A Retrospective Study of Serum Calcium Status in Tehran, Iran (105,128 Samples, from 2009-2018)
-
Dariush D. Farhud
,
Marjan Zarif-Yeganeh
,
Atefeh Mehrabi
,
Ali-Reza Afshari
,
Mohammad Bagher Rokni
,
Keyvan Majidi
,
Maryam Jalali
,
Ali Akbar Amir Zargar
,
Abdolfattah Sarafnejad
,
Hamid Reza Sadeghipour
,
Shaghayegh Zokaei
,
Farideh Khosravi
,
Mahmoud Jalali
,
Mohammad Khazeni
Abstract
Background: Calcium is a necessary mineral for life to keep the body and bones healthy. Various factors including hormones, diet, age, and gender affect serum calcium status. The aim of this sturdy was to assess the serum calcium level (SCL) of Tehran population, which has about 10 million multi-Ethnic populations and represents from the whole country.
Methods: In this retrospective study, the measured SCL of 105,128 individuals referred to different laboratories of Tehran, Iran were evaluated and its relationship with the age, gender, seasons, and different years during 2009-2018, were analyzed.
Results: After excluding outliers, 91,257samples remained, which 61162 (58.64%) and 30,095 (41.36%) were female and male, respectively. The mean SCL was 9.36 (9.35, 9.37) mg/dl (95%CI). The highest and lowest SCLs were 3.1 and 18.2mg/dl, respectively. From the total study population, 74127 (81.23%) had normal SCLs, 14110 (15.46%) had hypocalcemia, and 3020 (3.31%) had hypercalcemia. SCLs were normal in 83.6% of men and 79.66% of women. Women had a significantly higher frequency of hypocalcemia compared to men (17.2% vs. 12.83%, p<0.0001).
Conclusion: Normal and abnormal SCLs were significantly different in age groups and in both genders. It means that gender and age affect SCLs. Every year of increasing age, reduces the chance of hypercalcemia by 40%, significantly. Age seems to affect hypercalcemia more than hypocalcemia. Age in men increases the risk of hypocalcemia, and reduces the risk of hypocalcemia in women. Therefore, it is recommended to encourage dietary calcium intake among premenopausal women and older men.
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31. Omidvar N, Neyestani T-R, Hajifaraji M, Eshraghian M-R, Rezazadeh A, Armin S, Haidari H, Zowghi T (2015). Calcium intake, major dietary sources and bone health indicators in Iranian primary school children. Iran J Pediatr, 25.
32. Bone HG, Bolognese MA, Yuen CK, Kendler DL, Wang H, Liu Y, San Martin J (2008). Effects of denosumab on bone mineral density and bone turnover in postmenopausal women. J Clin Endocrinol Metab, 93:2149-2157.
33. Covell LL, Ganti AK (2015). Treatment of advanced thyroid cancer: role of molecularly targeted therapies. Target Oncol, 10:311-24.
34. Pravina P, Sayaji D, Avinash M (2013). Calcium and its role in human body. International Journal of Research in Pharmaceutical and Biomedical Sciences, 4:659-668.
35. Van Cromphaut S, Rummens K, Stockmans I, et al (2003). Intestinal calcium transporter genes are upregulated by estrogens and the reproductive cycle through vitamin D receptor‐independent mechanisms. J Bone Miner Res, 18:1725-1736.
36. Rafferty K, Walters G, Heaney R (2007). Calcium fortificants: overview and strategies for improving calcium nutriture of the US population. J Food Sci, 72:R152-R158.
37. Mäkinen OE, Wanhalinna V, Zannini E, Arendt EK (2016). Foods for special dietary needs: Non-dairy plant-based milk substitutes and fermented dairy-type products. Crit Rev Food Sci Nutr, 56:339-349.
38. Maxwell JE, Sherman SK, O'Dorisio TM, Howe JR (2014). Medical management of metastatic medullary thyroid cancer. Cancer, 120:3287-301.
2. Health UDo, Services H (2004). Bone health and osteoporosis: a report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Office of the Surgeon General, 87.
3. Ross AC, Taylor CL, Yaktine AL, Del Valle HB (2011). Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academies Press.
4. Siyam FF, Klachko DM (2013). What is hypercalcemia? The importance of fasting samples. Cardiorenal Med, 3:232-238.
5. Shaker JL, Deftos L (2018). Calcium and phosphate homeostasis. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000.
6. DeLuca HF (2008). Evolution of our understanding of vitamin D. Nutr Rev, 66:S73-S87.
7. Farhud DD, Mehrabi A, Sarafnejad A, et al (2019). A comprehensive, epidemiological and ecological descriptive study on vitamin d status in Iran (308005 People, from 2009–2018). Iran J Public Health, 48:644.
8. Chen NC, Hsu CY, Chen CL (2017). The strategy to prevent and regress the vascular calcification in dialysis patients. BioMed Res Int, 2017.
9. Kraus MA, Kalra PA, Hunter J, Menoyo J, Stankus N (2015). The prevalence of vascular calcification in patients with end-stage renal disease on hemodialysis: a cross-sectional observational study. Ther Adv Chronic Dis, 6:84-96.
10. Bos D, Ikram MA, Elias-Smale SE, et al (2011). Calcification in major vessel beds relates to vascular brain disease. Arterioscler Thromb Vasc Biol, 31:2331-2337.
11. Bostick RM, Kushi LH, Wu Y, Meyer KA, Sellers TA, Folsom AR (1999). Relation of calcium, vitamin D, and dairy food intake to ischemic heart disease mortality among postmenopausal women. Am J Epidemiol, 149:151-161.
12. Walker HK, Hall WD, Hurst JW (1990). Clinical methods: the history, physical, and laboratory examinations. Boston: Butterworths; 1990. ISBN-10: 0-409-90077-X.
13. Cooper MS, Gittoes NJ (2008). Diagnosis and management of hypocalcaemia. BMJ, 336:1298-1302.
14. Frølich A (1998). Prevalence of hypercalcaemia in normal and in hospital populations. Dan Med Bull, 45:436-439.
15. Moe SM (2008). Disorders involving calcium, phosphorus, and magnesium. Prim Care, 35:215-237.
16. Del Valle HB, Yaktine AL, Taylor CL, Ross AC (2011). Dietary reference intakes for calcium and vitamin D. Washington (DC): National Academies Press (US); 2011.
17. Prasad N, Bhadauria D (2013). Renal phosphate handling: Physiology. Indian J Endocrinol Metab, 17:620.
18. Bellido T, Saini V, Pajevic PD (2013). Effects of PTH on osteocyte function. Bone, 54:250-257.
19. Copp DH, Cheney B (1962). Calcitonin—a hormone from the parathyroid which lowers the calcium-level of the blood. Nature, 193:381-382.
20. Felsenfeld AJ, Levine BS (2015). Calcitonin, the forgotten hormone: does it deserve to be forgotten? Clin Kidney J, 8:180-187.
21. Bansal N, Katz R, de Boer IH, et al (2013). Influence of estrogen therapy on calcium, phosphorus, and other regulatory hormones in postmenopausal women: the MESA study. J Clin Endocrinol Metab, 98:4890-4898.
22. Kassem M, Harris SA, Spelsberg TC, Riggs BL (1996). Estrogen inhibits interleukin‐6 production and gene expression in a human osteoblastic cell line with high levels of estrogen receptors. J Bone Miner Res, 11:193-199.
23. Beto JA (2015). The role of calcium in human aging. Clinical Nutrition Research, 4:1-8.
24. Anonymus (2021) URL. Available from: http://www.citypopulation.de/en/world/agglomerations/
25. Starki S, Loebis B, Husada SM, Mahdinasari NN, Efffendy E (2021). Calcium Levels Differences in Men with Schizophrenia Treated with Olanzapine and Risperidone in Prof. Dr. M Ildrem Psychiatric Hospital Medan. Open Access Macedonian Journal of Medical Sciences, 9:274-279.
26. Thongprayoon C, Cheungpasitporn W, Chewcharat A, Mao MA, Thirunavukkarasu S, Kashani KB (2020). Hospital mortality and long-term mortality among hospitalized patients with various admission serum ionized calcium levels. Postgrad Med, 132:385-390.
27. Balk E, Adam G, Langberg V, et al (2017). Global dietary calcium intake among adults: a systematic review. Osteoporos Int, 28:3315-3324.
28. Nicklas TA, O'Neil CE, Fulgoni III VL (2009). The role of dairy in meeting the recommendations for shortfall nutrients in the American diet. J Am Coll Nutr, 28:73S-81S.
29. Novotny R, Boushey C, Bock MA, et al (2003). Calcium intake of Asian, Hispanic and white youth. J Am Coll Nutr, 22:64-70.
30. Bailey RL, Gahche JJ, Lentino CV, et al (2011). Dietary supplement use in the United States, 2003–2006. J Nutr, 141:261-266.
31. Omidvar N, Neyestani T-R, Hajifaraji M, Eshraghian M-R, Rezazadeh A, Armin S, Haidari H, Zowghi T (2015). Calcium intake, major dietary sources and bone health indicators in Iranian primary school children. Iran J Pediatr, 25.
32. Bone HG, Bolognese MA, Yuen CK, Kendler DL, Wang H, Liu Y, San Martin J (2008). Effects of denosumab on bone mineral density and bone turnover in postmenopausal women. J Clin Endocrinol Metab, 93:2149-2157.
33. Covell LL, Ganti AK (2015). Treatment of advanced thyroid cancer: role of molecularly targeted therapies. Target Oncol, 10:311-24.
34. Pravina P, Sayaji D, Avinash M (2013). Calcium and its role in human body. International Journal of Research in Pharmaceutical and Biomedical Sciences, 4:659-668.
35. Van Cromphaut S, Rummens K, Stockmans I, et al (2003). Intestinal calcium transporter genes are upregulated by estrogens and the reproductive cycle through vitamin D receptor‐independent mechanisms. J Bone Miner Res, 18:1725-1736.
36. Rafferty K, Walters G, Heaney R (2007). Calcium fortificants: overview and strategies for improving calcium nutriture of the US population. J Food Sci, 72:R152-R158.
37. Mäkinen OE, Wanhalinna V, Zannini E, Arendt EK (2016). Foods for special dietary needs: Non-dairy plant-based milk substitutes and fermented dairy-type products. Crit Rev Food Sci Nutr, 56:339-349.
38. Maxwell JE, Sherman SK, O'Dorisio TM, Howe JR (2014). Medical management of metastatic medullary thyroid cancer. Cancer, 120:3287-301.
| Files | ||
| Issue | Vol 51 No 4 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i4.9245 | |
| Keywords | ||
| Calcium Hypocalcemia Hypercalcemia Iran | ||
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How to Cite
1.
Farhud DD, Zarif-Yeganeh M, Mehrabi A, Afshari A-R, Rokni MB, Majidi K, Jalali M, Amir Zargar AA, Sarafnejad A, Sadeghipour HR, Zokaei S, Khosravi F, Jalali M, Khazeni M. A Retrospective Study of Serum Calcium Status in Tehran, Iran (105,128 Samples, from 2009-2018). Iran J Public Health. 2022;51(4):839-850.
