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    ABSTRACT: We sought to evaluate the association of urine calcium excretion (UCaE), which reflects systemic calcium absorption, with cardiovascular (CV) events and mortality in outpatients with prevalent coronary heart disease (CHD). Calcium supplementation is associated with vascular calcification and adverse CV outcomes in patients with end-stage renal disease. Recent studies have raised concern that this phenomenon may also extend to the general population. However, previous studies have assessed oral calcium intake, which correlates poorly with systemic calcium absorption. We measured UCaE from 24-hour urine collections provided by 903 outpatients who were recruited from 2000 to 2002. We used Cox proportional hazard models to evaluate the association of baseline UCaE with a primary end point of any CV event (myocardial infarction [MI], heart failure, stroke, or CV mortality). During a mean follow-up of 6 ± 3 years, 287 subjects (32%) had a CV event. After multivariate adjustment for demographics, traditional CV risk factors, and kidney function, there was no association between UCaE and the primary end point of any CV event (per 10-mg/day greater UCaE, hazard ratio 1.00, 95% confidence interval 0.98 to 1.02). Evaluation of individual CV outcomes revealed a lower rate of MI with higher UCaE (hazard ratio 0.97, 95% confidence interval 0.94 to 1.00). In conclusion, greater UCaE is not associated with higher overall CV event rates or mortality in outpatients with stable CHD. On the contrary, greater UCaE is associated with a modestly lower rate of MI. These findings suggest that greater systemic calcium absorption does not confer CV harm in outpatients with prevalent CHD.
    The American journal of cardiology 09/2012; 110(12). DOI:10.1016/j.amjcard.2012.08.007 · 3.43 Impact Factor
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    ABSTRACT: Appropriate calcium intake is necessary for the accrual and maintenance of bone mass. A significant proportion of the world's population does not haveadequate calcium intake, and thus, supplementation plays akey role in maintaining bone homeostasis and other aspects of health. Since a series of reports fromthe Auckland calcium study and metaanalysisindicated that calcium supplementation was associated withan increased risk for adverse cardiovascular events,concern over the safety of calcium supplementation has grown; however, considerable inconsistencies in the reproducibility were found and questions regarding the study methodologies have been raised. In addition, since the increased adverse cardiovascular events by calcium supplementation were observed in calcium-replete-subjects, it should be clarified whether the same risk profile would be observed in countries with low calcium intake. Dietary calcium intake varies widely across the world; cardiovascular event risk factors and outcomes also vary and appear to be the opposite of calcium intake levels. Furthermore, the effects of calcium supplementation were shown to depend on dietary calcium intake, with a better bone mineral density response for low calcium intake subjects compared to that in calciumreplete subjects. Based on these evidences, the risk-benefit ratio of calcium supplement is likely to be different in different region of the world. Therefore, accumulation of evidence to establish population-specific guidelines for calcium supplementation is warranted before extrapolating the results obtained from a limited number of studies to the other people with different age, gender, ethnicity and risk profile across the world. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Cellular Biochemistry 02/2015; DOI:10.1002/jcb.25119 · 3.37 Impact Factor
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    Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 04/2012; 27(4):960-1. DOI:10.1002/jbmr.1569 · 6.59 Impact Factor