Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Tip 2 Diyabetli Bireylerde Serum Kalsiyum Düzeyi ve Diyet Kalsiyum Alımı ile Kardiyometabolik Risk Faktörleri Arasındaki İlişki: Kesitsel Bir Çalışma
Association of Serum Calcium Level and Dietary Calcium Intake with Cardiometabolic Risk Factors in Patients with Type 2 Diabetes Mellitus: A Cross Sectional Study
Hatice ÖZÇALIŞKAN İLKAYa, Gülhan SAMURb
aErciyes Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, Kayseri, Türkiye
bHacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, Ankara, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(4):963-75
doi: 10.5336/healthsci.2022-90594
Article Language: TR
Full Text
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Amaç: Bu çalışmada, Tip 2 diyabetli bireylerde serum kalsiyum düzeyi ve diyet kalsiyum alımı ile kardiyometabolik risk faktörleri ve ilgili parametreler arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya 93'ü kadın (%78,2), 26'sı erkek (%21,8) olmak üzere toplam 119 Tip 2 diyabetli birey (medyan yaş=55 yıl) katılmıştır. Bireylere, yüz yüze görüşme yöntemi ile anket formu uygulanmıştır. Bireylerin beslenme alışkanlıkları, besin tüketim sıklıkları, 24 saatlik geriye dönük besin tüketim kayıtları, fiziksel aktivite kayıtları, antropometrik ölçüm değerleri, vücut bileşimi analizleri, biyokimyasal bulguları, kan basıncı ölçümlerine ilişkin veriler elde edilmiştir. Bulgular: Hemoglobin A1c (%) düzeyi <7 olan grupta, ≥7 olan gruba göre serum kalsiyum düzeyi anlamlı derecede yüksek iken (p<0,05); düşük yoğunluklu lipoprotein düzeyi <100 mg/dL olan grupta, ≥100 mg/dL olan gruba göre ve sistolik kan basıncı düzeyi <130 mmHg olan grupta, ≥130 mmHg olan gruba göre diyet kalsiyum alım miktarları anlamlı derecede yüksektir (her ikisi için p<0,01). Diyet kalsiyum alım düzeyi yeterli olan grupta, yetersiz olan gruba kıyasla çok düşük yoğunluklu lipoprotein kolesterol ve trigliserit konsantrasyonlarının düşüklüğü 3. modelde sınırda anlamlıdır (sırasıyla p=0,05; p=0,052). Diyet kalsiyum alım düzeyi yeterli olan grupta, yetersiz olan gruba göre sistolik kan basıncı düzeyi ilk analizde ve 1. modelde anlamlı miktarda düşüktür (her ikisi için p<0,05). Sonuç: Tip 2 diyabetli bireylerde serum kalsiyum düzeyi ve diyet kalsiyum alımı, bazı kardiyometabolik risk faktörleriyle ilişkilidir.

Anahtar Kelimeler: Tip 2 diabetes mellitus; serum kalsiyum düzeyi; diyet kalsiyum alımı; kardiyometabolik risk faktörleri
ABSTRACT
Objective: The aim of this study was to investigate the relationship between serum calcium level, dietary calcium intake, and cardiometabolic risk factors and associated parameters in patients with Type 2 diabetes mellitus (T2DM). Material and Methods: The study was conducted on a total of 119 patients with T2DM (93 women 78.2%, 26 men 21.8%; median age=55 years). A questionnaire form was applied to the individuals by face-to-face interview method. Data on individuals' nutritional habits, food consumption frequencies, 24-hour dietary recalls, physical activity records, anthropometric measurements, body composition analyzes, biochemical findings, blood pressure measurements were obtained. Results: In the group with hemoglobin A1c (%) <7, the serum calcium level was significantly higher than in the group with ≥7 (p<0.05). Dietary calcium intakes are significantly higher in the group with low-density lipoprotein cholesterol level <100 mg/dL compared to the group with ≥100 mg/dL, and in the group with systolic blood pressure level <130 mmHg compared to the group with ≥130 mmHg (for both, p<0.01). The lower very low-density lipoprotein cholesterol and triglyceride concentrations in the group with adequate dietary calcium intake compared to the group with inadequate dietary intake were borderline significant in the third model (p=0.05; p=0.052, respectively). The systolic blood pressure level was significantly lower in the group with adequate dietary calcium intake compared to the group with inadequate dietary calcium intake in the first analysis and first model (p<0.05 for both). Conclusion: Serum calcium level and dietary calcium intake are associated with some of cardiometabolic risk factors in individuals with T2DM.

Keywords: Type 2 diabetes mellitus; serum calcium level; dietary calcium intake; cardiometabolic risk factors
REFERENCES:
  1. Sasson C, Eckel R, Alger H, Bozkurt B, Carson A, Daviglus M, et al. American Heart Association Diabetes and Cardiometabolic Health Summit: Summary and Recommendations. J Am Heart Assoc. 2018;7(15):e009271. [Crossref]  [PubMed]  [PMC] 
  2. Cunha CM, Costa PRF, de Oliveira LPM, Queiroz VAO, Pitangueira JCD, Oliveira AM. Dietary patterns and cardiometabolic risk factors among adolescents: systematic review and meta-analysis. Br J Nutr. 2018;119(8):859-79. [Crossref]  [PubMed] 
  3. Drewnowski A, Rehm CD, Vieux F. Breakfast in the United States: Food and Nutrient Intakes in Relation to Diet Quality in National Health and Examination Survey 2011⁻2014. A Study from the International Breakfast Research Initiative. Nutrients. 2018;10(9):1200. [Crossref]  [PubMed]  [PMC] 
  4. Shah IU, Sameen A, Manzoor MF. Association of dietary calcium, magnesium, and vitamin D with type 2 diabetes among US adults: National health and nutrition examination survey 2007-2014-A cross‐sectional study. Food Sci Nutr. 2021;9(3):1480-90. [Crossref]  [PubMed]  [PMC] 
  5. Kong SH, Kim JH, Hong AR, Cho NH, Shin CS. Dietary calcium intake and risk of cardiovascular disease, stroke, and fracture in a population with low calcium intake. Am J Clin Nutr. 2017;106(1):27-34. [Crossref]  [PubMed] 
  6. Zhang F, Ye J, Zhu X, Wang L, Gao P, Shu G, et al. Anti-obesity effects of dietary calcium: the evidence and possible mechanisms. Int J Mol Sci. 2019;20(12):3072. [Crossref]  [PubMed]  [PMC] 
  7. Dugan CE, Fernandez ML. Effects of dairy on metabolic syndrome parameters: a review. Yale J Biol Med. 2014;87(2):135-47. [PubMed]  [PMC] 
  8. Gomes JMG, Costa JDA, Alfenas RCG. Effect of increased calcium consumption from fat-free milk in an energy-restricted diet on the metabolic syndrome and cardiometabolic outcomes in adults with type 2 diabetes mellitus: a randomised cross-over clinical trial. Br J Nutr. 2018;119(4):422-30. [Crossref]  [PubMed] 
  9. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007;92(6):2017-29. [Crossref]  [PubMed]  [PMC] 
  10. Wright DC, Hucker KA, Holloszy JO, Han DH. Ca2+ and AMPK both mediate stimulation of glucose transport by muscle contractions. Diabetes. 2004;53(2):330-5. [Crossref]  [PubMed] 
  11. Mu-oz-Garach A, García-Fontana B, Mu-oz-Torres M. Vitamin D status, calcium intake and risk of developing type 2 diabetes: an unresolved issue. Nutrients. 2019;11(3):642. [Crossref]  [PubMed]  [PMC] 
  12. Akter S, Eguchi M, Kochi T, Kabe I, Nanri A, Mizoue T. Association of serum calcium and phosphate concentrations with glucose metabolism markers: the furukawa nutrition and health study. Nutrients. 2020;12(8):2344. [Crossref]  [PubMed]  [PMC] 
  13. Sun G, Vasdev S, Martin GR, Gadag V, Zhang H. Altered calcium homeostasis is correlated with abnormalities of fasting serum glucose, insulin resistance, and beta-cell function in the Newfoundland population. Diabetes. 2005;54(11):3336-9. [Crossref]  [PubMed] 
  14. Fraser A, Williams D, Lawlor DA. Associations of serum 25-hydroxyvitamin D, parathyroid hormone and calcium with cardiovascular risk factors: analysis of 3 NHANES cycles (2001-2006). PLoS One. 2010;5(11):e13882. [Crossref]  [PubMed]  [PMC] 
  15. Pushparani DS, Nirmala S. High level of serum calcium and iron influences the risk of type 2 diabetes mellitus with periodontitis. Journal of Asian Scientific Research. 2014;4(2):70-82. [Link] 
  16. Nwankwor H, Nwatu C, Okwara C, Young E, Olisaka L, Ezomike N, et al. Low serum calcium levels occur in Nigerian adults with type 2 diabetes and correlates negatively with their glycosylated hemoglobin levels: A case-control study. Nigerian Journal of Medicine. 2020;29(2):229-33. [Crossref] 
  17. Hajhashemy Z, Rouhani P, Saneei P. Dietary calcium intake in relation to type-2 diabetes and hyperglycemia in adults: A systematic review and dose-response meta-analysis of epidemiologic studies. Sci Rep. 2022;12(1):1050. [Crossref]  [PubMed]  [PMC] 
  18. Papageorgiou M, Merminod F, Ferrari S, Rizzoli R, Biver E. Associations of calcium intake and calcium from various sources with blood lipids in a population of older women and men with high calcium Intake. Nutrients. 2022;14(6):1314. [Crossref]  [PubMed]  [PMC] 
  19. Das S, Choudhuri D. Role of dietary calcium and its possible mechanism against metabolic disorders: A concise review. J Food Biochem. 2021;45(4):e13697. [Crossref]  [PubMed] 
  20. Jayedi A, Zargar MS. Dietary calcium intake and hypertension risk: a dose-response meta-analysis of prospective cohort studies. Eur J Clin Nutr. 2019;73(7):969-78. [Crossref]  [PubMed] 
  21. Ozcaliskan Ilkay H, Sahin H, Tanriverdi F, Samur G. Association between magnesium status, dietary magnesium intake, and metabolic control in patients with type 2 diabetes mellitus. J Am Coll Nutr. 2019;38(1):31-9. [Crossref]  [PubMed] 
  22. Rakıcıoğlu N, Tek Acar N, Ayaz A, Pekcan G. Yemek ve Besin Fotoğraf Kataloğu. 2. Baskı. Ankara: Ata Ofset Matbaacılık; 2009.
  23. BeBİS (Beslenme Bilgi Sistemi) Beslenme Veri Tabanı Yazılımı. İstanbul: 2004. Stuttgart, Almanya: Hohenhim Üniversitesi. Erişim Tarihi: 05.10.2022 [Link] 
  24. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington (DC): National Academies Press (US); 1997. [PubMed] 
  25. Human energy requirements: report of a joint FAO/ WHO/UNU Expert Consultation. Food Nutr Bull. 2005;26(1):166. [PubMed] 
  26. Baysal A, Aksoy M, Besler HT, Bozkurt N, Keçecioğlu S, Mercanlıgil, ve ark; editörler. Diyet El Kitabı. 5. baskı. Ankara: Hatiboğlu Yayınları; 2008.
  27. Physical status: The use of and interpretation of anthropometry: report of a WHO Expert Committee. Geneva (Switzerland): Office of Publications, WHO; 1995. [Link] 
  28. Waist circumference and waist-hip ratio: report of a WHO expert consultation. Geneva (Switzerland): WHO Document Production Services; 2011. [Link] 
  29. American Diabetes Association Professional Practice Committee. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S144-S74. Erratum in: Diabetes Care. 2022. [Crossref]  [PubMed] 
  30. American Diabetes Association Professional Practice Committee, Draznin B, Aroda VR, Bakris G, Benson G, Brown FM, Freeman R, et al. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S83-S96. [Crossref]  [PubMed] 
  31. da Silva Ferreira T, Torres MR, Sanjuliani AF. Dietary calcium intake is associated with adiposity, metabolic profile, inflammatory state and blood pressure, but not with erythrocyte intracellular calcium and endothelial function in healthy pre-menopausal women. Br J Nutr. 2013;110(6):1079-88. [Crossref]  [PubMed] 
  32. Kim J, Hwang JY, Kim KN, Choi YJ, Chang N, Huh KB. Relationship between milk and calcium intake and lipid metabolism in female patients with type 2 diabetes. Yonsei Med J. 2013;54(3):626-36. [Crossref]  [PubMed]  [PMC] 
  33. Skowrońska-Jóźwiak E, Jaworski M, Lorenc R, Karbownik-Lewińska M, Lewiński A. Low dairy calcium intake is associated with overweight and elevated blood pressure in Polish adults, notably in premenopausal women. Public Health Nutr. 2017;20(4):630-7. [Crossref]  [PubMed] 
  34. Rosanoff A. Rising Ca:Mg intake ratio from food in USA Adults: a concern? Magnes Res. 2010;23(4):S181-93. [PubMed] 
  35. Dai Q, Shu XO, Deng X, Xiang YB, Li H, Yang G, et al. Modifying effect of calcium/magnesium intake ratio and mortality: a population-based cohort study. BMJ Open. 2013;3(2):e002111. Erratum in: BMJ Open. 2013;3(5):null. [Crossref]  [PubMed]  [PMC] 

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