High or Low Calcium Intake Increases Cardiovascular Disease Risks in Older Patients With Type 2 Diabetes

Jui-Hua Huang; Leih-Ching Tsai; Yu-Chen Chang; Fu-Chou Cheng

Disclosures

Cardiovasc Diabetol. 2014;13(120) 

In This Article

Results

The characteristics of the 197 older patients with type 2 diabetes are summarized in Table 1. Among all the patients, 60.9% of the patients' Ca intake was less than the previous RDA (600 mg/day) and 87.3% patients' Ca intakes were below the current AI (1000 mg/day). In addition, 87.3% of the patients' Mg intake was below RDA, and the total energy, carbohydrate, fat, and Mg intakes were different between men and women (p ≦ 0.05). The analyses were adjusted for potential confounders, which included lifestyle factors such as physical activity, smoking, and alcohol consumption (data not shown).

As shown in Table 2, the dietary Ca:Mg intake ratio was significantly associated with the levels of CRP, platelets, and RDW (p < 0.05). The subgroup with a Ca:Mg intake ratio of 2.0–2.5 had significantly lower CRP and RDW than the one with a Ca:Mg intake ratio of >3.6. Moreover, the subgroup with a Ca:Mg intake ratio of 2.0–2.5 had a lower proportion of patients with ≥2 high inflammatory markers, when compared with the other subgroups. However, the dietary Ca:Mg intake ratio was not significantly associated with leukocyte count. In addition, the subgroup with a Ca:Mg intake ratio of 2.0–2.5 presented a significantly higher Ca intake than those with Ca:Mg intake ratios of ≤1.3 and 1.4–1.9. In contrast, the subgroup with a Ca:Mg intake ratio of 2.0–2.5 exhibited a significantly lower Ca intakes than the one with a Ca:Mg intake ratio of >3.6. Moreover, the dietary Ca:Mg intake ratio showed a marginal correlation with Mg intakes (p = 0.099).

The relationships between CRP and dietary Ca or Mg intake alone are shown in Figure 1. Dietary Ca intake was significantly correlated to the CRP level (p = 0.038). Moreover, patients consuming moderate amount of Ca (402–600 mg Ca/day) had lower CRP than those consuming high amount of Ca, i.e. >600 mg Ca/day (0.9 ± 0.4 vs. 1.8 ± 0.3, p = 0.033). In addition, patients consuming high or recommended amount of Mg (RDA for Mg for healthy men and women in Taiwan above 65 years of age is 350–360 and 300–310 mg/day, respectively) had a lower CRP level than those consuming low amount of Mg (0.8 ± 0.5 vs.1.9 ± 0.3, p = 0.012).

Figure 1.

Relationship between CRP and Ca or Mg intake alone. (1) CRP and Ca intakes. (2) CRP and Mg intakes. The analyses were adjusted for sex, age, BMI, physical activity levels, smoking, alcohol consumption, total energy, carbohydrate, protein and fat intakes, and Mg intakes for different levels of Ca intakes or Ca intakes for different levels of Mg intakes. Data are adjusted mean ± standard error (SE). A p value of <0.05 was considered statistically significant. *indicates significant differences between moderate and high Ca intakes by Bonferroni's multiple comparisons test.

The correlations between different CRP levels (low, moderate, and high CVD risks) and different Ca and Mg intake levels (nine subgroups) were analyzed by chi-square test. The findings showed that CRP levels were correlated to dietary Ca and Mg intakes. Although some cells had an expected count of <5, the Chi-square test showed a statistically significant result (p = 0.001). The above-mentioned nine subgroups with different levels of Ca and Mg intakes were categorized as follows: 1) low Ca and low Mg intakes; 2) low Ca and moderate Mg intakes; 3) low Ca and high Mg intakes; 4) moderate Ca and low Mg intakes; 5) moderate Ca and moderate Mg intakes; 6) moderate Ca and high Mg intakes; 7) high Ca and low Mg intakes; 8) high Ca and moderate Mg intakes; and 9) high Ca and high Mg intakes. In addition, the correlations between different CRP levels (low, moderate, and high CVD risks) and dietary Ca:Mg intake ratio were examined by one-way ANOVA. The results showed that the dietary Ca:Mg intake ratios in the low, moderate, and high CVD risk groups were 2.1 ± 1.3, 2.8 ± 1.8, and 3.0 ± 1.8, respectively (p = 0.016).

The distribution of patients with high CVD risk (CRP >3 mg/L) according to different levels of Ca and Mg intakes (nine subgroups) is presented in Figure 2. Among the patients with high CVD risk, 37.1% had low Ca and low Mg intakes, 28.6% had high Ca and low Mg intakes, 20.0% had high Ca and moderate Mg intakes, and 5.7% had low Ca and high Mg intakes. In addition, the high Ca and high Mg intakes subgroup, moderate Ca and moderate Mg intakes subgroup, and low Ca and moderate Mg intakes subgroup each comprised 2.9% of the patients with high CVD risk. No patients with high CVD risk consumed a diet with moderate amount of Ca and low or high amount of Mg. Furthermore, 97.1% of the high CVD risk patients were found to consume high or low amount of Ca and only 2.9% consumed moderate amount of Ca, even when these patients were stratified by Mg intakes. Among the high CVD risk patients who consumed low or high amount of Ca, the percentage of patients who consumed low amount of Mg was higher than that of patients who consumed moderate to high amount of Mg (65.7% vs. 31.5%).

Figure 2.

Distribution of high CVD risk patients according to Ca and Mg intakes. CRP >3 mg/L defined as high CVD risk. Data are presented as percent (%).

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