title: Dietary intake of calcium and phosphorus and serum concentration in relation to the risk of coronary artery calcification in asymptomatic adults.
abstract: OBJECTIVE
  The current data regarding the association between calcium and phosphorus and cardiovascular disease are lacking. The aim of this study was to explore whether dietary calcium and phosphorus intake and their serum levels are associated with the prevalence of coronary artery calcification (CAC) using cardiac computed tomography in asymptomatic participants without a history of chronic kidney disease or cardiovascular disease.
  
  
  RESULTS
  A cross-sectional study was performed in 23 652 Korean participants (40.8±7.3 years, male 83.5%) without chronic kidney disease (estimated glomerular filtration rate≥60 mL/min per 1.73 m(2)) or clinically overt cardiovascular disease, who underwent cardiac computed tomographic estimation of CAC scores as part of a general health checkup in addition to completing a self-administered food frequency questionnaire. We assessed the relationship of dietary calcium and phosphorus intake and serum levels with CAC scores using both multivariate-adjusted Tobit models and multinomial logistic regression models. Neither dietary calcium nor phosphorus intake was consistently associated with CAC scores. However, the serum calcium, phosphorus, and calcium-phosphorus product levels were significantly associated with the CAC score ratios. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest quartiles of serum calcium, phosphorus, and calcium-phosphorus product levels to the lowest quartiles were 1.89 (1.36-2.64), 3.33 (2.55-4.35), and 3.98 (3.00-5.28), respectively (P for trend <0.001).
  
  
  CONCLUSIONS
  Elevated serum levels of calcium, phosphorus, and calcium-phosphorus product, but not dietary consumption, are associated with increased CAC scores. Our findings should be explored in further research.
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Mi
authors.initials: SM
authors.lastname: Kwak
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea. sh703.yoo@gmail.com jskim@cnuh.co.kr.
authors.forename: Jong Sung
authors.initials: JS
authors.lastname: Kim
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Yuni
authors.initials: Y
authors.lastname: Choi
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Yoosoo
authors.initials: Y
authors.lastname: Chang
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Min-Jung
authors.initials: MJ
authors.lastname: Kwon
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Jin-Gyu
authors.initials: JG
authors.lastname: Jung
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Chul
authors.initials: C
authors.lastname: Jeong
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Jiin
authors.initials: J
authors.lastname: Ahn
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Hocheol
authors.initials: H
authors.lastname: Shin
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea (S.M.K., Y. Choi, Y. Chang, M.-J.K., C.J., J.A., H.S.K., H.S., S.R.); Department of Family Medicine, School of Medicine, Graduate School, Chungnam National University, Daejeon, Republic of Korea (S.M.K., J.S.K., J.-G.J.); Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Republic of Korea (J.S.K., J.-G.J.); and Department of Occupational and Environmental Medicine (Y. Chang, C.J., S.R.), Department of Laboratory Medicine (M.-J.K.), Department of Anesthesiology and Pain Medicine (H.S.K.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea. sh703.yoo@gmail.com jskim@cnuh.co.kr.
authors.forename: Seungho
authors.initials: S
authors.lastname: Ryu
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D002136:Calcium, Dietary / Q000097:blood*; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D016226:Phosphorus, Dietary / Q000097:blood*; D011237:Predictive Value of Tests; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015854:Up-Regulation; D061205:Vascular Calcification / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D002136:Calcium, Dietary; D016226:Phosphorus, Dietary
keywords: calcium; coronary vessels; phosphorus