: 829-835. 10.1007/BF01670531.CrossRefPubMed Hedback G, Tisell LE, Bengtsson BA, Hedman I, Oden A: Premature death in patients operated on for primary hyperparathyroidism. World J Surg. 1990, 14: 829-835. 10.1007/BF01670531.CrossRefPubMed
4.
go back to reference Hedbäck G, Oden A: Survival of patients operated on for primary hyperparathyroidism. Surgery. 1999, 125: 240-241. 10.1016/S0039-6060(99)70274-6.CrossRefPubMed Hedbäck G, Oden A: Survival of patients operated on for primary hyperparathyroidism. Surgery. 1999, 125: 240-241. 10.1016/S0039-6060(99)70274-6.CrossRefPubMed
5.
go back to reference Hedbäck G, Oden A: Increased risk of death from primary hyperparathyroidism: an update. Eur J Clin Invest. 1998, 28: 271-276. 10.1046/j.1365-2362.1998.00289.x.CrossRefPubMed Hedbäck G, Oden A: Increased risk of death from primary hyperparathyroidism: an update. Eur J Clin Invest. 1998, 28: 271-276. 10.1046/j.1365-2362.1998.00289.x.CrossRefPubMed
6.
go back to reference Nilsson IL, Yin L, Lundgren E, Rastad J, Ekbom A: Clinical presentation of primary hyperparathyroidism in Europe: nationwide cohort analysis on mortality from nonmalignant causes. J Bone Miner Res. 2002, 17 (Suppl 2): N68-N74.PubMed Nilsson IL, Yin L, Lundgren E, Rastad J, Ekbom A: Clinical presentation of primary hyperparathyroidism in Europe: nationwide cohort analysis on mortality from nonmalignant causes. J Bone Miner Res. 2002, 17 (Suppl 2): N68-N74.PubMed
7.
go back to reference Øgard CG, Engholm G, Almdal TP, Vestergaard H: Increased mortality in patients hospitalized with primary hyperparathyroidism during the period 1977–1993 in Denmark. World J Surg. 2004, 28: 108-111. 10.1007/s00268-003-7046-0.CrossRefPubMed Øgard CG, Engholm G, Almdal TP, Vestergaard H: Increased mortality in patients hospitalized with primary hyperparathyroidism during the period 1977–1993 in Denmark. World J Surg. 2004, 28: 108-111. 10.1007/s00268-003-7046-0.CrossRefPubMed
8.
go back to reference Wermers RA, Khosla S, Atkinson EJ, Grant CS, Hodgson SF, O'Fallon WM: Survival after the diagnosis of hyperparathyroidism: a population-based study. Am J Med. 1998, 104: 115-122. 10.1016/S0002-9343(97)00270-2.CrossRefPubMed Wermers RA, Khosla S, Atkinson EJ, Grant CS, Hodgson SF, O'Fallon WM: Survival after the diagnosis of hyperparathyroidism: a population-based study. Am J Med. 1998, 104: 115-122. 10.1016/S0002-9343(97)00270-2.CrossRefPubMed
9.
go back to reference Silverberg SJ, Shane E, Jacobs TP, Siris E, Bilezikian JPA: 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med. 1999, 341: 1249-1255. 10.1056/NEJM199910213411701.CrossRefPubMed Silverberg SJ, Shane E, Jacobs TP, Siris E, Bilezikian JPA: 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med. 1999, 341: 1249-1255. 10.1056/NEJM199910213411701.CrossRefPubMed
10.
go back to reference Chambless LE, Folsom AR, Clegg LX, Sharrett AR, Shahar E, Nieto FJ: Carotid wall thickness is predictive of incident clinical stroke: the Atherosclerosis Risk in Communities (ARIC) study. Am J Epidemiol. 2000, 151: 478-487. 10.1093/oxfordjournals.aje.a010233.CrossRefPubMed Chambless LE, Folsom AR, Clegg LX, Sharrett AR, Shahar E, Nieto FJ: Carotid wall thickness is predictive of incident clinical stroke: the Atherosclerosis Risk in Communities (ARIC) study. Am J Epidemiol. 2000, 151: 478-487. 10.1093/oxfordjournals.aje.a010233.CrossRefPubMed
11.
go back to reference O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, WolfsonJr SK: Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999, 340: 14-22. 10.1056/NEJM199901073400103.CrossRefPubMed O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, WolfsonJr SK: Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999, 340: 14-22. 10.1056/NEJM199901073400103.CrossRefPubMed
12.
go back to reference Burke GL, Evans GW, Riley WA, Sharrett AR, Howard G, Barnes RW: Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) Study. Stroke. 1995, 26: 386-391. 10.1161/01.STR.26.3.386.CrossRefPubMed Burke GL, Evans GW, Riley WA, Sharrett AR, Howard G, Barnes RW: Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) Study. Stroke. 1995, 26: 386-391. 10.1161/01.STR.26.3.386.CrossRefPubMed
13.
go back to reference Nuzzo V, Tauchmanovà L, Fonderico F, Trotta R, Fittipaldi MR, Fontana D: Increased intima-media thickness of the carotid artery wall, normal blood pressure profile and normal left ventricular mass in subjects with primary hyperparathyroidism. Eur J Endocrinol. 2002, 147: 453-459. 10.1530/eje.0.1470453.CrossRefPubMed Nuzzo V, Tauchmanovà L, Fonderico F, Trotta R, Fittipaldi MR, Fontana D: Increased intima-media thickness of the carotid artery wall, normal blood pressure profile and normal left ventricular mass in subjects with primary hyperparathyroidism. Eur J Endocrinol. 2002, 147: 453-459. 10.1530/eje.0.1470453.CrossRefPubMed
14.
go back to reference Rubin MR, Rundek T, McMahon DJ, Lee HS, Sacco RL, Silverberg SJ: Carotid artery plaque thickness is associated with increased serum calcium levels: the Northern Manhattan study. Atherosclerosis. 2007, 194: 426-432. 10.1016/j.atherosclerosis.2006.08.027.CrossRefPubMedPubMedCentral Rubin MR, Rundek T, McMahon DJ, Lee HS, Sacco RL, Silverberg SJ: Carotid artery plaque thickness is associated with increased serum calcium levels: the Northern Manhattan study. Atherosclerosis. 2007, 194: 426-432. 10.1016/j.atherosclerosis.2006.08.027.CrossRefPubMedPubMedCentral
15.
go back to reference Foley Robert N, Collins Allan J, AreefIshani , Kalra Philip A: Calcium-phosphate levels and cardiovascular disease in community-dwelling adults: The Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J. 2008, 156 (3): 556-563. 10.1016/j.ahj.2008.05.016.CrossRefPubMed Foley Robert N, Collins Allan J, AreefIshani , Kalra Philip A: Calcium-phosphate levels and cardiovascular disease in community-dwelling adults: The Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J. 2008, 156 (3): 556-563. 10.1016/j.ahj.2008.05.016.CrossRefPubMed
16.
go back to reference Cifuentes M, Fuentes C, Mattar P, Tobar N, Hugo E, Ben-Jonathan N: Obesity-associated proinflammatory cytokines increase calciumsensing receptor (CaSR) protein expression in primary human adipocytes and LS14 human adipose cell line. Arch Biochem Biophys. 2010, 500: 151-156. 10.1016/j.abb.2010.05.033.CrossRefPubMed Cifuentes M, Fuentes C, Mattar P, Tobar N, Hugo E, Ben-Jonathan N: Obesity-associated proinflammatory cytokines increase calciumsensing receptor (CaSR) protein expression in primary human adipocytes and LS14 human adipose cell line. Arch Biochem Biophys. 2010, 500: 151-156. 10.1016/j.abb.2010.05.033.CrossRefPubMed
17.
go back to reference Pujia A, Gnasso A, Irace C, Colonna A, Mattioli PL: Common carotid arterial wall thickness in NIDDM subjects. Diabetes Care. 1994, 17: 1330-6. 10.2337/diacare.17.11.1330.CrossRefPubMed Pujia A, Gnasso A, Irace C, Colonna A, Mattioli PL: Common carotid arterial wall thickness in NIDDM subjects. Diabetes Care. 1994, 17: 1330-6. 10.2337/diacare.17.11.1330.CrossRefPubMed
18.
go back to reference White AD, Folsom AR, Chambless LE: Community surveillance of coronary heart disease in the Atherosclerosis Risk in Communities (ARIC) Study: methods and initial two years' experience. J ClinEpidemiol. 1996, 49: 223-233. White AD, Folsom AR, Chambless LE: Community surveillance of coronary heart disease in the Atherosclerosis Risk in Communities (ARIC) Study: methods and initial two years' experience. J ClinEpidemiol. 1996, 49: 223-233.
19.
go back to reference Walker MD, Fleischer J, Rundek T, McMahon DJ, Homma S, Sacco R: Carotid Vascular Abnormalities in Primary Hyperparathyroidism. J ClinEndocrinolMetab. 2009, 94: 3849-3856.CrossRef Walker MD, Fleischer J, Rundek T, McMahon DJ, Homma S, Sacco R: Carotid Vascular Abnormalities in Primary Hyperparathyroidism. J ClinEndocrinolMetab. 2009, 94: 3849-3856.CrossRef
20.
go back to reference Bots ML, Iglesias del Sol A, Grobbee DE: Carotid intima-media thickness measurements in observational and intervention studies. CurrResVasc Dis. 1998, 3: 274-283. Bots ML, Iglesias del Sol A, Grobbee DE: Carotid intima-media thickness measurements in observational and intervention studies. CurrResVasc Dis. 1998, 3: 274-283.
21.
go back to reference Fujii K, Abe I, Ohya Y, Onaka U, Tominaga M, Ohmori S: Association between hyperinsulinemia and intima-media thickness of the carotid artery in normotensive men. J Hypertens. 1997, 15: 167-172. 10.1097/00004872-199715020-00007.CrossRefPubMed Fujii K, Abe I, Ohya Y, Onaka U, Tominaga M, Ohmori S: Association between hyperinsulinemia and intima-media thickness of the carotid artery in normotensive men. J Hypertens. 1997, 15: 167-172. 10.1097/00004872-199715020-00007.CrossRefPubMed
22.
go back to reference Kim MK, Kim G, Jang EH, Kwon HS, Baek KH, Oh KW: Altered calcium homeostasis is correlated with the presence of metabolic syndromeand diabetes in middle-aged and elderly Korean subjects: the Chungju MetabolicDisease Cohort study (CMC study). Atherosclerosis. 2010, 212: 674-81. 10.1016/j.atherosclerosis.2010.07.005.CrossRefPubMed Kim MK, Kim G, Jang EH, Kwon HS, Baek KH, Oh KW: Altered calcium homeostasis is correlated with the presence of metabolic syndromeand diabetes in middle-aged and elderly Korean subjects: the Chungju MetabolicDisease Cohort study (CMC study). Atherosclerosis. 2010, 212: 674-81. 10.1016/j.atherosclerosis.2010.07.005.CrossRefPubMed
23.
go back to reference Yonghan He, Huaqi Zhang JianghuaTeng, Lina Huang, Ying Li, Changhao Sun: Involvement of calcium-sensing receptor in inhibition of lipolysis throughintracellular cAMP and calcium pathways in human adipocytes. Biochem Biophys Res Commun. 2011, 404: 393-399. 10.1016/j.bbrc.2010.11.129.CrossRef Yonghan He, Huaqi Zhang JianghuaTeng, Lina Huang, Ying Li, Changhao Sun: Involvement of calcium-sensing receptor in inhibition of lipolysis throughintracellular cAMP and calcium pathways in human adipocytes. Biochem Biophys Res Commun. 2011, 404: 393-399. 10.1016/j.bbrc.2010.11.129.CrossRef
24.
go back to reference Chow JY, Estrema C, Orneles T, Dong X, Barrett KE, Dong H: Calcium-sensing receptor modulates extracellular Ca(2+) entry via TRPC-encoded receptor-operated channels in human aortic smooth muscle cells. Am J Physiol Cell Physiol. 2011, 301: C461-8. 10.1152/ajpcell.00389.2010.CrossRefPubMedPubMedCentral Chow JY, Estrema C, Orneles T, Dong X, Barrett KE, Dong H: Calcium-sensing receptor modulates extracellular Ca(2+) entry via TRPC-encoded receptor-operated channels in human aortic smooth muscle cells. Am J Physiol Cell Physiol. 2011, 301: C461-8. 10.1152/ajpcell.00389.2010.CrossRefPubMedPubMedCentral
25.
go back to reference Kim JY, Kim N, Yenari MA, Chang W: Mild Hypothermia Suppresses Calcium-Sensing Receptor (CaSR) Induction Following Forebrain Ischemia While Increasing GABA-B Receptor 1 (GABA-B-R1) Expression. Transl Stroke Res. 2011, 1;2: 195-201.CrossRef Kim JY, Kim N, Yenari MA, Chang W: Mild Hypothermia Suppresses Calcium-Sensing Receptor (CaSR) Induction Following Forebrain Ischemia While Increasing GABA-B Receptor 1 (GABA-B-R1) Expression. Transl Stroke Res. 2011, 1;2: 195-201.CrossRef
26.
go back to reference Brix JM, Stingl H, Höllerl F, Schernthaner GH, Kopp HP, Schernthaner G: Elevated Fetuin-A concentrations in morbid obesity decrease after dramatic weight loss. J ClinEndocrinolMetab. 2010, 95: 4877-81.CrossRef Brix JM, Stingl H, Höllerl F, Schernthaner GH, Kopp HP, Schernthaner G: Elevated Fetuin-A concentrations in morbid obesity decrease after dramatic weight loss. J ClinEndocrinolMetab. 2010, 95: 4877-81.CrossRef
27.
go back to reference Mori K, Emoto M, Inaba M: Fetuin-A and the cardiovascular system. AdvClin Chem. 2012, 56: 175-95. Mori K, Emoto M, Inaba M: Fetuin-A and the cardiovascular system. AdvClin Chem. 2012, 56: 175-95.
Metadata
Title
Serum calcium level is related to both intima-media thickness and carotid atherosclerosis: a neglect risk factor in obese/overweight subjects
Authors
Tiziana Montalcini
Gaetano Gorgone
Arturo Pujia
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Translational Medicine / Issue 1/2012
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/1479-5876-10-114

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