Abstract
Calcium and phosphate may play an important role in cardio-metabolic abnormalities, including type 2 diabetes; however, epidemiological evidence of the association of calcium and phosphate status with glucose metabolism among Asians is limited. In the current study, we performed a cross-sectional analysis of the association of serum calcium, phosphate, and calcium–phosphate product concentrations with glucose metabolism markers among Japanese individuals. Overall, 1701 workers (aged 18–78 years) who participated in a health survey were enrolled in this study. Multivariable linear regression models were used to estimate means of homeostatic model assessment of insulin resistance (HOMA-IR), homeostatic model assessment of β-cell function (HOMA-β), and glycated hemoglobin (HbA1c). Serum calcium concentration was positively associated with HOMA-IR and HbA1c (p for trend < 0.01). Multivariable-adjusted means (95% confidence interval (CI)) of HOMA-IR for the lowest and highest quartiles of serum calcium were 0.78 (0.75–0.82) and 1.01 (0.96–1.07), respectively. The corresponding values for HbA1c were 5.24 (5.22–5.27) and 5.29 (5.26–5.32), respectively. Serum phosphate and calcium–phosphate product concentrations were inversely associated with HOMA-IR (p for trend < 0.01). Multivariable-adjusted means (95% CI) of HOMA-IR for the lowest and highest quartiles of serum phosphate were 1.04 (0.99–1.09) and 0.72 (0.69–0.76), respectively. The corresponding values for calcium–phosphate product were 1.04 (0.99–1.09) and 0.73 (0.69–0.77), respectively. The current findings suggest that higher serum calcium and lower serum phosphate concentrations are associated with IR among apparently healthy adults.
Highlights
Besides other noncommunicable diseases, such as cardiovascular disease or cancer, diabetes mellitus is a major cause of death and disability [1,2]
There has been no study of the association of serum phosphate with HbA1c levels which reflects a long-term glucose status. To explore these issues further, the present study aimed to examine the association of circulating calcium, phosphate, and calcium–phosphate product concentrations with glucose metabolism markers, including fasting insulin, fasting plasma glucose (FPG), homeostatic model assessment of insulin resistance (HOMA-insulin resistance (IR)), homeostatic model assessment of β-cell function (HOMA-β), and HbA1c levels among Japanese workers
The calcium–phosphate product concentration was highly correlated with serum phosphate concentration (Spearman’s correlation coefficient = 0.99; p < 0.001); it was weakly correlated with serum calcium concentration (Spearman’s correlation coefficient = 0.15; p < 0.001)
Summary
Besides other noncommunicable diseases, such as cardiovascular disease or cancer, diabetes mellitus is a major cause of death and disability [1,2]. The global prevalence of diabetes mellitus among adults has been reported to be approximately 9.3% in 2019 and is expected to further increase to 10.9% by 2045 [3]. Japan is one of the countries with the highest number of adults with diabetes, affecting approximately 7.4 million or 7.9% of the Japanese population [4]. Attention has been paid to understand the role of calcium and phosphate in the etiology of type 2 diabetes (T2D)
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