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Serum calcium is associated with dyslipidemia in Korean adults: a cross-sectional study

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      Abstract. Objective: The relationship between calcium intake and risk of cardiovascular disease is still debated. The purpose of this study was to investigate the association of calcium intake and serum calcium with dyslipidemia in Korean adults. Methods: This was a population-based, cross-sectional study of 640 subjects (320 men and 320 women) aged 20 – 69 years (average 43.7 years) recruited from eight provinces of South Korea in 2014. Daily calcium intake, serum calcium, and serum lipid profiles of the subjects were analyzed and their correlation was evaluated. Multiple logistic regression analysis was also conducted to calculate odds ratios and 95% confidence intervals (CI) for prevalence of dyslipidemia by serum calcium. Results: Calcium intake was not significantly correlated with serum lipids or calcium. However, serum calcium was positively correlated with serum total cholesterol (p < 0.001) and triglycerides (p < 0.001). The unadjusted prevalence of hypercholesterolemia according to serum calcium tertiles was significantly increased with increments of serum calcium (4.7%, 6.1%, and 12.6% in the T1 – T3 groups; p < 0.005). The unadjusted odds ratio (OR) for having hypercholesterolemia was also significantly increased according to serum calcium tertiles (first tertile reference, third tertile OR = 2.93, 95% CI = 1.38 – 6.22, p for trend < 0.001). The association of serum calcium with the prevalence of hypercholesterolemia was not changed after adjusting for gender, body weight, age, and body mass index. Conclusion: No significant association was found between calcium intake and serum lipid profiles; however, elevated serum calcium within the normal range was shown to be associated with an increased prevalence of dyslipidemia in a Korean cohort.

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      Recent data from this laboratory demonstrate that increasing adipocyte intracellular Ca(2+) results in a coordinated stimulation of lipogenesis and inhibition of lipolysis. We have also noted that increasing dietary calcium of obese patients for 1 year resulted in a 4.9 kg loss of body fat (P<0.01). Accordingly, we tested the possibility that calcitrophic hormones may act on adipocytes to increase Ca(2+) and lipid metabolism by measuring the effects of 1, 25-(OH)(2)-D in primary cultures of human adipocytes, and found significant, sustained increases in intracellular Ca(2+) and a corresponding marked inhibition of lipolysis (EC(50) approximately 50 pM; P<0.001), suggesting that dietary calcium could reduce adipocyte mass by suppressing 1,25-(OH)(2)-D. To test this hypothesis, we placed transgenic mice expressing the agouti gene specifically in adipocytes on a low (0.4%) Ca/high fat/high sucrose diet either unsupplemented or with 25 or 50% of the protein replaced by non-fat dry milk or supplemented to 1.2% Ca with CaCO(3) for 6 wk. Weight gain and fat pad mass were reduced by 26-39% by the three high calcium diets (P<0.001). The high calcium diets exerted a corresponding 51% inhibition of adipocyte fatty acid synthase expression and activity (P<0.002) and stimulation of lipolysis by 3. 4- to 5.2-fold (P<0.015). This concept of calcium modulation of adiposity was further evaluated epidemiologically in the NHANES III data set. After controlling for energy intake, relative risk of being in the highest quartile of body fat was set to 1.00 for the lowest quartile of Ca intake and was reduced to 0.75, 0.40, and 0.16 for the second, third, and fourth quartiles, respectively, of calcium intake for women (n=380;P<0.0009); a similar inverse relationship was also noted in men (n=7114; P<0.0006). Thus, increasing dietary calcium suppresses adipocyte intracellular Ca(2+) and thereby modulates energy metabolism and attenuates obesity risk.
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        Metal ions play an important role in biological systems, and without their catalytic presence in trace or ultratrace amounts many essential co-factors for many biochemical reactions would not take place. However, they become toxic to cells when their concentrations surpass certain optimal (natural) levels. Copper is an essential metal. Catalytic copper, because of its mobilization and redox activity, is believed to play a central role in the formation of reactive oxygen species (ROS), such as O2-* and *OH radicals, that bind very fast to DNA, and produce damage by breaking the DNA strands or modifying the bases and/or deoxyribose leading to carcinogenesis. The chemistry and biochemistry of copper is briefly accounted together with its involvement in cancer and other diseases.
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          Serum copper and ceruloplasmin levels are known to increase in several malignancies such as osteosarcomas, some gastrointestinal tumors, and lung cancer. In this study serum copper and ceruloplasmin levels in 40 patients with primary brain tumors were studied. Both parameters were increased in sera of patients with tumors in comparison with healthy subjects or patients with non-tumorous neurological diseases. It is concluded that copper and ceruloplasmin represent a good complement to some other nonspecific parameters in evaluating the activity of malignancy and the therapeutic results.

            Author and article information

            Trace Elements and Electrolytes
            Dustri-Verlgag Dr. Karl Feistle
            October 01 2017
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            : 10
            : 159-165
            © 2017
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