Serum Calcium Measurements Research Articles

8115 Evaluation Of The Incidence Of Hypoparathyroidism In Patients Undergoing Anterior Cervical Surgery

Abstract Disclosure: L.D. Santos: None. G. Oliveira Martins: None. J.V. Lima: None. L.A. Alvares: None. M.N. Lemos: None. L. Costa Figueiredo: None. E.N. Sakane: None. N. Scalissi: None. Introduction: The consensus published in 2022 suggests that a parathyroid hormone (PTH) level below 10 pg/mL may predict permanent hypoparathyroidism. However, these data have not yet been tested in the Brazilian population.Objective: To assess the clinical and laboratory characteristics of patients undergoing anterior cervical surgery, aiming to identify whether a postoperative PTH level below 10 pg/mL is associated with permanent hypoparathyroidism in a tertiary center in Brazil. Methods: We conducted a retrospective study with a chart review analysis. Results: We analyzed 59 patients who underwent anterior cervical surgery, with a mean age of 53 years (SD= +/- 17). 81% of the patients were alcohol consumers, and 76% were smokers. Regarding the surgical indication, 60.34% were for thyroid cancer, 17.24% for thyroid goiter, 13.79% for Graves' disease, 5.17% for glottic cancer, and 3.45% for primary hyperparathyroidism. Of the total operated patients, 49.15% were diagnosed with permanent hypoparathyroidism. The distribution of patients with permanent hypoparathyroidism was as follows: thyroid cancer 34.5%, Graves' disease 24.1%, goiter 24.1%, glottic cancer 10.3%, and primary hyperparathyroidism 7%. There was no significant difference in the occurrence of post-surgical hypoparathyroidism concerning the type of surgical indication (p>0.05). Regarding PTH 24 hours after surgery, a significant difference was observed between the group with permanent hypoparathyroidism and the group without the disease, with a mean PTH of 5.0 pg/mL and 10 pg/mL, respectively (p<0.05). As for serum calcium collected 24 hours post-surgery, there was no significant difference between the groups with and without permanent hypoparathyroidism (7.5 x 8.0 mg/dL; p>0.05). Conclusion: The PTH measurement in the first 24 hours postoperatively has proven to be more discriminative than the serum calcium measurement during the same period in identifying patients with permanent hypoparathyroidism. Presentation: 6/2/2024

Association of serum calcium levels with diabetic kidney disease in normocalcemic type 2 diabetes patients: a cross-sectional study

To explore the association between serum calcium levels within normal ranges and Diabetic Kidney Disease (DKD) in type 2 diabetes patients. In this cross-sectional study, we analyzed clinical data from type 2 diabetes patients admitted to the Endocrinology Department of the Affiliated Hospital of Qingdao University from January 1, 2021, to December 1, 2022. We measured serum calcium levels, corrected for albumin, and screened for diabetes-related complications, including DKD. The association between corrected serum calcium levels and DKD was evaluated using logistic regression, with adjustments made for potential confounders and a generalized additive model (GAM) to explore non-linear relationships, supplemented by subgroup analyses. Among the 3016 patients (52.55% male, 47.45% female), the mean corrected serum calcium was 2.29 ± 0.08 mmol/L. DKD was present in 38.73% of patients. A 0.1 mmol/L increase in corrected serum calcium was associated with a 44% increased risk of DKD (OR = 1.44, 95% CI 1.28–1.61, p < 0.0001). The GAM indicated a linear relationship between corrected serum calcium and DKD risk, consistent across subgroups. Corrected serum calcium levels were linearly associated with DKD risk in type 2 diabetes patients, underlining its potential role in risk assessment. These findings emphasize the clinical importance of monitoring serum calcium levels. However, the need for further prospective studies to confirm these findings is underscored by the study’s cross-sectional design.

Serum calcium as a candidate marker in detecting stunting in toddler

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;Monitoring the nutritional status of toddlers is a very important thing to do. Calcium is one of the blood parameters that can be assessed, because calcium deficiency will affect the child's linear growth. So far, monitoring of nutritional status is only based on anthropometry and is not followed by assessment of blood parameters. &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Objectives:&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;em&gt; &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;This study aims to measure serum calcium levels as a candidate marker in detecting stunting in toddlers. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Method:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; The design of this research is cross sectional with 62 samples of toddlers aged 2-5 years. Data on sample characteristics was obtained through a questionnaire, as for serum calcium levels measurement, venous blood samples were taken and measured with the colorimetric method. The incidence of stunting is obtained based on TB/U measurements and Z-score was calculated using Anthro 1.02 software. Data were then analyzed univariately (frequency distribution) and bivariately (&lt;/em&gt;&lt;em&gt;independent t-test and &lt;/em&gt;&lt;em&gt;chi-square) using SPSS version 22. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Results:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; Based on anthropometric measurements, it was found that 21 (33.9%) toddlers had stunting, 28 (45.1%) toddlers had low Serum calcium levels and the majority of toddlers (54.9%) had normal serum calcium levels. There was no significant difference (p=0.989) in mean serum calcium levels between stunting and non-stunting toddlers (1.961 ± 0.223 µq/dL vs 1.960 ± 0.175 µq/dL). Bivariate results also showed that there was no significant relationship (p=0.414) between serum calcium levels and the incidence of stunting. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Conclusion:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; Measuring serum calcium levels cannot be used as a candidate marker for detecting stunting in toddlers. Further research is needed with a larger number of samples and measurements of various parameters related to calcium balance.&lt;/em&gt;&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Untargeted metabolomics revealed the mechanism of aucubin on glucocorticoid-induced osteoporosis in mice through modulating arachidonic acid metabolism

Glucocorticoid-induced osteoporosis (GIOP) represents the most prevalent form of secondary osteoporosis. Aucubin (AU), a principal active component found in traditional herbal medicines such as Eucommia ulmoides, has been demonstrated to enhance osteoblast differentiation. Nonetheless, the precise therapeutic effects of AU on GIOP and the complex underlying regulatory mechanisms warrant further investigation. We first established a GIOP model in female mice and then assessed the therapeutic effects of AU using micro-CT analysis, biomechanical testing, measurements of serum calcium (Ca) and phosphorus (P) levels, and histological analyses using Hematoxylin and Eosin (HE) and Masson staining. Subsequently, non-targeted metabolomics was employed in order to study the effects of AU on serum metabolites in GIOP mice. The levels of the factors related to these metabolites were quantified using real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) and western blot analyses. Finally, the effects of AU on osteoblastic and osteoclastic differentiation were examined. We found that AU significantly ameliorated bone microarchitecture and strength in GIOP mice. It mitigated pathological damages such as impairment of trabecular bone structure and reduction in collagen fibers, while concurrently elevating serum levels of Ca and P. Non-targeted metabolomics revealed that Arachidonic acid (AA) metabolism serves as a common pathway between the control and GIOP groups, as well as between the high-dose AU (AUH) and GIOP groups. AU notably upregulates prostaglandin-endoperoxide synthase 2 (PTGS2) and microsomal prostaglandin-E synthase 1 (PTGES) expression and downregulates prostaglandin-H2 D-isomerase (PTGDS) expression. Furthermore, AU treatment increased the expression of runt-related transcription factor 2 (Runx2) and transcription factor Sp7 (Osterix), enhanced serum alkaline phosphatase (ALP) activity, and reduced osteoclast expression. These results indicate that AU is a potential drug for treating GIOP, and its mechanism is related to regulating AA metabolism and promoting osteoblast differentiation. However, the key targets of AU in treating GIOP still need further exploration.

Effect of Swimming Free 50 Meters for Males on Calcium Levels and Some Enzymes of Thyroid and Parathyroid Gland

Study purpose. This study aimed to investigate the effect of swimming free 50 meters on calcium levels and activities of some key enzymes involved in calcium metabolism in males. Materials and Methods. Eleven healthy male adults were selected to participate in the study. They freely swam 50 meters daily for four weeks. A one-group pretest-posttest design was used to evaluate the effect of the swimming intervention on markers of calcium metabolism. Measurements were taken for participants before and after swimming. Fasting blood samples were collected before and after swimming to measure serum calcium levels as well as the activities of alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), 5'-nucleotidase, thyroid stimulating hormone (TSH) and parathormone (PTH) by standard enzymatic methods. Results. After four weeks of swimming free 50 meters daily, serum calcium levels showed a statistically significant increase compared to baseline (p &lt; 0.05). The activities of ALP, AST, and ALT were significantly higher post-intervention (p &lt; 0.05 for all enzymes). There were no significant changes in 5'-nucleotidase, TSH, and PTH activities. Conclusions. The results indicate that swimming free 50 meters daily for four weeks increases serum calcium levels, likely through enhanced bone resorption as suggested by the elevated activities of ALP, AST, and ALT. However, there were no significant effects on thyroid and parathyroid functions as assessed by TSH and PTH.

Association of serum phosphate, calcium and alkaline phosphatase with risk of incident fractures in healthy older adults.

Aging increases fracture risk through bone loss and microarchitecture deterioration due to an age-related imbalance in bone resorption and formation during bone remodelling. We examined the associations between levels of phosphate, calcium, and alkaline phosphatase, and fracture risk in initially-healthy older individuals. A post-hoc analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial recruited 16,703 Australian participants aged ≥70 years and 2,411 US participants aged ≥65 years. Analyses were conducted on ASPREE-Fracture substudy participants from Australia with serum calcium, phosphate, and alkaline phosphatase measurement. Fracture data were collected post-randomization. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CIs). Phosphate, calcium, and alkaline phosphatase were analysed in deciles (D1-D10), with deciles 4-7 (31-70%) as the reference category. Restricted cubic spline curves were used to identify nonlinear associations. Of the 9915 participants, 907 (9·2%) persons had incident fractures recorded over 3·9 (SD 1·4) years. In the fully adjusted model, males in the top decile (D10) of phosphate had 78% higher risk of incident fracture (HR 1·78, 95% CI 1·25-2·54). No such association was observed for females (HR 1·09, 95% CI 0·83-1·44). The population attributable fraction in men within the D10 phosphate category is 6·9%. This result confirms that, high-normal serum phosphate levels are associated with increased fracture risk in older men.

Serum Calcium and HbA1c Levels in Sudanese Patients with Type II Diabetes mellitus: is there any correlation?

Background: By influencing the production and release of insulin from the pancreatic beta cells, calcium ions have a significant impact on glycemic control. Calculating calcium levels is crucial for tracking insulin secretion because hypocalcaemia in non-diabetic individuals is linked to impaired insulin release. The purpose of this study was to measure serum calcium levels and compares them to HbA1c levels in Sudanese patients with type II diabetes who reside in Khartoum State. Methods: At the Al-Amal Diabetes Center, 60 Sudanese patients with type II diabetes were the subjects of a cross-sectional hospital-based study conducted between March and June 2021. Demographic information, the length of diabetes, the kind of treatment, and co-morbidity were all covered by a standard questionnaire. Using the Mindray B 300 device, the HbA1c and serum Ca2+ were measured. SPSS version 25 was used to analyze the data. Results: The participants' mean age was 56.8±13 years. Of the participants, two thirds are men. The average duration of diabetes was 12.0±8.8 years. The results showed that the mean HbA1c was 8.2± 2.5 % and the mean serum Ca2+ was 8.5± 0.4 mg/dl. HbA1c and serum Ca2+ did not show any discernible correlation (r = 0.104 and P = 0.429). Serum Ca2+ levels did not significantly correlate with the participants' ages or the length of time they had diabetes mellitus. Conclusion: The results of this study showed that neither the duration of the DM nor the HbA1c were significantly correlated with the serum Ca2+ level. These results need to be confirmed by a more extensive investigation.

Vitamin D as Supplementary Treatment for Newly Diagnosed Pulmonary Tuberculosis patients

Objective: To compare vitamin D with placebo in patients with pulmonary tuberculosis in terms of clinical improvement and sputum conversion. Materials And Methods: This is a prospective randomized, double blind, placebo controlled comparative study conducted for a period of 12 weeks in a tertiary care centre in south India. Total Subjects were 60 new cases of pulmonary tuberculosis who are getting TB treatment initiation, Subjects were randomly allocated into two groups, group A and group B comprising of 30 patients in each group. Group A received vitamin D and group B received placebo. Dosage of vitamin D was 0.25mg/day, given in initial six weeks of antituberculosis drug therapy. Serum level of 25-hydroxyvitamin D was measured at time of diagnosis and at 8 weeks of anti-tuberculous therapy. Measurements of haemoglobin, leukocyte count and serum calcium were done at beginning and repeated at 6th, 8th and 12 weeks. Acid fast bacilli were examined at beginning and on 6th, 8thand 12 weeks. Primary outcome was evaluation of conversion time of sputum smear; secondary outcome was clinical improvement as assessed by TB score. Results: There is no significant difference in mean values of age, haemoglobin level, calcium level,serum Vitamin D, TB score and total lymphocyte count in both groups at start of study.There was no statistical difference in serum calcium level, haemoglobin level and total lymphocyte level at end of study. Mean serum vitamin D level at 8th week of treatment was 27.83±7.09ng/dl in group A and 18.83±2.27 in group B, there was statistically significant difference between two groups. Sixth week sputum conversion in 30 subjects of vitamin D group is 100% and in placebo group, it is 76.7%, which was statistically significant. Conclusion: Supplementary vitamin D when added to first line anti-tuberculous drugs results in shorter conversion time and less severe TB clinical manifestation without any manifestations of hypercalcemia. Therefore, it is recommended to add vitamin D as supplementary treatment to first-line anti-tuberculous drugs in treatment course of active pulmonary TB.

Brown Tumor with Multiple Lesions as a Manifestation of Tertiary Hyperparathyroidism: A Case Report and Literature Review

Brown tumor is an uncommon focal lytic bone lesion, which is considered as an end-stage lesion of abnormal bone metabolism, caused by long-standing increased parathyroid hormone levels. It is a rare manifestation of hyperparathyroidism that is classified into three types, of which tertiary is the rarest. It can be found in any part of the skeleton, and in some cases, occurs in multiple bones and can be easily misdiagnosed as a metastatic tumor. Therefore, although uncommon, it should be generally considered as a differential diagnosis with bone malignancy lesions, and particularly in patients with renal failure on long-term hemodialysis. In the present case report, a young patient with end stage renal disease presented with tertiary hyperparathyroidism revealed by multiple brown tumors of the pelvis and mandible. We recall through this observation the importance of clinical context, the complementary roles that different imaging modalities can play in different settings, and the relevance of measuring serum calcium and parathyroid hormone before the diagnosis of osteolytic bone lesions.

Serum zinc and calcium level in patients with psoriasis

The purpose of this study was to measure the serum zinc and calcium levels in psoriatic individuals. The Dhaka Medical College's Biochemistry Department conducted a cross-sectional study from 2021 to 2022, involving 110 participants aged 20-55. Group A included 55 diagnosed psoriasis patients and group B included 55 healthy individuals. Serum zinc and calcium measurements were made using a colorimetric technique. Statistical analysis was conducted using the study's data, using unpaired Student's 't' test for continuous variables, Chi-square test for categorical variables, and Spearman's rank correlation coefficient test for correlation (p&gt; 0.5). When compared to healthy subjects, psoriatic patients' mean SD serum zinc and calcium levels (57.488.86 and 7.600.58, respectively) were substantially lower (p 0.001) than those of healthy subjects (79.427.37 and 8.750.45, respectively). Psoriasis and serum zinc and calcium showed a significant inverse relationship (r = -0.769, p0.001 and r = -0.736, p0.001, respectively). Only low serum zinc (p0.066) and considerably low serum calcium (p0.006) were identified in patients with long-term psoriasis (&gt;5 years). It can be inferred from this study that psoriasis patients had lower serum levels of calcium and zinc. Thus, regular evaluation of these biomarkers may be useful in preventing worse outcomes brought on by hypozincemia and hypocalcemia.

Low vitamin D and uric acid status in patients with benign paroxysmal positional vertigo.

Growing evidence reported that vitamin D and uric acid metabolism played roles in the occurrence of benign paroxysmal positional vertigo, an otoconia-related vestibular disorder. We aimed to investigate the serum 25-hydroxy vitamin D (25(OH)D) and uric acid in patients with benign paroxysmal positional vertigo and to determine the risk factor for benign paroxysmal positional vertigo. This case-control study comprised 182 patients with benign paroxysmal positional vertigo and 182 age- and gender-matched controls. All subjects' age, body mass index, systolic blood pressure, diastolic blood pressure, 25-hydroxyvitamin D (25(OH)D), uric acid and serum calcium measurements were analyzed. We found a female preponderance of benign paroxysmal positional vertigo patients, with a median of 60 (52-66) years old. The results showed low vitamin D status both in benign paroxysmal positional vertigo and controls, with no significant difference of 25(OH)D levels between benign paroxysmal positional vertigo patients and controls (P > 0.05). Compared with the control group, patients with benign paroxysmal positional vertigo had a higher prevalence of vitamin D deficiency and a lower prevalence of vitamin D sufficiency (P < 0.05). Uric acid was significantly lower in the benign paroxysmal positional vertigo groups (P < 0.05). Logistic regression analysis revealed that age and uric acid were considered higher risk predictors for benign paroxysmal positional vertigo. Our study observed low vitamin D status in patients with benign paroxysmal positional vertigo, with no significant differences of the 25(OH)D level in patients with benign paroxysmal positional vertigo and controls. Elderly, vitamin D deficiency and low uric acid levels may be risk factors for benign paroxysmal positional vertigo occurrence.

Clinical Value of CASR Gene Polymorphism on Cinacalcet Response in Hemodialysis Patients with Secondary Hyperparathyroidism

Abstract Background Secondary hyperparathyroidism (SHPT) is a common complication of chronic kidney disease (CKD) patients on dialysis, associated with increased cardiovascular mortality and morbidity. Aim to evaluate frequency of variants of CaSR genes related to PTH regulation and to assess the effect of these single nucleotide polymorphisms on cinacalcet response among prevalent hemodialysis patients (HD) with SHPT. Patients and Methods This study included 50 prevalent HD patients with SHPT were recruited from Ain Shams University Hospitals' dialysis units. Clinical stable end-stage renal disease (ESDR) (35 males (70%) and 15 females (30%)), ≥ 18 years old on adequate HD for ≥ 6 months, with intact PTH (iPTH) ≥300 pg/ml and had been treated by cinacalcet. The patient was followed retrospectively for 6 months by measuring serum calcium, phosphorous, alkaline phosphatase, PTH to evaluate the response of cinacalcet. CASR gene and single nucleotide polymorphism (SNP) (rs1042636 and rs1802757) were measured by real-time PCR. Results CASR Gene/SNP rs1042636 (A/G), AA homozygous gene (wild gene) was present in n = 48 (96%) while AG heterozygous gene was present in n = 2 (4%). CASR Gene/SNP rs1802757(C/T), CC homozygous gene (wild gene) was present in n = 42 patients (84%) while CT heterozygous gene was present in n = 6 patients (12%). 21 patients (42%) responded to treatment of SHPT with reduction percent and 29 patients (58%) were non-responding to cinacalcet treatment for 6 months duration. The results showed no significant correlation between CASR gene polymorphism and response to treatment (p-value &amp;gt;0.05). Conclusion There is no statistically significant correlation between single nucleotide polymorphisms (SNPs) of the calcium sensing receptor gene (CASR) and response to cinacalcet as treatment of SHPT among HD patients, for further investigation studies.

Cinacalcet Reverses Short QT Interval in Familial Hypocalciuric Hypercalcemia Type 1.

Familial hypocalciuric hypercalcemia type 1 (FHH-1) defines an autosomal dominant disease, related to mutations in the CASR gene, with mild hypercalcemia in most cases. Cases of FHH-1 with a short QT interval have not been reported to date. Three family members presented with FHH-1 and short QT interval (<360 ms), a condition that could lead to cardiac arrhythmias, and the effects of cinacalcet, an allosteric modulator of the CaSR, in rectifying the abnormal sensitivity of the mutant CaSR and in correcting the short QT interval were determined. CASR mutational analysis was performed by next-generation sequencing and functional consequences of the identified CaSR variant (p.Ile555Thr), and effects of cinacalcet were assessed in HEK293 cells expressing wild-type and variant CaSRs. A cinacalcet test consisting of administration of 30 mg cinacalcet (8 Am) followed by hourly measurement of serum calcium, phosphate, and parathyroid hormone during 8 hours and an electrocardiogram was performed. The CaSR variant (p.Ile555Thr) was confirmed in all 3 FHH-1 patients and was shown to be associated with a loss of function that was ameliorated by cinacalcet. Cinacalcet decreased parathyroid hormone by >50% within two hours, and decreases in serum calcium and increases in serum phosphate occurred within 8 hours, with rectification of the QT interval, which remained normal after 3 months of cinacalcet treatment. Our results indicate that FHH-1 patients should be assessed for a short QT interval and a cinacalcet test used to select patients who are likely to benefit from this treatment.

Association of Serum Calcium with the Risk of Chronic Obstructive Pulmonary Disease: A Prospective Study from UK Biobank.

Although intracellular calcium had been demonstrated to involve in the pathogenesis of chronic obstructive pulmonary disease (COPD), the association between serum calcium and COPD risk remains unclear. We included 386,844 participants with serum calcium measurements and without airway obstruction at the baseline from UK Biobank. The restricted cubic splines were used to assess the dose-response relationship. Multivariable cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of albumin-corrected calcium concentrations with the risk of COPD incidence and mortality. During a median of 12.3 years of follow-up, 10,582 incident COPD cases were documented. A linear positive association was observed between serum calcium concentrations and the risk of COPD incidence. Compared to participants with normal serum calcium (2.19-2.56 mmol/L), a 14% higher risk of COPD was observed in hypercalcemic participants (≥2.56 mmol/L, HR = 1.14; 95% CI: 1.02-1.27). No significant effect modifications were observed in stratified variables. In survival analysis, 215 COPD-specific deaths were documented after a median survival time of 3.8 years. Compared to participants with normal serum calcium, hypercalcemic participants had a 109% (HR = 2.09, 95% CI: 1.15-3.81) increased risk for COPD-specific mortality. Our study indicated that hypercalcemia was associated with an elevated risk of COPD incidence and mortality in the European population, and suggested that serum calcium may have a potential impact on the progression of COPD.

A Comparative Study of Serum Calcium and Magnesium in Post-Menopausal and Pre- Menopausal Women

Background: Menopause is marked by decreased female sex hormones and many of the symptoms experienced during this phase may be related to changes in serum levels of certain trace minerals especially calcium and magnesium. Aim: The main purpose of the study was to measure serum calcium and magnesium in postmenopausal women and to compare with that in pre-menopausal women. Methods: Serum calcium and magnesium were estimated in 30 postmenopausal women and 30 premenopausal women, who were selected following inclusion and exclusion criteria. Statistical analysis was done by using Graph pad Quickcalcs calculator. Student's unpaired t test was done to compare between both groups and p-value was determined to know the statistical significance. Results: Postmenopausal women were found to have lower serum calcium (8.659±0.91) and serum magnesium (1.63±0.16) when compared to premenopausal women who had serum calcium of (9.604 ± 0.70) and serum magnesium (2.48±0.55). The lowered calcium and magnesium levels were found to be extremely statistically significant with a p-value of &lt;0.0001. Conclusion: Serum calcium and magnesium were decreased in post-menopausal women when compared to pre-menopausal women, which needs to be corrected to avoid certain postmenopausal symptoms and other serious health problems. This may improve cardiovascular and bone health in post menopausal women.

Sex differences in vitamin D and behavioral profiles among children with allergic diseases.

Previous studies have suggested that vitamin D has a protective effect on allergic diseases, while an individual's sex may have a moderating effect on the relationship between vitamin D and allergic-related immunity. This study aimed to determine the role of vitamin D in children with coexisting allergic diseases in the context of sex differences and to explore the behavioral profiles of these patients. We recruited a total of 103 children with atopic diseases and divided them into four groups: males with one allergic disease (MA1, n = 20), males with two or more allergic diseases (MA2, n = 26), females with one allergic disease (FA1, n = 30), and females with two or more allergic diseases (FA2, n = 27). We measured serum calcium levels using the colorimetric method and serum 25-OH vitamin D total levels using electrochemiluminescence immunoassay. We found that MA2 had significantly lower vitamin D levels than MA1 and FA2. The levels of IgE were negatively correlated with vitamin D in females, whereas the levels of IgE were not significantly correlated with vitamin D in males. Furthermore, serum IgE was significantly correlated with children's adaptive skills, and different sexes were associated with different aspects of adaptive skills. Our findings suggest a protective role of vitamin D in the development of one allergic disease against the coexistence of allergic diseases in males, as well as extend the evidence for sex differences in immunity by demonstrating a sex-different correlation between IgE and vitamin D and the relationship between IgE and children's adaptive skills.

Association of Total Serum Calcium Level with Obesity Markers (Body Mass Index and Waist Circumference) among Healthy Young Saudis

Background &amp; Objective: The pathophysiology of obesity and comorbid diseases may be associated with the levels of intracellular and extracellular calcium. This study aimed to investigate the association between overweight/obesity measures and the total serum calcium level in young Saudis. Methods: This was a cross-sectional observational study that involved 121 healthy young Saudi participants of both genders. Venipuncture was performed to obtain blood samples of 4 ml. Serum specimens were extracted and aliquoted into Eppendorf tubes, then preserved at a temperature of -20°C until the time of analysis. Anthropometric Measures (BMI and WC) were measured. SPSS software was used for statistical analysis. The measurement of total serum calcium was conducted through the utilization of a Human Diagnostics kit (Wiesbaden, Germany) on a hospitex Diagnostics Eos-bravo Autoanalyzer. The statistical analysis was conducted using the SPSS software. Results: The sample population consisted of 87.6% males, 27.3% smokers, 57% students, and 66.9% individuals with a university degree or higher. Nearly 50% of participants were 15–23 years old. Obese subjects had considerably lower total serum calcium than normal weight subjects. BMI and WC inversely correlated with calcium levels. Conclusion: The present study confirms the inverse relationship between total serum calcium level and obesity in the Saudi healthy population. Calcium supplementation could lower obesity-related chronic disease mortality and morbidity and hence reduce healthcare expenses and increases healthy life years. Keywords: calcium; obesity; overweight; waist circumference; body mass index; Saudi Arabia.

P14 Postoperative calcium monitoring is not necessary in hemi-thyroidectomy patients

Abstract Introduction There is no standardised practice for the management of calcium post-operatively. Hemithyroidectomies pose a smaller risk for PH, compared to total thyroidectomies. The aim of the study was to establish if routine testing of serum calcium was needed in patients undergoing hemithyroidectomy operations. Methods We have included patients that had hemithyroidectomy between 2017 -2021. Patients operated on between 04/2017-03/2019 had post-operative blood test for serum calcium (Group A) while patients operated on between 04/2019-10/2021 did not have any testing (Group B). Results 178 patients were included in the analysis (70 In group A and 108 in group B). Baseline chrematistics (age p= 0.815, sex p=0.0324, indication of surgery, ASA grade p=0.086) were not statistically different between groups. The percentage of malignancy on histology did not statistically differ (23% for group 1 and 36% for group 2, p=0.069). Group A patients were found to have borderline low adjusted calcium level (&amp;lt;2.2 mmol/l) in 6% of the cases (lowest level of recorded calcium was 2.13 mmol/l). The mean adj. calcium for Group A pts was 2.34 (SD:0.1). There were no patients in Group A or group B who developed clinical symptoms of hypocalcemia. The length of stay (LOS) did not statistically differ (mean LOS:1.3 days for group 1 (SD:1.4) and 1.3 days (SD:1.6) for group 2, p=0.981). Conclusion Hemithyroidectomy patients do not develop clinically relevant hypocalcaemia, hence do not require routine post-operative serum calcium measurement. This could be a cost-saving and quality-improvement initiative for Units performing thyroid surgery.

Characteristics and outcome of severe hypercalcemia on admission to the emergency department: a retrospective cohort study.

To investigate the prevalence of hypercalcemia (>2.60 mmol/l) and severe hypercalcemia (≥2.80 mmol/l) on admission. Symptoms, causes, course of serum calcium, treatment and outcome of severe hypercalcemia were evaluated and compared to historical data from previous studies. In this retrospective cohort study, all patients presenting to the interdisciplinary emergency department of the Buergerspital Solothurn between 01 January 2017 and 31 December 2020 with measurements of serum calcium were included. Chart reviews were performed for patients with calcium ≥2.80 mmol/l to assess clinical presentation, course of disease and treatment for severe hypercalcemia. Of 31,963 tested patients, 869 patients (2.7%) had hypercalcemia on the admission, of which 161 had severe hypercalcemia. Non-albumin corrected calcium was 3.07 (0.32) while albumin corrected calcium was 3.34 (0.44). Calcium was higher in patients with malignancy-related hypercalcemia (3.18 [0.34] versus 3.00 [0.3], p <0.001). Neuropsychiatric (35%) and gastrointestinal (24%) were the leading symptoms. Malignancy was the most common identifiable cause of hypercalcemia (40%), with lung cancer (20%), multiple myeloma (14%) and renal cell carcinoma (11%) being the main cancer types. 36% of patients with severe hypercalcemia took calcium supplements. Bisphosphonate treatment was an independent predictor of a fall in calcium until day 5 (regression coefficient: -0.404, standard error 0.11, p <0.001). Hypercalcemia was not mentioned in the final discharge report in 38% of cases. Severe hypercalcemia is common and malignancy-related in almost half of the cases. Neuropsychiatric and gastrointestinal symptoms were most prevalent. Awareness of hypercalcemia, particularly in cancer patients and those with known triggering factors, should be raised in order to identify and treat this harmful disorder early.

Rapid detection of serum calcium based on supramolecular aggregates of a cationic perylene in vitro

The steady-state level of serum calcium is of great significance to human body. Accurate and rapid detection of serum calcium is a crucial component of clinical diagnosis and blood calcium census. Current detection of Ca2+ in living environment mainly focus on intracellular imaging, and there are few probes appropriate for serum calcium detection. In this work, we designed a fluorescence sensing system based on the indicator displacement assays (IDAs) strategy using supramolecular complex formed by 3,4,9,10-tetra-(4-trimethylaminobutoxy-carbonyl)-perylene (PBTMA) and casein phosphopeptides (CPPs). Due to the synergistic effect of non-covalent interactions, the complex can be induced by Ca2+ to disintegrate, thus realizing the visual and rapid detection of serum calcium. The quantitative range is 0.01–3.0 mM, while the limit of detection (LOD) and the visual detection limit are 8.4 μM and 0.1 mM, respectively. This method features good stability, selectivity and anti-interference. It can be used for serum samples (recovery rate: 103.4%–106.3%; relative standard deviation (RSD): 2.21%–3.46%). Furthermore, a portable device for rapid serum calcium measurement was designed, which could substantially improve the applicability of this method. To our knowledge, this is the first organic small molecule fluorescent probe capable of application in the range of serum calcium concentrations.