title: A Mendelian randomization study of the effect of calcium on coronary artery disease, myocardial infarction and their risk factors.
abstract: Meta-analyses of randomized controlled trials (RCTs) suggest calcium could have adverse effects on cardiovascular disease, although these findings are controversial. To clarify, we assessed whether people with genetically higher calcium had a higher risk of coronary artery disease (CAD), myocardial infarction (MI) and their risk factors. We used a two-sample Mendelian randomization study. We identified genetic variants (single nucleotide polymorphisms (SNPs)) that independently contributed to serum calcium at genome-wide significance which we applied to large extensively genotyped studies of CAD, MI, diabetes, lipids, glycaemic traits and adiposity to obtain unconfounded estimates, with body mass index (BMI) as a control outcome. Based on 4 SNPs each 1 mg/dl increase in calcium was positively associated with CAD (odds ratio (OR) 1.49, 95% confidence interval (CI) 1.02-2.17), MI (OR 1.58, 95% CI 1.06-2.35), LDL-cholesterol (0.21 standard deviations, 95% CI 0.01-0.4), total cholesterol (0.21 standard deviations, 95% CI 0.03-0.38) and possibly triglycerides (0.19 standard deviations, 95% CI -0.1-0.48), but was unlikely related to BMI although the estimate lacked precision. Sensitivity analysis using 13 SNPs showed a higher risk for CAD (OR 1.87, 95% CI 1.14-3.08). Our findings, largely consistent with the experimental evidence, suggest higher serum calcium may increase the risk of CAD.
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.|School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Xu
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Shi Lin
authors.initials: SL
authors.lastname: Lin
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.|School of Urban Public Health, Hunter College and CUNY School of Public Health, New York, New York, USA.
authors.forename: C Mary
authors.initials: CM
authors.lastname: Schooling
mesh_terms: D000483:Alleles; D015415:Biomarkers; D002118:Calcium / Q000097:blood / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism*; D005260:Female; D020022:Genetic Predisposition to Disease; D055106:Genome-Wide Association Study; D005838:Genotype; D006801:Humans; D008297:Male; D057182:Mendelian Randomization Analysis; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism*; D016017:Odds Ratio; D020641:Polymorphism, Single Nucleotide; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002118:Calcium