Serum calcium level is related to both intima-media thickness and carotid atherosclerosis: a neglect risk factor in obes
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RESEARCH
Open Access
Serum calcium level is related to both intima-media thickness and carotid atherosclerosis: a neglect risk factor in obese/overweight subjects Tiziana Montalcini*, Gaetano Gorgone and Arturo Pujia
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. Keywords: Calcium, Atherosclerosis, Carotid, Obesity, Ultrasound
Background Experimental studies suggested that calcium-phosphate metabolism could influence the pathogenesis of vascular diseases. In fact, several studies showed an increased cardiovascular morbidity and mortality in primary hyperparathyroidism (PHPT)[1-8]. Furthermore, increased carotid intima-media thickness (CIMT), a subclinical predictor of coronary and cerebrovascular events [9-12], was found in patients with PHPT and high calcium levels [13], suggesting a causative role of hypercalcemia. However, in most * Correspondence: [email protected] Clinical Nutrition Unit, Department of Medical and Surgical Science, School of Medicine, University Magna Grecia, Viale S Venuta, 88100, Catanzaro, Italy
patients with PHPT, serum calcium levels is in normal range [9]. A study showed that serum calcium level, within the normal range, was positively associated to carotid atherosclerotic plaques presence [14]. Consequently, to date, the link between the serum calcium level and the cardiovascular diseases has not been fully elucidated. Furthermore, calcium and phosphate levels seem to exert differential effects, depending on the type and location of the vascular bed [15]. In pa
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