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Published on: June 2, 2022
Association of Serum Calcium with the Risk of Chronic Obstructive Pulmonary Disease: A Prospective Study from UK
Xinglin Wan1, Lulu Chen2, Zheng Zhu2
1Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Insights
High serum calcium levels, or hypercalcemia, are linked to increased risk of developing chronic obstructive pulmonary disease (COPD) and dying from it. This suggests calcium may influence COPD progression.
Area of Science:
- Biomedical Research
- Pulmonary Medicine
- Clinical Epidemiology
Background:
- Intracellular calcium's role in chronic obstructive pulmonary disease (COPD) pathogenesis is known.
- The association between serum calcium levels and COPD risk is not well-established.
Purpose of the Study:
- To investigate the relationship between serum calcium concentrations and the risk of COPD incidence and mortality.
Main Methods:
- Utilized UK Biobank data from 386,844 participants.
- Employed restricted cubic splines for dose-response analysis.
- Applied multivariable Cox regression to assess hazard ratios for COPD risk.
Main Results:
- A positive linear association was found between serum calcium and COPD incidence.
- Hypercalcemia (≥2.56 mmol/L) increased COPD risk by 14% (HR=1.14).
- Hypercalcemia significantly elevated COPD-specific mortality risk by 109% (HR=2.09).
Conclusions:
- Hypercalcemia is associated with higher COPD incidence and mortality in European populations.
- Serum calcium levels may play a role in COPD progression.
Background:
Although intracellular calcium had been demonstrated to involve in the pathogenesis of chronic obstructive pulmonary disease (COPD), the association between serum calcium and COPD risk remains unclear.
Methods:
We included 386,844 participants with serum calcium measurements and without airway obstruction at the baseline from UK Biobank. The restricted cubic splines were used to assess the dose-response relationship. Multivariable cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of albumin-corrected calcium concentrations with the risk of COPD incidence and mortality.
Results:
During a median of 12.3 years of follow-up, 10,582 incident COPD cases were documented. A linear positive association was observed between serum calcium concentrations and the risk of COPD incidence. Compared to participants with normal serum calcium (2.19-2.56 mmol/L), a 14% higher risk of COPD was observed in hypercalcemic participants (≥2.56 mmol/L, HR = 1.14; 95% CI: 1.02-1.27). No significant effect modifications were observed in stratified variables. In survival analysis, 215 COPD-specific deaths were documented after a median survival time of 3.8 years. Compared to participants with normal serum calcium, hypercalcemic participants had a 109% (HR = 2.09, 95% CI: 1.15-3.81) increased risk for COPD-specific mortality.
Conclusion:
Our study indicated that hypercalcemia was associated with an elevated risk of COPD incidence and mortality in the European population, and suggested that serum calcium may have a potential impact on the progression of COPD.
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