Low Calcium Group Research Articles

Calcium- and Sodium-Rich Food Intake among Koreans with and without Metabolic Syndrome: Cross-Sectional Analysis of the Korean Genome and Epidemiology Study.

The prevalence of metabolic syndrome (MetS) is increasing. While calcium and sodium are known nutritional factors used for managing MetS, few studies have focused on food-based analyses. This cross-sectional study examined the distribution of calcium- and sodium-rich food intake among Koreans with MetS. This cross-sectional analysis evaluated 130,423 participants from the Health Examinees-Gem cohort study. Foods contributing up to 90% of the calcium and sodium intake were selected from the semi-quantitative food frequency questionnaire, and consumption levels were calculated. MetS was defined as satisfying three or more criteria from the National Cholesterol Education Program Adult Treatment Panel III. The results are presented as odds ratios (OR) with an interquartile range (ORIQR) and 95% confidence interval. Participants with MetS showed a low calcium intake (ORIQR = 0.95 and 0.92 for men and women, respectively), low consumption of dairy products (ORIQR = 0.92 and 0.89), beverages except for coffee or green tea (ORIQR = 0.97 and 0.96), and bread (ORIQR = 0.96 and 0.94). Men with MetS consumed high total sodium (ORIQR = 1.04), and large amounts of Kimchi (ORIQR = 1.03), fermented paste (ORIQR = 1.04), and noodles (ORIQR = 1.07). Women with MetS consumed more Kimchi than those without MetS (ORIQR = 1.04). The odds ratio for the low calcium and high sodium group compared to the high calcium and low sodium group was 1.26. The MetS group consumed less calcium-rich foods and more sodium-rich foods than those without MetS. Patients with MetS might benefit from precise recommendations of high calcium-rich and low sodium-rich foods.

Interaction of blood calcium with milk yield, energy metabolites, subclinical mastitis, and reproductive performance in crossbred dairy cows.

Limited literature is available on the consequences of postpartum low blood calcium (Ca) concentration in crossbred cows. The research aimed to investigate the correlation between postpartum serum Ca levels and various parameters, including milk yield, serum energy metabolites, milk somatic cell count, and reproductive factors in crossbred cows. Following parturition, a total of 45 potential high-yielding F2 (HF × Sahiwal; Genotype: 75:25) dairy cows were enrolled . These cows were categorized based on plasma calcium concentrations into three groups: a low calcium group (Ca-L) with a calcium concentration of <5 mg/dL, a medium calcium group (Ca-M) with a calcium concentration ranging from 5 to 8.5 mg/dL, and a high calcium group (Ca-H) with a calcium concentration exceeding 8.5 mg/dL. The study parameters were measured over an 8-week period. The results indicated that overall milk yield and blood glucose were significantly higher in the Ca-H group compared to Ca-M and Ca-L (p < .01). Blood cholesterol was significantly higher in Ca-M (p < .01), while blood triglyceride was significantly lower in both Ca-M and Ca-H. Overall, blood cortisol did not show a significant change between these groups (p < .01); however, progesterone levels were higher (p < .01) in Ca-M and Ca-H cows. Furthermore, somatic cell count (SCC) significantly (p < .01) decreased in cows with Ca-H compared to Ca-L. Additionally, postpartum oestrous interval and interestrus interval decreased significantly (p < .01) in Ca-M and Ca-H compared to Ca-L. These findings suggest that cows with blood calcium levels exceeding 8.5 mg/dL exhibited significantly higher milk yield, blood metabolite levels, a lower likelihood of subclinical mastitis, and earlier reproductive activity after calving.

The effects of maternal calcium status during late gestation on lamb growth and survival in twin-bearing Merino ewes grazing pasture.

Our project aimed to investigate whether low maternal calcium status during late gestation decreased weight, growth and survival of lambs born to twin-bearing Merino ewes grazing pasture. On day 130 of gestation, approximately a 10 mL blood sample was collected from 108 twin-bearing Merino ewes. Blood pH and calcium ion concentration were measured in whole blood and serum was analysed for calcium, magnesium, phosphate, beta hydroxy butyrate, non-esterified fatty acids and cholesterol. Six to 18 h after birth and at 49 days of age, lamb live weight was recorded. Ewe serum calcium level at day 130 of gestation were divided into tertiles (1.58-2.13, 2.14-2.30, and 2.31-2.99 mmol/L) with ewes classified as either Low, Med or High (n = 36 per group). A general linear mixed model was used to analyse the data. Survival to 1, 2, 3 and 7 days of age was lower for lambs born to ewes in the Low calcium group compared with those born in the Med and High calcium groups (P < 0.05). At day 49 of age, lamb survival tended to be lower for lambs in the Low (73.6%) compared with Med (86.8%) and High (85.3%) calcium groups (P < 0.1). There were no differences in lamb body weight (P > 0.05). Calcium levels of ewes in the Low calcium group were, on average, indicative of subclinical hypocalcaemia, with this group of ewes also having the lowest lamb survival rate, suggesting that maternal subclinical hypocalcaemia reduces lamb survival. Further studies, particularly on improving maternal calcium levels, are warranted.

Effect of low-calcium and standard-calcium dialysate on serum calcium, phosphorus and full-segment parathyroid hormone in patients on peritoneal dialysis: A retrospective observational study.

To investigate the effects of low-calcium and standard-calcium dialysate in patients with chronic kidney disease on peritoneal dialysis, and find out which dialysate has less vascular calcification effect. A total of 141 patients who had undergone peritoneal dialysis (PD) for 2 years in the PD centre from January 2012 to December 2017 were included and divided into two groups according to the calcium concentration of the PD fluid used. There were 79 cases in the low-calcium group, with a dialysate calcium concentration of 1.25 mmol/L and 62 cases in the standard-calcium group, with a dialysate calcium concentration of 1.75 mmol/L. The demographic characteristics and clinical information before initiation of PD were collected and compared between the two groups. Information on the serum calcium, phosphorus and PTH, systolic and diastolic blood pressures and the use of antihypertensive and phosphate-lowering drugs in the second year of dialysis was also collected and compared between the two groups. Vascular calcification was assessed in patients on PD treatment. The mean serum calcium concentrations before initiation of PD in the low- and standard-calcium groups were 1.94 ± 0.27 and 1.89 ± 0.28 mmol/L, respectively. The serum calcium concentrations after PD were 2.30 ± 0.21 and 2.41 ± 0.23 mmol/L, respectively. After PD, the serum calcium concentration in both groups was significantly increased (p < 0.05). The serum calcium concentration in the low-calcium group after PD treatment was lower than that in the standard-calcium group, and the difference was statistically significant (p < 0.05). Compared with the standard-calcium group, patients in the low-calcium group had significantly higher parathyroid hormone concentrations (p < 0.05). More types of phosphate-lowering drugs were used (59.49%) in the low-calcium group than that in the standard-calcium group (35.48%; p < 0.05). The number of antihypertensive drug usage were also higher in the low-calcium group, and the difference was statistically significant (p < 0.05). As for the vascular calcification effect, the two groups have shown no statistical difference in abdominal aortic calcification rate, carotid arteriosclerosis rate and aortic arch calcification rate (p < 0.05). We found that low-calcium PD fluid may increase the PTH level and the proportion of CKD patients using antihypertensive drug and phosphorus-lowering drug, but the vascular calcification effect of the low and standard calcium PD fluid needs further exploration. This paper provides new evidence for the choice of dialysate for PD, low-calcium dialysate has no outstanding advantages for long term dialysis.

Vendor Independent Coronary Calcium Scoring Improves Individual Risk Assessment: MESA (Multi-Ethnic Study of Atherosclerosis)

BackgroundSubstantial variation in Agatston scores (AS) acquired with different computed tomography (CT) scanners may influence patient risk classification. ObjectivesThis study sought to develop a calibration tool for state-of-the-art CT systems resulting in vendor-neutral AS (vnAS), and to assess the impact of vnAS on coronary heart disease (CHD) event prediction. MethodsThe vnAS calibration tool was derived by imaging 2 anthropomorphic calcium containing phantoms on 7 different CT and 1 electron beam tomography system, which was used as the reference system. The effect of vnAS on CHD event prediction was analyzed with data from 3,181 participants from MESA (Multi-Ethnic Study on Atherosclerosis). Chi-square analysis was used to compare CHD event rates between low (vnAS <100) and high calcium groups (vnAS ≥100). Multivariable Cox proportional hazard regression models were used to assess the incremental value of vnAS. ResultsFor all CT systems, a strong correlation with electron beam tomography–AS was found (R2 >0.932). Of the MESA participants originally in the low calcium group (n = 781), 85 (11%) participants were reclassified to a higher risk category based on the recalculated vnAS. For reclassified participants, the CHD event rate of 15% was significantly higher compared with participants in the low calcium group (7%; P = 0.008) with a CHD HR of 3.39 (95% CI: 1.82-6.35; P = 0.001). ConclusionsThe authors developed a calibration tool that enables calculation of a vnAS. MESA participants who were reclassified to a higher calcium category by means of the vnAS experienced more CHD events, indicating improved risk categorization.

Running exercise with and without calcium supplementation from tuna bone reduced bone impairment caused by low calcium intake in young adult rats

Inadequate calcium intake during childhood and adolescence is detrimental to bone metabolism. Here, we postulated that calcium supplement prepared from tuna bone with tuna head oil should benefit for skeletal development than CaCO3. Forty female 4-week-old rats were divided into calcium-replete diet (0.55% w/w, S1, n = 8) and low-calcium groups (0.15% w/w for 2 weeks; L; n = 32). Then L were subdivided into 4 groups (8/group), i.e., remained on L, L + tuna bone (S2), S2 + tuna head oil + 25(OH)D3 and S2 + 25(OH)D3. Bone specimens were collected at week 9. We found that 2 weeks on low calcium diet led to low bone mineral density (BMD), reduced mineral content, and impaired mechanical properties in young growing rats. Intestinal fractional calcium absorption also increased, presumably resulting from higher plasma 1,25(OH)2D3 (1.712 ± 0.158 in L vs. 1.214 ± 0.105 nM in S1, P < 0.05). Four-week calcium supplementation from tuna bone further increased calcium absorption efficacy, which later returned to the basal level by week 9. Calcium supplementation successfully restored BMD, bone strength and microstructure. However, 25(OH)D3 + tuna head oil + tuna bone showed no additive effect. Voluntary running also effectively prevented bone defects. In conclusion, both tuna bone calcium supplementation and exercise are effective interventions for mitigating calcium-deficient bone loss.

Protective effects of calcium against cadmium-induced toxicity in juvenile grass carp (Ctenopharyngodon idellus)

Cadmium (Cd) is one of the dominant metal pollutants present in the aquatic environment that affects ion homeostasis, oxidative stress (OS) and immune responses of aquatic organisms. Given the physicochemical similarities between Cd2+ and calcium (Ca2+) ions, their antagonism may facilitate the mitigation of Cd-induced toxicity. To better understand the role of Ca in protecting against Cd-induced toxicity in teleosts, juvenile grass carp were exposed to Cd (measured concentration 3 μg/L) and a gradient of Ca concentrations (measured concentration 1.5 mg/L, 2.5 mg/L, 3.0 mg/L, and 3.5 mg/L in the control (CTL) group, low calcium (LCA) group, medium calcium (MCA) group, and high calcium (HCA) group, respectively) for 30 days. Inductively coupled plasma mass spectrometry (ICP-MS) data analyses showed that simultaneous exposure to Ca impaired the accumulation of Cd in all tested tissues. Besides, Ca addition maintained the plasma ion (Na+, K+, Cl-) homeostasis, alleviated Cd-induced oxidative stress (OS), and regulated the activities and transcriptional levels of ATPase. Furthermore, transcriptional heatmap analysis demonstrated that several indicator genes for OS and calcium signaling pathway were found to be significantly modulated by Ca addition. This work delineates a protective effect of Ca against Cd-induced toxicity in grass carp, providing new insight into the possible solutions to Cd pollution issues in aquaculture industry.

Chondroitin sulfate alleviates osteoporosis caused by calcium deficiency by regulating lipid metabolism

The use of non-drug intervention for calcium deficiency has attracted attention in recent years. Although calcium carbonate is the preferred raw material for calcium supplementation, there are few reports on the mechanism of the combined action of chondroitin sulfate and calcium to alleviate osteoporosis from the perspective of gut microbiota and metabolomics. In this study, a rat model of osteoporosis was established by feeding a low-calcium diet. The intestinal microbiota abundance, fecal and plasma metabolite expression levels of rats fed a basal diet, a low-calcium diet, a low-calcium diet plus calcium carbonate, and a low-calcium diet plus chondroitin sulfate were compared. The results showed that compared with the low calcium group, the calcium content and bone mineral density of femur were significantly increased in the calcium carbonate and chondroitin sulfate groups. 16 S rRNA sequencing and metabolomics analysis showed that chondroitin sulfate intervention could reduce short-chain fatty acid synthesis of intestinal flora, slow down inflammatory response, inhibit osteoclast differentiation, promote calcium absorption and antioxidant mechanism, and alleviate osteoporosis in low-calcium feeding rats. Correlation analysis showed that the selected intestinal flora was significantly correlated with metabolites enriched in feces and plasma. This study provides scientific evidence of the potential impact of chondroitin sulfate as a dietary supplement for patients with osteoporosis.

Analysis and identification of ancient glass components based on qualitative-quantitative data mining

First of all, the data is visualized by grouping the data in the form and drawing a scatter diagram. By observing the distribution of the data in the scatter plot, the classification indexes of high-potassium glass and lead-barium glass were found. Secondly, the Spearman coefficient is used to test these classification indicators. The results show that the constructed classification system is more accurate, the Spearman coefficient is small, and the fitting effect is excellent. Secondly, through the combination of qualitative and quantitative methods, the cultural relics sub-category classification index was double screened, and the chemical composition of the sub-category classification index was determined by combining the law analyzed from the scatter plot and the index weight solved by the entropy weight method. Then, the high-potassium glass was divided into low-calcium and low-copper group and high-calcium and high-copper group by K-means method. The glass was divided into high copper group, low sodium and high calcium group and high sodium and low calcium group. Finally, all the unknown types of cultural relics in the table are divided into subclasses, and the sensitivity and rationality of the classification system of major classes and subclasses are tested one by one by fitting the known data and calculating the contour coefficient. It is concluded that the classification system has a good fit to the data.

Pattern of pericardial calcification determines the mid-term postoperative outcome after pericardiectomy in chronic constrictive pericarditis

Abstract Background/Introduction Although pericardiectomy is an effective treatment of constrictive pericarditis (CP), clinical outcome is not always successful. Pericardial calcification is a unique finding in CP. However, the amount and localization of calcification vary. Computer tomography (CT) can visualize the pericardial calcification with high sensitivity and provide the anatomical assessment. Purpose We investigated that how the pattern and amount of pericardial calcification affect the mid-term postoperative outcome after pericardiectomy in CP. Methods All of the patients who underwent total pericardiectomy in our hospital from 2010 to 2020 were derived from electrical medical records (n=105). Among them, preoperative CT scans (non-gated non-contrast) of 98 patients were available and, thus, 98 consecutive patients were finally analyzed. Medical records were reviewed in a retrospective manner. Cardiovascular event is defined as cardiovascular death or hospitalization associated with a heart failure symptom and all cause event is defined as all events that require admission. CT scan was analyzed by Aquarius Workstation, and the volume and localization pattern of pericalcification were derived. Pericardium calcium score was given as an Agatston score. Results Of 98 patients, 25 (25.5%) patients were hospitalized with heart failure symptom after pericardiectomy. Median follow up duration of patients is 172 weeks. A group with cardiovascular event had higher NYHA grade (P&amp;lt;0.001), lower calcium volume (P=0.004), and lower calcium score (P=0.01). Multivariate cox proportional analysis showed that high ln(calcium score) before pericardiectomy was dependent predictor of cardiovascular event (hazard ratio, 0.90; P=0.04) and all cause event (hazard ratio, 0.91, P=0.04) after pericardiectomy. When we set the cut off value at 7.22, based on ROC curve, there was a significant difference in cardiovascular event between the groups divided by this cutoff value in Kaplan-Meier curve (P=0.002) and multivariate cox proportional analysis (P=0.04). In the subgroup analysis, myocardium invasion and circumferential calcification were more common in the high calcium score group. Idiopathic &amp; tuberculosis pericarditis were more associated with high calcium score group and post-operative pericarditis, other reasons (infection, radiation, etc) were more associated with low calcium group. Conclusion Low burden of pericardial calcification was associated high rate of mid-term clinical event after pericardiectomy CP. Preoperative evaluation of pericardial calcification pattern can be used as predictor of postoperative outcomes. Funding Acknowledgement Type of funding sources: None.

Vendor independent coronary calcium scoring improves individual risk assessment – the Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract Background Coronary artery calcium (CAC) scoring improves event prediction of coronary heart disease (CHD) and can be used to guide initiation or deferral of statin therapy in asymptomatic individuals at low-to-intermediate risk. However, there is substantial variation of CAC scores acquired with different CT scanners. Therefore, CAC scoring discrepancies may lead to suboptimal patients' treatment and harmonization is needed. Purpose The aim of our study was twofold. Our first aim was to develop a calibration tool resulting in vendor neutral Agatston Score (vnAS). Second, we aimed to assess the effect of using this calibration tool in the existing Multi-Ethnic Study of Atherosclerosis (MESA) study cohort on both risk prediction of coronary heart disease (CHD), and initiation of statin therapy. Methods Two static anthropomorphic phantoms containing multiple CAC inserts were imaged on seven different CT systems and one EBT system. For each CT system, the vnAS calculator parameters were derived using regression analysis based on Agatston scores from EBT and CT. To validate our vnAS, we used CAC scoring information and clinical data of participants from MESA study. All included participants (Cohort I, n=3181) were assigned to one out of four calcium groups, which were defined as zero-calcium (AS and vnAS of 0), low-calcium (AS and vnAS of 1–99) high-calcium (AS and vnAS ≥100), and reclassified individuals (AS &amp;lt;100 and vnAS ≥100). The occurrence of CHD events in each group was assessed and multivariable Cox regression models were used to assess the added value of the vnAS in the prediction of CHD events For a sub-cohort of 890 participants at intermediate cardiovascular risk, the potential benefit from statin therapy was estimated based on the number needed to treat (NNT). NNT were determined for patients with vnAS ≥100 and vnAS ≥300 with original AS below 100 (group I) or 300 (group II), respectively. Results For all CT systems, a high degree of correlation with EBT Agatston scores was shown (R2 &amp;gt;0.932). Using the vnAS, 85 individuals (2.7%) were reclassified from a lower to a higher risk category. For the reclassified participants, CHD event rates increased significantly from 7% to 15% (p=0.008) with a CHD hazard ratio of 3.39 (95% CI 1.82–6.35, p=0.001) (Figure 1). In intermediate risk cohort, the NNT was smaller for reclassified individuals as compared to their original (low) calcium group, at 7 vs 12 for group I and 2 vs 15 for group II, respectively. The summary of vnAS applicability is depicted in Figure 2. Conclusions We developed a calibration tool, which enables to calculate vendor neutral AS (vnAS). Based on vnAS, 85 individuals from MESA study, who were reclassified from a lower to a higher calcium category, did indeed have a higher CHD event rate. Consequently, the potential benefit from statin therapy, based on vnAS, was also increased for reclassified participants at intermediate cardiovascular risk. Funding Acknowledgement Type of funding sources: None.

When Incorporated into Fruit Sorbet Matrix, Are the Fructans in Natural Raw Materials More Beneficial for Bone Health than Commercial Formulation Added Alone?

Simple SummaryBecause of the serious consequences of osteoporosis, the prevention of this disease, which is also known as “the Silent Epidemic”, is considered essential to the maintenance of human health. It is crucial to maximize bone mass and strength during childhood and adolescence to reduce the risk of osteoporosis in later periods of life. The optimization of nutrition is one of the most important factors. Special attention should be paid to ensuring sufficient calcium intake, which is a problem in several population groups, and its bioavailability. We assessed the effect of fructans, taking into consideration their source (Jerusalem artichoke, yacon, commercial preparation) and the form of their addition to the diet (alone or as an ingredient of strawberry sorbet). A growing-female-rat model was used to assess the potential functional properties of these non-digestible carbohydrates in/without the “fruit matrix”, during calcium hypoalimentation. We showed that fructans have a protective effect during the inadequate supply of Ca, but their action is related to their source as well as the dietary matrix. It is important to look for new preventive strategies, and our paper gives an insight into various fructan sources, depicting their action and how these natural dietary components can be exploited.We assessed the extent to which fructans from various sources and added in various forms (raw materials in diet alone or incorporated into a strawberry matrix) differ in their effectiveness towards selected parameters related to bone health under calcium hypoalimentation in growing female Wistar rats. The aim of this study was to evaluate the levels of selected parameters involved in calcium metabolism, in response to a 12-week restriction of Ca intake: serum ions (Ca, Mg, P); the activity of alkaline phosphatase—using a BS 120 analyzer; the markers of bone turnover (osteocalcin, CTX; using a Rat-MidTMOsteocalcinEIA Kit and RatLapsTMEIA, respectively); and the bone mineral content (BMC) and density (BMD), using a Norland Excell Plus Densitometer. Among the examined markers, the CTX concentration increased dramatically under calcium hypoalimentation. The presence of Jerusalem artichoke (independently of the form of addition) and yacon root powder (with strawberry sorbet matrix) in the rats’ diet led to a significantly lower CTX concentration than was observed in the low-calcium control group. The type of fructan influenced the bone mass content. When fructan was added to the low-calcium diet as an ingredient of sorbet, it exerted more pronounced effects on the biochemical parameters of bone metabolism than when added alone, in the growing-female-rat model.

Preoperative Low Serum Calcium Levels Predict Poor Prognosis for Patients with Esophageal Cancer.

Purpose: Hypercalcemia has been reported as a poor prognostic factor in malignant tumors. However, no report has shown the clinical impact of serum calcium levels on patients with esophageal cancer. We evaluated the prognostic impact of preoperative serum calcium levels on patients with esophageal cancer.Methods: We evaluated 240 patients (197 men, 43 women; mean age, 66 years; age range, 34–85 years) with esophageal cancer who underwent radical surgery between September 2008 and December 2017. After assigning the patients to two groups (high calcium group, 8.8 mg/dL or more and low calcium group, 8.7 mg/dL or less), we compared the groups’ overall survival and the clinicopathological features. The clinicopathological and prognostic significance of preoperative serum calcium levels were evaluated in a univariate and multivariate analysis.Results: The patients with deep tumors showed low serum calcium levels significantly more frequently (P <0.05). The low calcium group showed a significantly worse prognosis than the high calcium group (P <0.05). However, low serum calcium level was not an independent poor prognostic factor.Conclusions: Preoperative low serum calcium levels were associated with advanced tumors. Low serum calcium might be associated with esophageal cancer progression.

Biomechanical Role of Trabecular Microstructure on Peri-implant Strain Based on Micro-CT Finite Element Modeling of Aging Mice.

To evaluate the influence of age and trabecular microstructure on peri-implant strain in aging and young mice models under compressive load. Eighteen 4-week-old female C57BL/6 mice (n = 6) were subjected to a 1.2% calcium content diet (young normal calcium group), and 7-month-old mice (n = 12) were randomly subjected to 0.01% and 1.2% calcium content diets (aging low and normal calcium groups, respectively) for 3 weeks. Histomorphometric and microcomputed tomography (micro-CT) analyses were used to investigate local alveolar bone microstructure. One maxilla segment from each group was reconstructed using micro-CT images to highlight the trabecular microstructure. A finite element analysis based on a computational model of the maxilla segment was performed to investigate peri-implant strain. Implants with three different diameters (0.3, 0.4, and 0.5 mm) were analyzed in these models. The aging low calcium group showed worse cancellous microstructure in hematoxylin and eosin (HE) staining, significantly increased osteoclast numbers (P < .05), and reduced bone volume fraction and trabecular thickness compared with the aging normal calcium group (P < .05). However, the young normal calcium group presented no difference in trabecular microstructure and osteoclast numbers compared with the aging normal calcium group. The aging low calcium group demonstrated increased strain intensity compared with the aging normal calcium group, whereas the young normal calcium and aging normal calcium groups showed comparable strain magnitude. The strain intensity of peri-implant bone increased with worse cancellous microstructure. When the diameter increased from 0.3 mm to 0.4 mm, the percentages of pathologic overload decreased regardless of bone microstructure. Deteriorated bone microstructure induced by a low calcium diet determined higher strain intensity, whereas, whenever age had no significant effect on trabecular microstructure, consequently, there was no substantial influence on strain. An increase of implant diameters can improve the strain distribution. Clinical decision-making should take into consideration the patient-specific and site-specific trabecular microstructure in preoperative assessment.

Is there a correlation between the initial calcium level and Balthazar classification in patients with acute pancreatitis?

While a life-threatening course is observed in 2-3% of patients with acute pancreatitis (AP), mortality can be up to 50% in severe AP. In our study, we research relationship between calcium level and Modified Balthazar (MB) score. 354 patients who were followed up with a diagnosis of AP between 2013 and 2019 were included in our study. Serum calcium level was measured within the first 24 h. Abdominal computed tomography (CT) was performed in all patients in the first 12 h and between 3 and 7 days. The severity of AP was determined according to the MB classification. The correlation between calcium level and MB classification was examined. 206 (58.2%) of the patients were women. Mean age was 54.8±17.9 years (range: 18-100). It was observed that the rate of severe AP was significantly higher in the low calcium group compared to the MB classification in which tomographies taken at ad-mission and 72 h after were evaluated (p<0.05). Furthermore, progression was higher in low calcium group (p<0.05). The cutoff value was 9.35 mg/dl for the ROC analysis performed to distinguish mild pancreatitis from moderate-severe pancreatitis according to the MB classification performed by CT obtained after 72 h based on the Ca values. For the cutoff value of 9.35 mg/dl (AUC: 0.581, p=0.018, 95% Cl: 0.514-0.649), the sensitivity was 57.4% and the specificity was 53.1%. Since there is a correlation between the initial calcium level and the severity of the disease according to the CT-scan obtained later, the calcium level gives us an idea of the course of the disease.

Serum biomarkers of the calcium-deficient rats identified by metabolomics based on UPLC/Q-TOF MS/MS

BackgroundWe previously identified the urinary biomarkers to diagnose calcium deficiency and nutritional rickets by ultra-performance liquid chromatography/quadrupole time-of-flight tandem mass spectrometry (UPLC/Q-TOF MS/MS). To find biomarkers of calcium deficiency and further confirm these biomarkers in serum, we performed serum metabolomics analysis of calcium-deficient rats.MethodsA calcium-deficient rat model was established with a low-calcium diet for 12 weeks. Serum metabolomics based UPLC/Q-TOF MS/MS and multivariate statistical analysis was performed to identify the alterations in metabolites associated with calcium deficiency in rats.ResultsBone mineral density, serum parathyroid hormone and alkaline phosphatase were significantly decreased in the low-calcium diet group (LCG) compared to the normal calcium diet group (NCG). Serum metabolic-profiling analysis could definitively distinguish between the LCG and NCG and identified 24 calcium-deficient biomarkers. Three metabolites (indoxyl sulfate, phosphate, and taurine) of the 24 biomarkers were found in our previous urinary metabolomics study of rats with a calcium deficiency and nutritional rickets. The areas under the curve (AUCs) of these three biomarkers were greater than 0.8, and the combination of any two biomarkers was higher than 0.95.ConclusionDietary calcium deficiency induced the alterations of metabolites in the serum of rats, and the three identified biomarkers had relatively high diagnostic values for calcium deficiency in rats.

The calcium concentration of peritoneal dialysis solution modifies levels of key mediators of peritoneal fibrosis.

BackgroundTo explore the effects of different calcium concentrations of peritoneal dialysis solution (PDS) on continuous ambulatory peritoneal dialysis (CAPD) and expression of vimentin (VIM), fibroblast‐specific protein (FSP1), and E‐cadherin.Materials and MethodsThis was a pilot study (#ChiCTR1900021387) conducted from January 2017 to December 2019 at the Hospital. The patients were randomized to undergo CAPD using PDS with a calcium concentration of 1.25 mmol/L (low concentration group) or 1.75 mmol/L (high concentration group). Changes in biochemistry before dialysis and at 6 and 12 months were analyzed.ResultsThere were 50 and 52 participants in the low and high calcium groups. The blood biochemical indexes were all different between the two groups (all P time < .05, P group < .05, P interaction < .05), but they remained within their normal ranges. VIM and FSP1 increased over 12 months (P time < .05); VIM and FSP1 levels in the high concentration group were higher than in the low concentration group (P group < .05, P interaction < .05), while E‐cadherin showed the inverse association (P time < .001, P group < .001, P interaction < .001). There was no difference in complications (P = .973).ConclusionThe calcium concentration in PDS might be an important factor affecting the progression of peritoneal fibrosis.

Effects of preoperative calcium levels and parathyroidectomy on renal function in primary hyperparathyroidism: a retrospective study

MethodsThis retrospective study enrolled 71 patients who underwent parathyroidectomy for PHPT in the General Surgery Department at Ondokuz Mayis University Hospital from 2010 to 2018. All patients were histopathologically diagnosed with parathyroid adenoma. Total serum calcium, serum creatinine, serum intact parathyroid hormone (PTH), and serum 25-hydroxyvitamin D3 (25(OH)D3) were measured before and 3-6 months after surgery. Patients were assigned to the low eGFR group (60-90 mL/min/1.73 m2) or normal eGFR group (≥90 mL/min/1.73 m2) and to the low calcium group (≤11.2 mg/dL) or high calcium group (˃ 11.2 mg/dL).ResultsIn the low eGFR and high calcium group, there were significantly more patients with hypertension and older age. In the normal eGFR and high calcium group, eGFR was significantly reduced after surgery. Independent predictors of eGFR change after surgery were age, pre-parathyroidectomy calcium, and pre-parathyroidectomy eGFR.ConclusionsAfter surgery, patients with low eGFR had preserved renal function, whereas those with normal eGFR had decreased renal function. Mild renal dysfunction in PHPT was associated with older age, hypertension, and high calcium levels.

Calcium deficient placental growth restriction is mediated by an increase in non-invasive integrin α5 and β4 phenotype.

Integrins are cell adhesion receptors that participated in endovascular invasion by cytotrophoblasts in preeclampsia. This study aimed to investigate the effect of calcium on cellular pathways influencing the trophoblast integration into endothelial cellular networks in vitro. Red fluorescent-labelled human uterine myometrial microvascular endothelial cells (UtMVECs) were seeded on Matrigel. Green fluorescent-labelled HTR-8/SVneo trophoblast cells were then co-cultured with endothelial cells in different concentrations of calcium for 24h. The calcium effects on HTR-8/SVneo cell integration were quantified by Image J. Quantitative PCR was performed to measure mRNA expression of integrins α1, α5, α6, β1 and β4. The concentrations of interleukin IL-6, matrix metalloproteinase-2 (MMP-2), MMP-9, PlGF and sFlt-1 in the conditioned medium were measured by ELISA while levels of cytokines IL-1β, IL-8, IL-10, TNF-α and INF-γ were assessed by magnetic Luminex assays™. Both calcium depletion (0.4mM) and low calcium (1.8mM) groups demonstrated inhibited integration of trophoblast cells into endothelial cellular networks, compared with the normal calcium group (2.4mM). The IL-6 production was reduced from conditioned media in both calcium depletion and low calcium groups. In calcium depletion group, mRNA expression of integrin α5 and β4 in trophoblasts was increased while integrin α1 was decreased. The in vitro trophoblast cell integration into endothelial cellular networks could be modified by altering media calcium through integrin switch away from integrins α5 and β4 and towards integrin α1 which may be required for healthy early trophoblast integration.

318 Total flavonoids from Rhizoma drynariae ameliorate low calcium-induced osteoporosis by regulating the bone metabolism in caged laying hens

Abstract Cage layer osteoporosis (CLO) is one of the most serious bone metabolic diseases in laying hens industry. This disease not only causes huge economic losses, but also greatly affects the welfare of animals. Traditional Chinese medicines are widely used for prevention and treatment of all kinds of diseases. It is famous for excellent treatment, low side effects, and wide range of use safety. Total flavonoids from Rhizoma drynariae (TFRD) is an herbal product extracted from the dried root of Rhizoma drynariae. Recently, many researcher reports about the beneficial effects of TFRD in relation to various types of bone conditions but no report is available about promoting effect of TFRD against CLO. Therefore, current study was conducted to explore the ameliorating effect of TFRD in low calcium-induced osteoporosis. A total of 144 Lohmann pink-shell laying hens of 31-week-old were equally distributed in four groups: The control group (containing calcium 3.5% in based diet), the low calcium group (containing calcium 1.5% in low-calcium diet), the test group 1 (adding 500 mg/kg TFRD to low-calcium diet), the test group 2 (adding 2000 mg/kg TFRD to low-calcium diet). The birds were fed the diets for 60 d. The bone mineral density of tibia was measured by dual-energy X-ray absorptiometry indicating that the low calcium group had lower bone density than the control group. Compared with the low calcium group, the supplementation of TFRD protects bone tissue and prevents bone density from decreasing. Serum biochemical analysis showed that TFRD supplementation decreased the level of alkaline phosphatase, tartrate-resistant acid phosphatase, osteocalcin and calcitonin. Therefore, adding TFRD to low-calcium diet can improve the activity of important biochemical markers, clearly inhibit bone resorption and alleviate osteoporosis induce by low-calcium diet in caged laying hens.