1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2Division of Endocrinology and Metabolism, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.
3Division of Endocrinology and Metabolism, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
4Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
5Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Copyright © 2017 Korean Diabetes Association
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Calcium and Phosphate Levels are Among Other Factors Associated with Metabolic Syndrome in Patients with Normal Weight
Characteristic | Corrected serum calcium tertile, mg/dL | Total | P valuea | ||
---|---|---|---|---|---|
Tertile 1 (<8.70) | Tertile 2 (8.70–8.94) | Tertile 3 (>8.94) | |||
Number | 4,174 | 4,334 | 4,198 | 12,706 | |
Incident case | 1,263 (28.0) | 1,095 (27.4) | 1,090 (26.0) | 3,448 (27.1) | 0.089 |
Male sex | 2,319 (55.6) | 2,395 (55.3) | 2,159 (51.4) | 6,873 (54.1) | <0.001b |
Smoker | 0.045b | ||||
Never | 2,352 (56.3) | 2,431 (56.1) | 2,474 (58.9) | 7,257 (57.1) | |
Current | 697 (16.7) | 734 (16.9) | 689 (16.4) | 2,120 (16.7) | |
Past | 1,125 (27.0) | 1,169 (27.0) | 1,035 (24.7) | 3,329 (26.2) | |
Age, yr | 50.5±8.1 | 51.0±8.3 | 51.3±8.2 | 51.0±8.2 | <0.001 |
WC, cm | 81.1±8.7 | 81.4±8.7 | 80.9±8.6 | 81.1±8.7 | 0.029 |
BMI, kg/m2 | 23.3±2.6 | 23.4±2.6 | 23.3±2.6 | 23.3±2.6 | 0.170 |
SBP, mm Hg | 110±14 | 112±14 | 113±15 | 112±14 | <0.001 |
DBP, mm Hg | 68±10 | 69±10 | 70±10 | 69±10 | <0.001 |
FPG, mg/dL | 88±13 | 89±13 | 91±15 | 89±14 | <0.001 |
HbA1c, % | 5.4±0.5 | 5.4±0.5 | 5.5±0.6 | 5.4±0.6 | <0.001 |
Triglyceride, mg/dL | 111±58 | 115±61 | 117±68 | 114±62 | <0.001 |
HDL-C, mg/dL | 59±14 | 59±13 | 60±14 | 59±14 | 0.001 |
Corrected calcium, mg/dL | 8.56±0.08 | 8.82±0.07 | 9.17±0.18 | 8.85±0.28 | - |
Diabetes | 170 (4.1) | 174 (4.0) | 201 (4.8) | 545 (4.3) | 0.148b |
Hypertension | 404 (9.7) | 495 (11.4) | 512 (12.2) | 1,411 (11.1) | 0.001b |
Hypercholesterolemia | 78 (1.9) | 119 (2.7) | 133 (3.2) | 330 (2.6) | 0.001b |
Presence of two components of MetS | 938 (22.5) | 1,107 (25.5) | 1,123 (26.8) | 3,168 (24.9) | <0.001b |
HOMA2-IR (n=7,945) | 1.16 (0.49) | 1.16 (0.48) | 1.13 (0.45) | 1.15 (0.47) | 0.066 |
Variable | B | P value |
---|---|---|
Age, yr | 0.041 | <0.001 |
BMI, kg/m2 | 0.282 | <0.001 |
SBP, mm Hg | 0.081 | <0.001 |
DBP, mm Hg | 0.091 | <0.001 |
TG, mg/dL | 0.042 | <0.001 |
HDL-C, mg/dL | 0.033 | <0.001 |
FPG, mg/dL | 0.095 | <0.001 |
HbA1c, % | 0.100 | <0.001 |
HOMA2-IR (n=7,945) | –0.026 | 0.021 |
Variable | Corrected serum calcium tertile, mg/dL | P for trenda | Continuous variables HR (95% CI) | ||
---|---|---|---|---|---|
Tertile 1 (<8.70) | Tertile 2 (8.70–8.94) | Tertile 3 (>8.94) | |||
Number | 4,174 | 4,334 | 4,198 | 0.482b | |
Incident cases, n (%) | 1,164 (27.9) | 1,194 (27.5) | 1,090 (26.0) | ||
Person-years of follow-up | 18,925 | 18,974 | 17,320 | ||
Incident cases of MetS/1,000 person-year | 61.5 | 62.9 | 62.9 | ||
Adjusted HR (95% CI)a | |||||
Crude model | 1 (reference) | 1.02 (0.94–1.11) | 1.02 (0.94–1.11) | 0.849 | 1.05 (0.93–1.19) |
Model 1 | 1 (reference) | 1.01 (0.93–1.10) | 1.02 (0.94–1.11) | 0.915 | 1.06 (0.94–1.20) |
Model 2 | 1 (reference) | 0.91 (0.84–0.99) | 0.85 (0.78–0.92) | 0.001 | 0.80 (0.71–0.91) |
Variable | Corrected calcium tertile, mg/dL | P for trenda | Continuous variables HR (95% CI) | ||
---|---|---|---|---|---|
Tertile 1 (<8.70) | Tertile 2 (8.70–8.94) | Tertile 3 (>8.94) | |||
Subjects with central obesity (n=3,223) | 1,032 | 1,121 | 1,070 | ||
No. of subjects incident cases, n (%) | 547 (53.0) | 545 (48.6) | 473 (44.2) | <0.001b | |
Adjusted HR (95% CI)a | |||||
Crude model | 1 (reference) | 0.92 (0.81–1.03) | 0.85 (0.75–0.96) | 0.030 | 0.84 (0.70–1.00) |
Model 1 | 1 (reference) | 0.92 (0.82–1.04) | 0.87 (0.77–0.99) | 0.090 | 0.88 (0.73–1.05) |
Model 2 | 1 (reference) | 0.87 (0.77–0.98) | 0.83 (0.74–0.94) | 0.009 | 0.82 (0.68–0.98) |
Subjects without central obesity (n=9,483) | 3,142 | 3,213 | 3,128 | ||
No. of subjects incident cases, n (%) | 617 (19.6) | 649 (20.2) | 617 (19.7) | 0.833b | |
Adjusted HR (95% CI)a | |||||
Crude model | 1 (reference) | 1.08 (0.97–1.20) | 1.13 (1.01–1.27) | 0.087 | 1.19 (1.01–1.40) |
Model 1 | 1 (reference) | 1.07 (0.95–1.19) | 1.13 (1.01–1.26) | 0.117 | 1.20 (1.02–1.41) |
Model 2 | 1 (reference) | 0.99 (0.88–1.10) | 0.91 (0.81–1.02) | 0.183 | 0.83 (0.70–0.98) |
Variable | Corrected calcium tertile, mg/dL | P for trenda | Continuous variables HR (95% CI) | ||
---|---|---|---|---|---|
Tertile 1 (<8.70) | Tertile 2 (8.70–8.94) | Tertile 3 (>8.94) | |||
Subjects with two components of MetS (n=3,168) | 1,027 | 1,101 | 1,040 | ||
No. of subjects incident cases, n (%) | 643 (62.6) | 630 (57.2) | 554 (53.3) | <0.001b | |
Adjusted HR (95% CI)a | |||||
Crude model | 1 (reference) | 0.89 (0.80–1.00) | 0.85 (0.76–0.95) | 0.016 | 0.76 (0.64–0.89) |
Model 1 | 1 (reference) | 0.89 (0.80–1.00) | 0.86 (0.77–0.96) | 0.024 | 0.77 (0.65–0.90) |
Model 2 | 1 (reference) | 0.87 (0.78–0.97) | 0.82 (0.73–0.92) | 0.002 | 0.71 (0.60–0.84) |
Subjects with fewer than two components of MetS (n=9,538) | 3,236 | 3,227 | 3,075 | ||
No. of subjects incident cases, n (%) | 566 (17.5) | 565 (17.5) | 490 (15.9) | 0.103b | |
Adjusted HR (95% CI)a | |||||
Crude model | 1 (reference) | 1.05 (0.93–1.18) | 1.03 (0.91–1.16) | 0.724 | 1.08 (0.90–1.29) |
Model 1 | 1 (reference) | 1.05 (0.93–1.17) | 1.03 (0.91–1.17) | 0.751 | 1.10 (0.92–1.32) |
Model 2 | 1 (reference) | 0.94 (0.83–1.05) | 0.89 (0.79–1.01) | 0.173 | 0.89 (0.74–1.08) |
Values are presented as number (%) or mean±standard deviation. WC, waist circumference; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HbA1c, glycosylated hemoglobin; HDL-C, high density lipoprotein cholesterol; MetS, metabolic syndrome; HOMA2-IR, homeostasis model assessment index 2 for insulin resistance. aOne-way analysis of variance for continuous variables, bChi-square test.
BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; TG, triglyceride; HDL-C, high density lipoprotein; FPG, fasting plasma glucose; HbA1c, glycosylated hemoglobin; HOMA2-IR, homeostasis model assessment index 2 for insulin resistance.
Model 1: adjusted for age and sex; Model 2: adjusted for model 1+systolic blood pressure, diastolic blood pressure, triglyceride, high density lipoprotein, fasting plasma glucose, smoking status, and conditions under medical treatment, including hypertension, diabetes, and hypercholesterolemia. MetS, metabolic syndrome; HR, hazard ratio; CI, confidence interval. aCox proportional hazard model, bChi-square test for linear by linear association.
Model 1: adjusted for age and sex; Model 2: adjusted for model 1+systolic blood pressure, diastolic blood pressure, triglyceride, high density lipoprotein, fasting plasma glucose, smoking status, and conditions under medical treatment, including hypertension, diabetes, and hypercholesterolemia. HR, hazard ratio; CI, confidence interval; aCox proportional hazard model (
Model 1: adjusted for age, sex; Model 2: adjusted for model 1+waist circumference, systolic blood pressure, diastolic blood pressure, triglyceride, high density lipoprotein, fasting plasma glucose, smoking status, and conditions under medical treatment, including hypertension, diabetes, and hypercholesterolemia. MetS, metabolic syndrome; HR, hazard ratio; CI, confidence interval. aCox proportional hazard model (