饥荒暴露和更高的血清钙水平与许多疾病的风险增加有关。包括老年痴呆症,动脉粥样硬化,糖尿病,和骨质疏松症。饥荒暴露是否对血清钙水平有任何影响尚不清楚。此外,血清钙的正常参考范围在不同人群之间是可变的。我们的目标是1)确定中国成年人钙的参考间隔;2)探索其与饥荒暴露的关系。
本研究的数据来自2010年3月至8月在嘉定区进行的流行病学调查的横断面研究,上海,中国。9千零11名估计肾小球滤过率(eGFR)≥60ml/min/1.73m2的参与者参与计算来自10569名40岁或以上参与者的总钙参考间隔。对9315名具有完整血清生化数据和出生年份信息的参与者进行了饥荒暴露分析。
在拒绝异常值之后,血清总钙的95%参考区间为2.122~2.518mmol/L白蛋白调节钙的方程式为:总钙0.019*(49-白蛋白),95%参考区间为2.151~2.500mmol/L与年龄平衡的对照组相比,在儿童期经历饥荒暴露的受试者中,处于血清钙(OR=1.350,95CI=1.199~1.521)和白蛋白校正钙(OR=1.381,95CI=1.234~1.544)的风险增加.女性更容易受到这种影响(血清总钙的OR=1.621,95CI=1.396-1.883;白蛋白调整钙的OR=1.722,95CI=1.497-1.980)。
饥荒暴露是与循环钙浓度变化相关的重要环境因素,新建立的血清钙正常范围和白蛋白调整钙方程,以及童年饥荒的历史,可能有助于识别钙稳态异常和相关疾病的受试者,尤其是女性。
Famine exposure and higher serum calcium levels are related with increased risk of many disorders, including Alzheimer\'s disease, atherosclerosis, diabetes, and osteoporosis. Whether famine exposure has any effect on serum calcium level is unclear. Besides, the normal reference range of serum calcium is variable among different populations. Our aims are 1) determining the reference interval of calcium in Chinese adults; 2) exploring its relationship with famine exposure.
Data in this study was from a cross-sectional study of the epidemiologic investigation carried out during March-August 2010 in Jiading district, Shanghai, China. Nine thousand and two hundred eleven participants with estimated glomerular filtration rate (eGFR) ≥60ml/min/1.73m2 were involved to calculate reference interval of total calcium from 10569 participants aged 40 years or older. The analysis of famine exposure was conducted in 9315 participants with complete serum biochemical data and birth year information.
After rejecting outliers, the 95% reference interval of total serum calcium was 2.122~2.518 mmol/L. The equation of albumin-adjusted calcium was: Total calcium + 0.019* (49-Albumin), with a 95% reference interval of 2.151~2.500 mmol/L. Compared to the age-balanced control group, there was an increased risk of being at the upper quartile of total serum calcium (OR=1.350, 95%CI=1.199-1.521) and albumin-adjusted calcium (OR=1.381, 95%CI=1.234-1.544) in subjects experienced famine exposure in childhood. Females were more vulnerable to this impact (OR= 1.621, 95%CI= 1.396-1.883 for total serum calcium; OR=1.722, 95%CI= 1.497-1.980 for albumin-adjusted calcium).
Famine exposure is an important environmental factor associated with the changes in circulating calcium concentrations, the newly established serum calcium normal range and albumin-adjusted calcium equation, together with the history of childhood famine exposure, might be useful in identifying subjects with abnormal calcium homeostasis and related diseases, especially in females.