J Stroke.
2019 Sep;21(3):312-323. 10.5853/jos.2019.00542.
Calcium Intake and Serum Calcium Level in Relation to the Risk of Ischemic Stroke: Findings from the REGARDS Study
- Affiliations
-
- 1Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN, USA. kk3399@cumc.columbia.edu
- 2Department of Vice Chancellor for Research/Tennessee Clinical and Translational Science Institute, University of Tennessee Health Science Center, Memphis, TN, USA.
- 3Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
- 4Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
- 5Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA.
- 6Department of Psychiatry, School of Medicine, Indiana University, Indianapolis, IN, USA.
- 7Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA.
- KMID: 2464648
- DOI: http://doi.org/10.5853/jos.2019.00542
Abstract
- BACKGROUND AND PURPOSE
Data on the association between calcium (Ca) and ischemic stroke are sparse and inconsistent. This study aimed to examine Ca intake and serum Ca levels in relation to risk of ischemic stroke.
METHODS
The primary analysis included 19,553 participants from the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study. A subcohort was randomly selected to create a case-cohort study (n=3,016), in which serum Ca levels were measured. Ischemic stroke cases were centrally adjudicated by physicians based on medical records. Cox proportional hazards regression for the cohort and weighted Cox proportional hazard regression with robust sandwich estimation method for the case-cohort analysis with adjustment for potential confounders were performed.
RESULTS
During a mean 8.3-year follow-up, 808 incident cases of ischemic stroke were documented. Comparing the highest quintile to the lowest, a statistically significant inverse association was observed between total Ca intake and risk of ischemic stroke (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.55 to 0.95; P(linear-trend)=0.183); a restricted cubic spline analysis indicated a threshold effect like non-linear association of total Ca intake with ischemic stroke (P(non-linear)=0.006). In the case-cohort, serum Ca was inversely associated with the risk of ischemic stroke. Compared to the lowest, the highest quintile of serum Ca had a 27% lower risk of ischemic stroke (HR, 0.73; 95% CI, 0.53 to 0.99; P(linear-trend)=0.013). Observed associations were mainly mediated by type 2 diabetes, hypertension, and cholesterol.
CONCLUSIONS
These findings suggest that serum Ca has inverse and Ca intake has threshold effect like association with risk of ischemic stroke.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Elevated Calcium after Acute Ischemic Stroke: Association with a Poor Short-Term Outcome and Long-Term Mortality
- The Effects of Lithium Treatment on the Serum Calcium, Ionized Calcium & Phosphate in Bipolar Disorder
- The Role of Calcium in Human Aging
- Association between intakes of minerals (potassium, magnesium, and calcium) and diet quality and risk of cerebral atherosclerosis in ischemic stroke patients
- The Relationship between of Calcium Intake and BMD in Middle-aged Women
