title: A structural equation model for assessment of links between changes in serum triglycerides, -urate, and -glucose and changes in serum calcium, -magnesium and -phosphate in type 2 diabetes and non-diabetes metabolism.
abstract: BACKGROUND
  This study investigates the associations between changes in serum triglycerides (S-TG), -urate (S-Urate), and -glucose (S-Glu) and changes in serum calcium (S-Ca), -magnesium (S-Mg), and -phosphate (S-P) in patients with type 2 diabetes compared with non-diabetic patients.
  
  
  METHODS
  The analysis is based on data collected from a secondary prevention population of women and men (W/M) at risk for cardiovascular disease (type 2 diabetes, 212/200; non-diabetes 968/703). The whole population (n = 2083) had a mean age of 51.0 (9.7) years and was stratified for sex and according to type 2 diabetes or non-diabetes. The patients were followed for, either half a year or one year and changes in risk factors were calculated from follow-up to baseline, the time when patients were admitted to the health center. The pattern of relationships was evaluated using a structural equation model.
  
  
  RESULTS
  Higher S-TG and S-Glu but lower S-Urate was revealed at baseline in type 2 diabetes women and men as compared to their counterparts, non-diabetes patients. Women with type 2 diabetes had higher S-Ca and lower S-Mg than non-diabetes women. Changes in S-Glu were associated with changes in S-Ca (+), baseline S-Ca (+), and S-Urate (-) in type 2 diabetes men. Changes in S-Urate were associated with changes in S-Mg (+) in type 2 diabetes women and non-diabetes men. In men with non-diabetes, changes in S-Glu were associated with changes in S-Mg (-). In women with non-diabetes, changes in S-Glu were associated with changes in S-P (-) and changes in S-Urate with changes in S-Ca (+).
  
  
  CONCLUSIONS
  With respect to metabolic disturbances in non-diabetes and the awareness of risk for type 2 diabetes, changes in S-Glu and changes in S-Ca, S-Mg, and S-P should be considered as risk factors for cardiovascular disease. Increased early detection and corrections of high S-Ca, low S-Mg, and S-P in obese patients may improve their metabolism and reduce the risk of CVD in patients with type 2 diabetes.
  
  
  BACKGROUND
  ISRCTN: ISRCTN79355192.
authors.affiliation: Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, SE-901 87 Umeå, Sweden. lena.haglin@vll.se
authors.forename: Lena
authors.initials: L
authors.lastname: Håglin
authors.forename: Lennart
authors.initials: L
authors.lastname: Bäckman
authors.forename: Birgitta
authors.initials: B
authors.lastname: Törnkvist
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002118:Calcium / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D048909:Diabetes Complications / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D016018:Least-Squares Analysis; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010710:Phosphates / Q000097:blood*; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood*; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D010710:Phosphates; D014280:Triglycerides; D014527:Uric Acid; D008274:Magnesium; D002118:Calcium