title: Associations between serum levels of calcium, parathyroid hormone and future risk of venous thromboembolism: the Tromsø study.
abstract: OBJECTIVE
  The relationship between serum levels of calcium, parathyroid hormone (PTH) and risk of venous thromboembolism (VTE) has not been addressed in population-based cohorts. We investigated the associations between serum levels of calcium and PTH, with future risk of VTE in a general adult population.
  
  
  METHODS
  Population-based cohort.
  
  
  METHODS
  A total of 27 712 subjects (25-87 years) who participated in Tromsø 4 (1994-1995) and Tromsø 5 (2001-2002) surveys were included in the study, and total calcium and PTH were measured in 27 685 and 8547 subjects respectively. Incident VTE was recorded through December 31, 2012. Cox-regression models with calcium and PTH as time-varying exposures were used to calculate hazard ratios (HR) of VTE by quartiles of calcium and PTH. Quartiles of calcium and PTH were also combined to assess the effect of discordants of both PTH and calcium (e.g. highest and lowest quartiles of both calcium and PTH) on VTE risk using the middle two quartiles as reference.
  
  
  RESULTS
  There were 712 VTEs during 15.0 years of median follow-up. Serum levels of calcium and PTH were not associated with risk of VTE. However, subjects with discordant high serum levels of both calcium and PTH (calcium ≥2.45 mmol/L and PTH ≥4.0 pmol/L) had increased risk of VTE compared to those in subjects with normal calcium and PTH (multivariable HR: 1.78, 95% CI: 1.12-2.84).
  
  
  CONCLUSIONS
  Serum levels of calcium and PTH separately were not associated with future risk of VTE, but subjects with high levels of both calcium and PTH had increased risk of VTE compared to those in subjects with normal levels.
authors.affiliation: Department of Clinical MedicineK.G. Jebsen Thrombosis Research and Expertise Center (TREC).
authors.forename: Gunhild
authors.initials: G
authors.lastname: Lerstad
authors.affiliation: Department of Clinical MedicineK.G. Jebsen Thrombosis Research and Expertise Center (TREC).|Division of Internal MedicineAkershus University Hospital, Lørenskog, Norway.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Brodin
authors.affiliation: Department of Clinical MedicineEndocrine Research Group, University of Tromsø - The Arctic University of Norway, Tromsø, Norway.|Division of Internal MedicineUniversity Hospital of North Norway, Tromsø, Norway.
authors.forename: Johan
authors.initials: J
authors.lastname: Svartberg
authors.affiliation: Department of Clinical MedicineEndocrine Research Group, University of Tromsø - The Arctic University of Norway, Tromsø, Norway.|Division of Internal MedicineUniversity Hospital of North Norway, Tromsø, Norway.
authors.forename: Rolf
authors.initials: R
authors.lastname: Jorde
authors.affiliation: Department of Clinical MedicineK.G. Jebsen Thrombosis Research and Expertise Center (TREC).|Department of Laboratory MedicineUniversity Hospital of North Norway, Tromsø, Norway.
authors.forename: Jan
authors.initials: J
authors.lastname: Brox
authors.affiliation: Department of Clinical MedicineK.G. Jebsen Thrombosis Research and Expertise Center (TREC).|Division of Internal MedicineUniversity Hospital of North Norway, Tromsø, Norway.
authors.forename: Sigrid K
authors.initials: SK
authors.lastname: Brækkan
authors.affiliation: Department of Clinical MedicineK.G. Jebsen Thrombosis Research and Expertise Center (TREC).|Division of Internal MedicineUniversity Hospital of North Norway, Tromsø, Norway.
authors.forename: John-Bjarne
authors.initials: JB
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010281:Parathyroid Hormone / Q000097:blood*; D016016:Proportional Hazards Models; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000097:blood / Q000453:epidemiology*
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium