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Journal article
Calcium Intake and Serum Calcium Level in Relation to the Risk of Ischemic Stroke: Findings from the REGARDS Study
Journal of stroke, v 21(3), pp 312-323
01 Sep 2019
PMID: 31590475
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background and Purpose Data on the association between calcium (Ca) and ischemic stroke are sparse and inconsistent. This study aimed to examine Ca intake and serum Ca levels in relation to risk of ischemic stroke.
Methods The primary analysis included 19,553 participants from the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study. A subcohort was randomly selected to create a case-cohort study (n=3,016), in which serum Ca levels were measured. Ischemic stroke cases were centrally adjudicated by physicians based on medical records. Cox proportional hazards regression for the cohort and weighted Cox proportional hazard regression with robust sandwich estimation method for the case-cohort analysis with adjustment for potential confounders were performed.
Results During a mean 8.3-year follow-up, 808 incident cases of ischemic stroke were documented. Comparing the highest quintile to the lowest, a statistically significant inverse association was observed between total Ca intake and risk of ischemic stroke (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.55 to 0.95; Plinear-trend=0.183); a restricted cubic spline analysis indicated a threshold effect like non-linear association of total Ca intake with ischemic stroke (Pnon-linear=0.006). In the case-cohort, serum Ca was inversely associated with the risk of ischemic stroke. Compared to the lowest, the highest quintile of serum Ca had a 27% lower risk of ischemic stroke (HR, 0.73; 95% CI, 0.53 to 0.99; Plinear-trend=0.013). Observed associations were mainly mediated by type 2 diabetes, hypertension, and cholesterol.
Conclusions These findings suggest that serum Ca has inverse and Ca intake has threshold effect like association with risk of ischemic stroke.
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Details
- Title
- Calcium Intake and Serum Calcium Level in Relation to the Risk of Ischemic Stroke: Findings from the REGARDS Study
- Creators
- Daniel T. Dibaba - Indiana University BloomingtonPengcheng Xun - Indiana University BloomingtonAlyce D. Fly - Indiana University BloomingtonAurelian Bidulescu - Indiana University BloomingtonCari L. Tsinovoi - Indiana University BloomingtonSuzanne E. Judd - University of Alabama at BirminghamLeslie A. McClure - Drexel UniversityMary Cushman - University of VermontFrederick W. Unverzagt - Indiana University – Purdue University IndianapolisKa He - Indiana University Bloomington
- Publication Details
- Journal of stroke, v 21(3), pp 312-323
- Publisher
- Korean Stroke Soc
- Number of pages
- 14
- Grant note
- U01 NS041588 / National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) R01ES021735 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA U01NS041588 / NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000488618300007
- Scopus ID
- 2-s2.0-85074080185
- Other Identifier
- 991019169419004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Peripheral Vascular Disease