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To update the efficacy and safety of different drugs for the treatment of patients with hyperphosphatemia in chronic kidney disease, we conducted a network meta-analysis of 22 therapies for the treatment of uncontrolled hyperphosphatemia in patients with chronic kidney disease (CKD). All randomized controlled trials on hyperphosphatemia published from January 2013 to November 2023 were searched from CNKI, VIP database, Wanfang database, PubMed, Scopus, and Cochrane databases. Meta-analysis was used to evaluate the serum phosphorus, calcium levels, total effective rate and adverse events of patients with chronic kidney disease (CKD). Data collection and quality evaluation were carried out by three evaluators, RevMan (5.5.3) and Stata (1.3.0). A total of 71 RCTs, and 22 treatment strategies were included in this NMA. The results showed that all treatment strategies were effective in improving patients’ blood phosphorus levels. Among them, SL + CT, CA + CC, SL and TCM had higher overall efficacy, RT, TCM and SL + CT had lower blood phosphorus levels, SL + CT, SL and NAM had lower blood calcium levels, and OAC, CC, NAM and SL had higher safety. Among them, SL + CT seems to be the most recommended treatment strategy. In addition, multidrug combination strategies usually have a higher efficacy and safety profile. [ABSTRACT FROM AUTHOR]

Context Serum calcium is frequently measured during the neonatal period, and it is known to be influenced by the vitamin D status. Objective We hypothesized that the 25-hydroxyvitamin D (25OHD) concentration may influence the lower limit of the serum calcium normal range in neonates. Methods We included in our prospective cohort study 1002 mother-newborn pair recruited from April 2012 to July 2014, in 2 centers located in the neighborhoods of Paris, France, whose serum calcium was measured at 3 days of life. We established, after exclusion of outliers, a 95% CI for serum calcium (i) in our whole population of 1002 neonates; (ii) in neonates with a cord blood 25OHD concentration ≥ 30 nmol/L; and (iii) in those with a 25OHD ≥ 50 nmol/L. Results The mean serum total calcium was 2.46 ± 0.13 nmol/L (95% CI: 2.19-2.72 mmol/L), 2.47 ± 0.25 mmol/L (95% CI: 2.22-2.72 mmol/L), and 2.50 ± 0.25 mmol/L (95% CI: 2.25-2.75 mmol/L) in the whole group, in the 514 neonates with 25OHD ≥ 30 nmol/L, and in the 202 neonates with 25OHD ≥ 50 nmol/L respectively. The lower limit of the 95% range was significantly higher in neonates with 25 OHD ≥ 30 nmol/L (P < 0.05) and ≥ 50 nmol/L (P <.001) than in the entire cohort. Conclusion We show that the lower limit of the normal serum calcium range is higher in groups with a higher 25OHD than in unselected subjects. We propose that the reference range for serum calcium in neonates is 2.25 to 2.75 mmol/L. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the association between serum calcium level and the risk of acute kidney injury (AKI) in patients with subarachnoid hemorrhage (SAH). Methods: In this retrospective cohort study, data on adults from the Medical Information Mart for Intensive Care (MIMIC-III and MIMIC-IV) databases, spanning from 2008 to 2019, were extracted. In the logistic regression models, confounding variables, including age, white blood cell (WBC), systolic blood pressure (SBP), heart rate, blood urea nitrogen (BUN), glucose, international normalized ratio (INR), and the Charlson Comorbidity Index (CCI), were finally adjusted by stepwise regression. The outcome event was the occurrence of AKI after intensive care unit (ICU) admission. The univariate and multivariate logistic regression models were utilized to assess the association between serum calcium level and the risk of AKI in SAH patients, with odds ratios (ORs) and 95% confidence intervals (CIs). To further explore the association, subgroup analyses were performed, stratified by age, Glasgow Coma Scale (GCS) scores, drugs, and surgical methods. Results: A total of 1,128 patients with SAH were included in the study, of which 457 patients developed AKI. Low levels of serum calcium were significantly associated with a high risk of AKI in patients with SAH, with an OR (95%CI) of 1.38 (1.01–1.89). Further subgroup analyses showed that low levels of calcium were significantly associated with a high risk of AKI in SAH patients aged ≥60 years (OR = 0.27, 95%CI: 0.09–0.83), who had GCS score ≥13 (OR = 1.57, 95%CI: 1.08–2.30), who did not use calcium channel blockers (CCB) (OR = 2.22, 95%CI: 1.16–4.25) and angiotensin-converting enzyme (ACE) inhibitors (OR = 1.51, 95%CI: 1.06–2.14), and who did not undergo aneurysm embolization (OR = 1.48, 95%CI: 1.01–2.17) and aneurysm clipping (OR = 1.45, 95%CI: 1.04–2.01). Conclusion: The results of our study indicated that low levels of serum calcium were significantly associated with the risk of AKI in patients with SAH. [ABSTRACT FROM AUTHOR]

This cohort study was to assess the association between serum calcium levels and the risk of acute kidney injury (AKI) in acute myocardial infarction (AMI) patients. This study was analyzed using data of 1286 AMI patients aged ≥18 years who stayed in ICU more than 24 h in Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Univariable logistic regression model was established to identify potential covariates. Univariate and multivariable logistic regression models were used to analyze the association between serum calcium and the risk of AKI in patients with AMI. The association between serum calcium and the risk of AKI in patients with AMI was also shown by restricted cubic spline (RCS) plot. Odds ratio (OR) and 95% confidence interval (CI) were calculated. The median follow-up time was 1.61 (1.23, 2.30) days, and 436 (33.90%) participants had AKI at the end of follow-up. After adjusting for covariates, elevated level of serum calcium level was related to reduced risk of AKI in AMI patients (OR = 0.88, 95%CI: 0.80–0.98). Decreased risk of AKI was found in AMI patients with serum calcium level of 8.40–8.90 mg/dL (OR = 0.54, 95%CI: 0.34–0.86) or ≥8.90 mg/dL (OR = 0.60, 95%CI: 0.37–0.99). The RCS plot depicted that serum calcium level was negatively correlated with the risk of AKI in patients with AMI. AMI patients with AKI had lower serum calcium levels compared with those without AKI. Increased serum calcium level was associated with decreased risk of AKI in patients with AMI. [ABSTRACT FROM AUTHOR]

Thongprayoon et al. found in a study of 12,599 non-dialysis adult hospitalized patients that serum calcium (SC) disturbances affected more than half of the patients and were associated with increased in-hospital mortality. Similar impacts of SC disturbances on in-hospital mortality have been observed in patients with acute myocardial infarction and the general hospitalized population. Atrial fibrillation (AF), the most common arrhythmia in the intensive care unit (ICU), affects around 6% of critically ill patients. However, the significance of the relationship between SC levels and in-hospital mortality in these patients remains unclear. This study aimed to explore the correlation between SC levels and in-hospital mortality in ICU patients diagnosed with AF. Data from the MIMIC-IV database included 11,621 AF patients (average age 75.59 ± 11.74 years; 42.56% male), with an in-hospital mortality rate of 8.90%. A nonlinear relationship between SC levels and in-hospital mortality was observed. Effect sizes on either side of the inflection point were 0.79 (HR: 0.79, 95% CI 0.67–0.94, P = 0.006) and 1.12 (HR: 1.12, 95% CI 1.01–1.25, P = 0.029). Sensitivity analyses confirmed these results. SC levels around 8.56 mg/dL were associated with the lowest risk of in-hospital mortality, with risks increasing as SC levels deviated from this point. SC levels below this inflection point were linked to more pronounced clinical impacts. This finding has significant clinical implications for clinicians. Therefore, in the treatment of ICU patients with AF, clinicians should closely monitor SC levels, with a focus on maintaining them around 8.56 mg/dL. [ABSTRACT FROM AUTHOR]

Background/Objectives: Type II diabetes mellitus (T2DM) is recognized as a condition of mild chronic inflammation, marked by increased levels of acute-phase proteins and various inflammatory indicators. These inflammatory substances, along with inflammation of adipose tissue and the secretion of adipocytokines, can contribute to insulin resistance and β cell dysfunction. By influencing both innate and adaptive immunity, vitamin D can inhibit the production of inflammatory cytokines and help mitigate the low-grade chronic inflammation associated with T2DM. Several strategies have been proposed to increase vitamin D levels effectively and safely, but the recent and strong ones have common tactics. Short-term high doses increase the level acutely, and long-term lower doses maintain sufficient levels. Methods: The aim of our work was to determine and verify the effectiveness of high doses of vitamin D to safely increase its level in patients with type 2 diabetes mellitus, as well as the effect of these doses on selected metabolic parameters. Data from 20 studies (vitamin D group n = 612, and control group n = 592) regarding the influence of vitamin D supplementation with doses above 4000 IU on serum 25(OH)D, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), blood pressure, serum calcium, and parathormone were pooled. Results: Vitamin D supplementation significantly improved serum 25(OH)D levels, with an average increase after intervention versus baseline at 177.09%. Our studies suggest that vitamin D supplementation may benefit various parameters in T2DM patients, including glycemic control, blood pressure, and PTH levels. Conclusions: Vitamin D supplementation may have beneficial effects on various parameters in type 2 diabetes patients, including glycemic control, blood pressure, and parathormone levels. However, the results are only sometimes consistent across all studies. Further examination is needed. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency and its outcome of parathyroid preservation in total thyroidectomy. Study Design: Case Series study. Setting: Department of Otorhinolaryngology, HMC, MTI, Peshawar. Period: 23rd June 2022 to 23rd Dec 2022. Methods: A total of 246 patients who underwent thyroidectomy were included in the study and followed up to determine the preservation of parathyroid gland, hypocalcaemia and recurrent laryngeal nerve injury. Results: The mean age of the sample was 37.7 + 12.3 years. There were 52.8% male patients and 47.2% female patients. 28.9% of patients had thyroid nodule and subtotal thyroidectomy was the most performed procedure Parathyroid gland preservation was recorded in 72%. On follow up, hypocalcemia was recorded in 16.3% and recurrent laryngeal nerve injury in 20.3%. Conclusion: Hypocalcemia and RLNI are significantly common after thyroidectomy. Hypocalcemia was significantly high in patients with low non preserved parathyroid gland. More research on high sample size and addressing other effect modifiers are recommended with intervention to preserve parathyroid gland. [ABSTRACT FROM AUTHOR]

Background:The relationship between serum calcium levels and the prognosis of cerebral infarction remains controversial. Purpose: This study aims to investigate the correlation between serum calcium levels and in-hospital mortality in critically ill patients with ischemic stroke admitted to the intensive care unit (ICU). Methods: A retrospective cohort study was conducted using data from the MIMIC-IV database. Demographic and clinical data of all participants were collected including gender, age, hypertension, diabetes, myocardial infarction, heart failure, chronic obstructive pulmonary disease, hemoglobin, potassium, sodium, anion gap, platelets, white blood cells, glucose, creatinine, Glasgow coma score (GCS), IV-tPA administration (rt-PA), and mechanical thrombectomy (MT). The outcome measure was in-hospital death. Multivariable-adjusted logistic regression analysis, curve fitting, interaction analysis, and threshold eect analysis were employed to evaluate the relationship between serum calcium levels and in-hospital mortality among ICU patients with cerebral infarction. Results: A total of 2,680 critically ill patients with cerebral infarction were enrolled, with a mean serum calcium level of 8.6 ± 0.8 mg/dL. The overall inhospital mortality rate was 19.5%, where Group 1 (serum calcium < 8.0 mg/dL) had a mortality rate of 27.7%, Group 2 (serum calcium 8–9 mg/dL) had a rate of 19.8%, and Group 3 (serum calcium ≥ 9 mg/dL) had a rate of 13.9%. There was a non-linear, S-shaped relationship between serum calcium levels and inhospital mortality. Serum calcium levels within the range of 7.70–9.50 mg/dL were found to be independently associated with increased in-hospital mortality in ICU patients with cerebral infarction. No significant interactions were detected in subgroup analyses, and the results of sensitivity analyses remained stable. Conclusion: Serum calcium levels are independently associated with in-hospital mortality in critically ill patients with cerebral infarction in the ICU setting. Within the range of 7.70–9.50 mg/dL, lower serum calcium levels increase the risk of in-hospital death among these patients, emphasizing the importance of close monitoring by ICU physicians [ABSTRACT FROM AUTHOR]

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Introduction: Urolithiasis is the formation of stony concretions in the bladder or urinary tract. Nearly 10% of the population suffers from urolithiasis, which has a high chance of recurring. Many resources are used to treat urinary stones globally, but the need for prevention has been neglected. Aim: To determine the levels of Calcium (Ca), Phosphorus (P), Uric Acid (UA) and Magnesium (Mg) in the blood and urine of patients with urolithiasis, as well as in urinary stones post-procedure. Materials and Methods: This cross-sectional study was conducted at the Department of General Surgery at the Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, Uttarakhand, India, from November 2021 to October 2022. A total of 80 patients suffering from urolithiasis were involved in the study. Serum and 24-hour urinary samples were collected for quantitative analysis of Mg, Ca, UA and Phosphate (Ph) levels. Urinary stones postsurgery were sent to the biochemistry section of the reference laboratory for semi-quantitative colorimetric determination and morphological analysis. Spearman’s Rank correlation coefficient was used to correlate two quantitative variables and a p-value of

Abstract Background Calcium is pivotal in the regulation of bodily homeostasis, with numerous studies highlighting its link to cardiovascular disease in the adult population. However, the relationship between serum calcium levels and the prognosis of heart failure (HF) patients is not clear. This study explored the association between serum total calcium (STC) and in-hospital mortality in patients with HF. Methods Clinical data of 1,176 patients with HF were obtained from the Multiparametric Intelligent Monitoring in Intensive Care III (MIMIC-III) database. The patients were categorized into STC quartiles, and baseline characteristics were comprehensively analyzed. Univariate and multivariate analyses were employed to identify factors associated with in-hospital mortality. To explore the non-linear relationship between STC and mortality, a two-piecewise linear regression model was applied. Subgroup analyses were conducted to identify potential confounding variables. Results In this cohort, 159 (13.53%) patients experienced in-hospital mortality. Significant differences in various parameters were observed among STC quartiles. Univariate analysis identified numerous factors associated with mortality. Multivariate analysis confirmed STC as an independent predictor of in-hospital mortality, with a negative association persisting even after adjusting for confounding factors (odds ratio [OR]: 0.49, 95%CI: 0.32–0.76; P = 0.0016). Non-linear analysis revealed an inflection point at 8.41 mg/dL, below which the risk of in-hospital death significantly increased (OR: 0.26, 95%CI: 0.12–0.55; P = 0.0005). Subgroup analyses indicated a pronounced inverse association in patients without atrial fibrillation or chronic obstructive pulmonary disease, as well as those with a left ventricular ejection fraction ≤ 50%. Conclusion This study identified STC as an independent predictor of in-hospital mortality in HF patients, with a non-linear relationship.

Purpose: The associations between serum calcium levels and the risk of all-cause dementia and vascular dementia (VaD) are not well understood. Additionally, the potential roles of hypertension, diabetes, and depression in this association need to be explored. This study aimed to investigate the links between serum calcium and all-cause dementia and VaD and to assess the role of hypertension, diabetes, and depression in that association. Methods: For this cohort study, data were extracted from the UK Biobank, a population-based longitudinal survey with baseline assessments from 2006 to 2010 in England, Wales, and Scotland. A total of 363 182 participants without dementia at baseline were included. Cases of all-cause dementia and VaD were identified through database linkage until December 31, 2022. The hazards of all-cause dementia and VaD were estimated using Cox proportional hazards regression models. Mediation analyses were performed to evaluate the mediation effect of hypertension, diabetes, and depression. Results: During a median follow-up of 13.8 years, 5 836 cases of all-cause dementia and 1 301 cases of VaD were identified. Participants with higher levels of serum calcium (in the third and fourth quartile, > 2.37 to ≤ 2.43 mmol/L and > 2.43 mmol/L) had a lower risk of all-cause dementia compared to those in the first quartile (≤ 2.32 mmol/L) (Hazard Ratio [HR] [95% Confidence Interval (CI)] in Q3: 0.87 (0.81–0.93), HR [95% CI] in Q4: 0.90 [0.84–0.97]). For VaD, HRs (95% CIs) in the second, third, and fourth quartiles were 0.80 (0.69–0.93), 0.76 (0.65–0.89), and 0.80 (0.69–0.93), respectively. Hypertension, diabetes, and depression significantly explained 18.67%, 2.57%, and 18.91% of the mediation effects on serum calcium-related dementia, respectively. Diabetes and depression contributed 1.85% and 15.34% of mediation effects on the association between serum calcium and the risk of VaD. Conclusion: This study found that individuals with higher serum calcium levels (> 2.37 mmol/L) had a reduced risk of developing dementia. Hypertension, diabetes, and depression significantly mediated the association. These findings highlight the significance of considering serum calcium levels as a potential indicator for the development of dementia. Further, optimizing the treatment of associated diseases and managing risk factors, particularly for individuals with lower serum calcium levels, is important. [ABSTRACT FROM AUTHOR]

Abstract To explore the association between serum calcium levels within normal ranges and Diabetic Kidney Disease (DKD) in type 2 diabetes patients. In this cross-sectional study, we analyzed clinical data from type 2 diabetes patients admitted to the Endocrinology Department of the Affiliated Hospital of Qingdao University from January 1, 2021, to December 1, 2022. We measured serum calcium levels, corrected for albumin, and screened for diabetes-related complications, including DKD. The association between corrected serum calcium levels and DKD was evaluated using logistic regression, with adjustments made for potential confounders and a generalized additive model (GAM) to explore non-linear relationships, supplemented by subgroup analyses. Among the 3016 patients (52.55% male, 47.45% female), the mean corrected serum calcium was 2.29 ± 0.08 mmol/L. DKD was present in 38.73% of patients. A 0.1 mmol/L increase in corrected serum calcium was associated with a 44% increased risk of DKD (OR = 1.44, 95% CI 1.28–1.61, p < 0.0001). The GAM indicated a linear relationship between corrected serum calcium and DKD risk, consistent across subgroups. Corrected serum calcium levels were linearly associated with DKD risk in type 2 diabetes patients, underlining its potential role in risk assessment. These findings emphasize the clinical importance of monitoring serum calcium levels. However, the need for further prospective studies to confirm these findings is underscored by the study’s cross-sectional design.

Thyroid hormones play a key role in the calcium homeostasis. Abnormal calcium levels in patients with hypothyroidism may lead to disease complications such as bone deformity, arthritis, blood clotting disorders, and nervous system dysfunctions. Several studies reported that serum calcium levels altered in patients with hypothyroidism, but results were inconsistent. It was aimed to determine the levels of serum calcium and serum albumin in patients with hypothyroidism. In this case-control study, a total of 60 subjects (30 hypothyroid patients and 30 age-matched healthy controls) were enrolled, aged between 18-60 years. Serum calcium and serum albumin were estimated along with thyroid function tests in each study subject. A student unpaired t-test was performed to compare the mean of variables. Pearson correlation analysis was performed among cases. A p-value < 0.05 was considered statistically significant. The mean of serum calcium, serum albumin, triiodothyronine (T3) and thyroxine (T4) were found significantly low in cases as compared to controls (p<0.001). However, the mean of thyroid stimulating hormone (TSH) was found significantly high in cases as compared to controls (p<0.001). A significant negative correlation was found between serum albumin and TSH among cases (r= -0.516, p<0.01). Serum calcium has shown a negative correlation with T3, T4 and TSH, but not significant. In conclusion, results showed that the mean of serum calcium, serum albumin, T3 and T4 were found significantly low in cases compared to controls. A significant negative correlation was found between serum albumin and TSH among cases. [ABSTRACT FROM AUTHOR]

To explore the association between serum calcium levels within normal ranges and Diabetic Kidney Disease (DKD) in type 2 diabetes patients. In this cross-sectional study, we analyzed clinical data from type 2 diabetes patients admitted to the Endocrinology Department of the Affiliated Hospital of Qingdao University from January 1, 2021, to December 1, 2022. We measured serum calcium levels, corrected for albumin, and screened for diabetes-related complications, including DKD. The association between corrected serum calcium levels and DKD was evaluated using logistic regression, with adjustments made for potential confounders and a generalized additive model (GAM) to explore non-linear relationships, supplemented by subgroup analyses. Among the 3016 patients (52.55% male, 47.45% female), the mean corrected serum calcium was 2.29 ± 0.08 mmol/L. DKD was present in 38.73% of patients. A 0.1 mmol/L increase in corrected serum calcium was associated with a 44% increased risk of DKD (OR = 1.44, 95% CI 1.28–1.61, p < 0.0001). The GAM indicated a linear relationship between corrected serum calcium and DKD risk, consistent across subgroups. Corrected serum calcium levels were linearly associated with DKD risk in type 2 diabetes patients, underlining its potential role in risk assessment. These findings emphasize the clinical importance of monitoring serum calcium levels. However, the need for further prospective studies to confirm these findings is underscored by the study's cross-sectional design. [ABSTRACT FROM AUTHOR]

Introduction: Current studies on the association between serum calcium levels and carotid atherosclerosis have yielded inconsistent results. This study aimed to elucidate this relationship through a comprehensive meta-analysis. Methods: A systematic search of PubMed, Embase, Cochrane Library, Scopus, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Weipu (VIP), and Wanfang databases was conducted, supplemented by manual retrieval, from their inception to October 2023. Two independent researchers conducted literature searches, data extraction, and quality assessment. Meta-analysis was performed using Review Manager 5.3 software on studies that met the inclusion criteria. Results: The analysis included 9 cross-sectional studies, encompassing a total sample size of 9,720 participants. The meta-analysis revealed a significant statistical difference in serum calcium levels between the carotid atherosclerosis group and the control group (p = 0.03). The standardized mean difference between the two groups was 0.21 (95% CI: 0.02, 0.41) using the control group as a reference. Conclusions: Our systematic analysis indicates a significant positive correlation between serum calcium levels and carotid atherosclerosis. [ABSTRACT FROM AUTHOR]

Background/Objectives: The most important prognostic factors in curatively treated prostate cancer are T and N stage, histology, grade group and initial PSA. A recent study found that men with blood calcium levels at the high end of the normal range are over two-and-a-half times more likely to develop fatal prostate cancer than those with lower calcium levels. However, there is limited evidence regarding the prognostic value of calcium levels at the time of prostate cancer diagnosis. We aimed to determine whether a calcium level in the upper range of normal values has any prognostic value in curatively treated prostate cancer. Methods: We conducted a retrospective analysis of 84 consecutive patients with prostate cancer who underwent curative-intent radiotherapy—either as primary treatment or adjuvant therapy—using external beam radiotherapy with or without brachytherapy. We analyzed all pertinent prognostic factors that could potentially impact disease-free survival. Results: The study revealed that calcium levels at diagnosis significantly predict disease-free survival, whereas the initial PSA level did not hold prognostic significance—likely due to interference from benign prostatic hyperplasia. Conclusions: If our findings are validated, calcium levels at the time of prostate cancer diagnosis could be incorporated into future predictive and prognostic models. [ABSTRACT FROM AUTHOR]

Background: Metastatic bone cancers are a significant clinical problem because metastasis disrupts normal bone homeostasis, including calcium dysregulation. Much less is known about hypocalcemia and its clinical consequences. The study analyzed serum calcium changes in metastatic bone cancer patients, assessed differences across diagnoses and clinical stages, and evaluated alkaline phosphatase levels and types of bone lesions. Method: A prospective study was conducted on 100 metastatic bone cancers using convenience sampling, at Indus Medical College Hospital, between March and April 2020. The patients were categorized based on the principle tumor type, clinical stage, and bone scan results. Serum calcium, corrected calcium, albumin, and ALP are measured and analyzed using descriptive and inferential statistics. Data analysis was done by SPSS using one-way ANOVA, t-tests, Pearson correlation, regression analysis, and Chi-square tests. A p-value of

PurposeThis study aimed to investigate the association between serum calcium levels and periodontitis in a U.S. adult population, using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2014.MethodData were analyzed from 8,601 participants aged over 30 years, who were categorized based on the presence or absence of periodontitis. Serum calcium levels were measured using standardized NHANES protocols, and periodontitis status was determined through clinical oral examinations. To assess the relationship between calcium levels and periodontitis, multivariate logistic regression models were applied across three levels of adjustment. Additionally, trend tests and subgroup analyses were conducted to explore associations across different demographic and clinical subgroups. A smoothing curve fitting and threshold effect analysis were also performed to examine potential nonlinear relationships.ResultsAfter adjusting multiple covariates, participants in the highest quartile of serum calcium showed an 18% reduced risk of periodontitis compared to those in the lowest quartile (OR = 0.82, 95% CI: 0.71–0.95, p = 0.0083; p for trend = 0.0057). The association remained stable across various subgroups. Smoothing curve fitting indicated a nonlinear negative correlation between calcium levels and periodontitis, though without a significant inflection point at 2.48 mmol/L (p = 0.094).ConclusionElevated serum calcium levels appear to be associated with a lower risk of periodontitis in adults. These findings suggest that adequate calcium intake may play a role in periodontitis prevention, providing valuable insight for clinical guidance on nutritional and preventive strategies in periodontal health.

AimThis study aimed to evaluate the association between serum calcium level and the risk of acute kidney injury (AKI) in patients with subarachnoid hemorrhage (SAH).MethodsIn this retrospective cohort study, data on adults from the Medical Information Mart for Intensive Care (MIMIC-III and MIMIC-IV) databases, spanning from 2008 to 2019, were extracted. In the logistic regression models, confounding variables, including age, white blood cell (WBC), systolic blood pressure (SBP), heart rate, blood urea nitrogen (BUN), glucose, international normalized ratio (INR), and the Charlson Comorbidity Index (CCI), were finally adjusted by stepwise regression. The outcome event was the occurrence of AKI after intensive care unit (ICU) admission. The univariate and multivariate logistic regression models were utilized to assess the association between serum calcium level and the risk of AKI in SAH patients, with odds ratios (ORs) and 95% confidence intervals (CIs). To further explore the association, subgroup analyses were performed, stratified by age, Glasgow Coma Scale (GCS) scores, drugs, and surgical methods.ResultsA total of 1,128 patients with SAH were included in the study, of which 457 patients developed AKI. Low levels of serum calcium were significantly associated with a high risk of AKI in patients with SAH, with an OR (95%CI) of 1.38 (1.01–1.89). Further subgroup analyses showed that low levels of calcium were significantly associated with a high risk of AKI in SAH patients aged ≥60 years (OR = 0.27, 95%CI: 0.09–0.83), who had GCS score ≥13 (OR = 1.57, 95%CI: 1.08–2.30), who did not use calcium channel blockers (CCB) (OR = 2.22, 95%CI: 1.16–4.25) and angiotensin-converting enzyme (ACE) inhibitors (OR = 1.51, 95%CI: 1.06–2.14), and who did not undergo aneurysm embolization (OR = 1.48, 95%CI: 1.01–2.17) and aneurysm clipping (OR = 1.45, 95%CI: 1.04–2.01).ConclusionThe results of our study indicated that low levels of serum calcium were significantly associated with the risk of AKI in patients with SAH.

Objectives The relationship between serum calcium and occurrence of MHO (metabolically healthy obesity) and MUNO (metabolically unhealthy non-obesity) remains unclear, and distinguishing these two phenotypes is difficult within primary healthcare units. This study explores that relationship.Methods This survey included 28590 adults from the National Health and Nutrition Examination Survey (NHANES) 2001–2018. Obesity phenotypes were categorized based on BMI and presence or absence of metabolic syndrome components. Weighted multivariate logistic regression analyses were used to assess the association between serum calcium levels and the obesity phenotype. Restricted cubic spline analysis characterized dose-response relationships, and stratified analyses explored these relationships across sociodemographic and lifestyle factors.Results The overall prevalence of MHO and MUNO were 2.6% and 46.6%, respectively. After adjusting for covariates, serum calcium exhibited a negative association with MHO [OR (95%): 0.49 (0.36,0.67), p

Background. Hypertension is the one of the important reasons of mortality and morbidity worldwide which affects around 6% to 32% of the general population. It has been documented that the serum calcium level has the impact on cardiovascular functions. Patients with essential hypertension display altered calcium metabolism, including elevated cytosolic calcium, reduced serum calcium levels and augmented urine excretion of calcium. Therefore, this study was undertaken in the direction for evaluate the link of calcium in newly diagnosed hypertensive patients. Materials and methods. This cross-sectional study was conducted in isolated newly diagnosed essential Hypertensive subjects who came to the hypertensive OPD, who were free from any other illness or under any medication. 100 cases and 50 controls were included in this study. Body mass index, Blood pressure and serum calcium levels were evaluated in the enrolled subjects. Student's t test and chi-square test were used for statistical analysis. Results. The mean serum calcium in newly diagnosed hypertensive group was 8.35 ± 1.04 and in control group it was 10.04 ± 0.66. The mean corrected calcium in newly diagnosed hypertensive group was 8.40 ± 1.01 and in control group it was 9.87 ± 4.76. These results were highly statistically significant p=0.000. Negative correlation was found between serum calcium and blood pressure among our subjects. Conclusion. Patients with essential hypertension had lower corrected serum calcium levels, and there was a substantial inverse association (negative correlation) between corrected serum calcium levels and blood pressures. So, while treating patients with hypertension, more attention to be given for the serum calcium levels.

Background: The role of oxidative stress in cardiovascular disease processes, such as atherogenesis, ischemic-reperfusion injury and cardiac remodeling, has been increasingly recognized in the past few decades. Currently, an increasing number of studies suggest that levels of oxidative stress markers in body fluids correlate with atherosclerotic disease activity. This finding may lead to novel clinical approaches in patients with coronary artery disease. Assessment of oxidative stress markers could modify risk stratification and treatment of patients with suspected coronary artery disease or myocardial infarction. Aim: To evaluate the patients of coronary artery disease proven by E.C.G, Coronary angiogram, and serum enzyme CK-MB. Methods: A Case-Control study was conducted among patients aged <65 years presenting with history consistent with AMI with Ischaemic myocardial pain > 30 min. duration but <24 hrs duration unrelieved by isosorbide dinitrate and ECG changes consistent with Tran mural infarction having 70% block in angiographic imaging for a period of 1 year from May -2021-June 2022.50 patients with AMI admitted in Acute coronary care unit and 30 matched controls. Serum level of Malondialdehyde (MDA) in patients and as well as the age and sex matched healthy controls. Serum Ascorbic Acid, lipid profile, serum ascorbic acid, serum calcium levels were correlated among the two groups. Results: Blood Malondialdehyde levels in study group is 6.0 ± 0.63 nmol/ml and in controls are 3.0 ± 0.53 nmol/ml. Serum ascorbic acid levels were decreased in study group. Serum Calcium level is increased in the study group with a mean value of 11.37 ± 0.58 mg/dl. in control group it was 10 ± 0.82 mg/dl. [ABSTRACT FROM AUTHOR]

Critical-sized long bone defects are those that would not heal spontaneously despite surgical stabilisation. The use of bioceramic scaffold has shown promising results in the repair of bone defects. The present study was undertaken to evaluate the serum biochemical parameters of Wistar rats treated for critical-sized segmental bone loss using biphasic hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) bioceramic scaffolds. The study was conducted in eighty male Wistar rats aged between 8-12 weeks, weighing 200-250 g body weight with critical-sized segmental defects in the femur. A 6 mm segmental mid-diaphyseal femoral defect was created under general anaesthesia. The bone defect was bridged with bioceramic scaffolds and retained in position with microplate and screws. Serum biochemical parameters serum calcium, phosphorous, acid phosphatase and alkaline phosphatase were evaluated four weeks before surgery, immediately after surgery and 4th, 8th, 12th, and 16th week after surgery. The evaluation of both serum calcium and phosphorous were found to be reliable indicators of new bone formation and mineralisation, whereas the evaluation of both serum acid phosphatase and alkaline phosphatase were found to be reliable indicators of bone healing during the treatment of critical-sized long bone defects in rats using biphasic hydroxyapatite and β-tricalcium phosphate bioceramic scaffolds. [ABSTRACT FROM AUTHOR]

Objectives: Aortic valve sclerosis has been proposed to signify greater cardiovascular risk; the correlation between serum trace elements and aortic valve sclerosis has been reported. Therefore, an in-depth exploration of the risk factors for aortic valve sclerosis and early intervention may reduce the risk of cardiovascular disease. Methods: In this study, Patients with aortic valve sclerosis and non-aortic valve sclerosis who underwent echocardiographic diagnosis in the People's Hospital of Xinjiang Uygur Autonomous Region during the period from 2019 to 2021 were selected for this study. The correlation between aortic valve sclerosis and serum phosphorus, calcium, and magnesium levels was explored using the propensity score matching technique by pairing the two groups of patients 1:1. Results: A total of 1,533 non-aortic valve sclerosis and 1,533 aortic valve sclerosis patients were included. Logistic regression analysis showed that serum magnesium [OR: 0.346; 95%CI: 0.227, 0.528] and serum calcium [OR: 7.022; 95%CI: 4.755, 10.369] were influential factors. Patients with low, intermediate, and high serum magnesium levels had a significantly lower risk of aortic valve sclerosis compared to patients with very low micronutrient levels (p < 0.05). Comparatively, patients with low or high serum calcium levels had an elevated risk of aortic valve sclerosis (p < 0.05). Conclusion: Serum magnesium may have a protective role against aortic valve sclerosis, while both low and high levels of serum calcium could be risk factor for the condition. These serum micronutrients may be indications of cardiovascular disease risk prediction or prevention, and more research is required. [ABSTRACT FROM AUTHOR]

In a previous study, we observed decreased 1,25-dihydroxyvitamin D levels, secondary hyperparathyroidism, and increased bone turnover markers in living kidney donors (LKDs) at 3 months and 36 months after kidney donation. In our recent survey-based study, we found no increased risk of fractures of all types but observed significantly more vertebral fractures in LKDs compared with matched controls. To elucidate the long-term effects of kidney donation on bone health, we recruited 139 LKDs and 139 age and sex matched controls from the survey-based participants for further mechanistic analyses. Specifically, we assessed whether LKDs had persistent abnormalities in calcium- and phosphorus-regulating hormones and related factors, in bone formation and resorption markers, and in density and microstructure of bone compared with controls. We measured serum markers, bone mineral density (BMD), bone microstructure and strength (via high-resolution peripheral quantitative computed tomography and micro-finite element analysis [HRpQCT]), and advanced glycation end-products in donors and controls. LKDs had decreased 1,25-dihydroxyvitamin D concentrations (donors mean 33.89 pg/mL vs. controls 38.79 pg/mL, percent difference = -12.6%; P  < .001), increases in both parathyroid hormone (when corrected for ionized calcium; donors mean 52.98 pg/mL vs. controls 46.89 pg/mL,% difference 13%; P  = .03) and ionized calcium levels (donors mean 5.13 mg/dL vs. controls 5.04 mg/dL; P  < .001), and increases in several bone resorption and formation markers versus controls. LKDs and controls had similar measures of BMD; however, HRpQCT suggested that LKDs have a statistically insignificant tendency toward thinner cortical bone and lower failure loads as measured by micro-finite element analysis. Our findings suggest that changes in the hormonal mileu after kidney donation and the long-term cumulative effects of these changes on bone health persist for decades after kidney donation and may explain later-life increased rates of vertebral fractures. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between serum uric acid and calcium levels and maternal and fetal complications in women diagnosed with preeclampsia. Early prediction, prevention, and management of preeclampsia are crucial for clinicians to improve health outcomes. Methods: The study included 189 women diagnosed with preeclampsia who delivered between 34 and 40 weeks of gestation, alongside a control group of 205 women without hypertension who delivered within the same gestational period. Data were retrospectively collected from the hospital records. Results: Pregnant women with preeclampsia had an average age of 30.9±6.3 years, which was significantly older than the 27.9±6.2 years in the control group (p<0.05). The average gestational week at birth was 37±1.7 in the case group and 38.0±1.4 in the control group, showing a significant difference (p<0.05). Emergency cesarean sections were more common in the preeclampsia group (p<0.05), whereas normal deliveries were prevalent in the control group (p<0.05). There were no significant differences in elective cesarean section rates between the groups. The case group had significantly higher rates of hospital stay, maternal intensive care requirement, intrauterine growth retardation, and in utero mort fetalis (p<0.05). Serum uric acid and calcium levels were significantly higher in the case group (p<0.05). Conclusion: Serum uric acid levels were significantly elevated in women with preeclampsia and correlated with severe complications, including eclampsia and hemolysis-elevated liver enzymes-low platelet syndrome, as well as prolonged intensive care stays for newborns. However, serum calcium levels did not show a significant association with maternal and fetal complications, highlighting the need for further research to explore these relationships. Identifying significant predictors of preeclampsia, such as serum uric acid levels, can aid in the early detection and management of preeclampsia, potentially reducing the risk of severe complications. Further randomized, controlled trials are needed to confirm these findings and explore preventive strategies. [ABSTRACT FROM AUTHOR]

Abstract Background There have been studies on the relationship between hepatitis B virus (HBV) infection and diet. We hypothesized HBV infection is related to dietary calcium intake, but the evidence is limited. This study aimed to examine whether dietary calcium intake is independently related to HBV infection in the United States population. Methods A total of 20,488 participants aged over 20 years from the National Health and Nutrition Examination Survey (NHANES), conducted from 2007 to 2020, were included in this study. Pearson correlation was used to test the association between dietary calcium and serum calcium. The relationships of HBV infection with dietary calcium and serum calcium were assessed by logistic regression models. Results There was a weak correlation between dietary calcium and serum calcium (r = 0.048). Logistic regression models indicated that HBV infection had a linear negative correlation with dietary calcium (OR 0.37; 95%CI 0.19, 0.76). For each additional 10 mg dietary calcium, the possibility of HBV infection was reduced by 63%. Hepatitis B positive participants had lower serum calcium content than negative participants. Stratified analysis shown the linear relationship between calcium and HBV infection varied among sex, race/ethnicity, and body mass index. Conclusion Our findings demonstrated HBV infection was linearly and inversely correlated with dietary calcium. The current study is expected to offer a fresh perspective on reducing HBV infection.

Background: Different investigations found electrolyte abnormalities in hypothyroidism. Basal processes and thyroid hormone effects on electrolytes like salt, potassium, and chloride are poorly understood. Few thyroid-electrolyte disorder data exist. We investigated the electrolyte imbalance between hypothyroidism and hyperthyroidism and their association. The mechanism and effect of thyroid hormones on mineral metabolism are also unknown. The present study examined the association between TSH and serum electrolytes (Sodium, Potassium, Chloride), Calcium, and Phosphorous in hypothyroid and hyperthyroid patients. Objective: We measured serum electrolytes (Sodium, Potassium, Chloride) and minerals (Calcium and Phosphorous) in hypothyroid and hyperthyroid patients and correlated them with serum TSH. Methods: 25 hyperthyroid and 294 hypothyroid cases were studied. 100 healthy controls were used. The thyroid profile (FT3, FT4, TSH), blood electrolytes (Sodium, Potassium, Chloride), and serum minerals (Calcium, Phosphorous) were determined and compared between patients and controls. Thyroid hormones were correlated with serum calcium, phosphorus, and electrolytes. Results: Hyperthyroid patients showed a substantial increase (p < 0.001) in serum calcium (11.14 ± 0.38) and phosphorous (4.48 ± 0.49) through statistical analysis. Significantly higher serum potassium (4.58±0.49) was observed in the hyperthyroid group. In the hyperthyroid group, serum sodium (133.11 ± 2.20) and chloride (100.73 ± 0.60) significantly decreased (p value <0.001) compared to the control group. A significant drop (p < 0.001) in serum calcium (7.66 ± 0.27) and phosphorous (2.83 ± 0.61) levels was predicted in hypothyroid patients. Conclusion: This study found highly unbalanced serum electrolytes in hypothyroid and hyperthyroid patients. To avoid complications, these individuals should have serum electrolytes monitored periodically. The present study also found that hypothyroid and hyperthyroid patients had abnormal mineral metabolism, which may cause metabolic problems. [ABSTRACT FROM AUTHOR]

Objective To investigate the influencing factors of acute kidney injury (AKI) in patients with severe acute pancreatitis (SAP). Methods A retrospective study was conducted to collect the clinical data of 66 patients with SAP, and they were divided into AKI group and non-AKI group according to whether they had AKI, and the risk factors of AKI in SAP patients were analyzed by logistic regression and receiver operating characteristic (ROC) curve, respectively. Results The overall age, acute physiology and chronic health status assessment (APACHEII.) scores of patients with SAP and AKI were higher than those without comorbidity, but diabetes mellitus was more common in patients without comorbidity (P<0.05). The results of stepwise regression analysis showed that increased APACHEII. score, SIRI, platelet/lymphocyte ratio (PLR), systemic immune inflammatory index (SII) and serum calcium were independent risk factors for AKI in SAP patients (P<0.05).< THE RESULTS OF ROC CURVE SHOWED THAT, IN ADDITION TO SERUM CREATININE, APACHE II. SCORE, SIRI INDEX AND SERUM CALCIUM LEVEL HAD CERTAIN DIAGNOSTIC VALUE FOR AKI IN PATIENTS WITH SAP, AMONG WHICH THE AUC OF APACHEII SCORE WAS 0.880 (95%CI 0.787~0.974, CUT-OFF VALUE 11.50 points), the AUC of SIRI index was 0.662 (95%CI 0.521~0.804, cut-off value 10.89), and the AUC of serum calcium level was 0.754(95%CI 0.627~0.881, cut-off value 2.07 mmol/L), P < 0.05; When the above three indexes were combined with serum creatinine, the diagnostic efficacy of AKI in patients with SAP could be further improved, and the AUC of serum creatinine + serum calcium was the largest, reaching 0.969 (95%CI 0.929~1.000, P<0.05). SIRI index and serum calcium level have diagnostic value for AKI in patients with SAP, and the combination of serum creatinine can improve the diagnostic efficacy of AKI, providing a new means for clinical identification of AKI in patients with SAP. [ABSTRACT FROM AUTHOR]

Introduction: Serum calcium rapidly declines at birth because of the sudden interruption of the maternal-fetal calcium influx. Several factors are known to influence serum calcium in the first days of life, including circulating concentrations of maternal vitamin D. Objective was to establish the normal range variations of neonatal serum calcium according to the current French vitamin D supplementation during pregnancy, i.e., 100,000 IU of cholecalciferol during the third trimester. Methods: We included in our prospective cohort study 1,002 mother-newborn dyads recruited from April 2012 to July 2014 in two centers located in the neighborhoods of Paris, France. Results: Total serum calcium at 3 days of life in neonates varied from 2.06 mmol/L to 2.73 mmol/L [2.5 and 97.5 percentiles], with a mean of 2.45 mmol/L. Serum calcium was similar between babies born from vitamin D-supplemented mothers and those born from non-supplemented ones. In univariate and multivariable analyses, we demonstrated the importance of maternal and cord blood 25(OH)D concentrations for newborn serum calcium maintenance. Conclusion: We established that the expected serum calcium in neonates ranges between 2.06 mmol/L and 2.73 mmol/L which is significantly wider than the adult range. This finding should help physicians in the diagnosis of hypo- or hypercalcemia. In addition, our study supports the importance of vitamin D supplementation and 25(OH)D status for neonatal serum calcium maintenance. [ABSTRACT FROM AUTHOR]

Simple Summary: In the present study, we tested whether supplementing dietary calcium for older sows would increase their blood calcium concentrations and decrease the incidence of stillbirths. We found that the increased dietary calcium did not influence blood calcium concentrations or the incidence of stillbirths. However, regardless of treatment, sows with low levels of calcium were associated with an increased incidence of stillbirths. In order to minimize stillbirths, sow nutritional management must aim to maintain adequate serum calcium concentrations. The present study was undertaken to determine the effect of daily calcium chloride (CaCl2) supplementation from day of entry into the farrowing house until day of farrowing (6.4 ± 0.3 d) on stillbirth rates. Landrace × Large White sows (parities 4 to 6; n = 53) were offered 40 g/d CaCl2 (n = 28) or served as controls (n = 25). The morning before their estimated farrowing date, a blood sample was obtained from 25 sows for calcium measurement and a urine sample from 22 sows for pH measurement. The feeding of CaCl2 decreased urinary pH compared to the control group (p < 0.001), indicative of an induced metabolic acidosis, but there was no effect of feeding CaCl2 on serum calcium concentrations or the incidence of stillbirths. Nonetheless, regardless of treatment, sows with higher serum calcium concentrations (>2.5 vs. <2.5 mmol) or lower urine pH (<7.0 vs. >7.0) had fewer stillborn piglets (p < 0.001 for both). While showing that low serum calcium levels will increase stillbirth rates, our data indicate that the administration of 40 g/d CaCl2 for 6 d prior to farrowing was not sufficient to increase serum calcium or decrease stillbirth incidence. [ABSTRACT FROM AUTHOR]

The success rate of extracorporeal shock wave lithotripsy (ESWL) is influenced by various factors, including stone density, and is determined through computed tomography scans in terms of Hounsfield units (HU). Materials and Methods: This retrospective single-center study was conducted in the King Fahad Hospital. Sixty-seven adult patients with renal and ureteric stones were selected randomly and enrolled in the study. Their ages ranged from 20 to 69 years. The patients were examined with non-contrast enhancement (NCCT) to assess the HU of their stones and were consequently treated with ESWL. Results: Of the 67 patients, 37.3% had stones that were completely fragmented, while 62.7% had stones that were partially fragmented. The HU, location of the stone, multiplicity of the stone, and patient age were found to be significant factors contributing to stone fragility (p-values < 0.05). The HU data were found to have a positive significant linear correlation with serum calcium (r = 0.28, p-value = 0.036), while serum acid had a negative correlation (r = −0.55, p-value < 0.001). Thus, the probability of calcium-containing stone formation increases with increased HU. In contrast, uric acid stone formation likely develops with decreasing HU with serum uric acid. Renal stones in patients with diabetes mellitus and hypertension were not completely fragmented compared to those without clinical history. Conclusions: Mean HU, location of the stone, laterality, stone status, and the number of ESWL sessions are the most significant factors affecting stone fragility. CT attenuation values can predict the composition of stones from serum calcium and uric acid examinations. Hypertension and diabetes mellitus are risk factors for renal stone fragmentation.

Abstract Background Chronic diarrhea is difficult to prevent and treat due to its complex etiology and pathogenesis. It places a huge burden on patients and public healthcare. It is known that the regulation of body homeostasis relies heavily on calcium. However, in the general population, the relationship between calcium and chronic diarrhea remains uncertain. Methods We assessed the association between serum calcium and diarrhea using data from the 2005–2010 National Health and Nutrition Examination Survey (NHANES). Serum calcium level was measured from collected blood samples. Diarrhea was assessed using the Bristol Stool Scale (BSFS) (types 1–7). The stability of the results was assessed using logistic regression and sensitivity analysis. The dose–response association between serum calcium and the risk of diarrhea was analyzed using a restricted cubic spline plot. Results This study included 12,342 participants. In each of the five models, an increased calcium level was negatively associated with the incidence of diarrhea (OR[95%CI]:0.26 [0.13–0.53], 0.28 [0.14–0.58], 0.4 [0.19–0.82], 0.27 [0.11–0.64] and 0.24 [0.10–0.59], respectively). When serum calcium was analyzed as a categorical variable, a significant association between serum calcium and diarrhea prevalence was found. The restricted cubic spline plot showed a linear relationship between serum calcium and diarrhea. Sensitivity analysis confirmed that the results were stable. Conclusion The results of our cross-sectional study suggest that a higher level of serum calcium may reduce the incidence of diarrhea. In the future, this finding should be further validated in a randomized controlled trial.

Abstract Objectives This study aimed to analyze the correlation between serum calcium changes and short-term prognosis of patients with acute type A aortic dissection. Methods Patients who underwent acute type A aortic dissection surgery at Fujian Heart Medical Center between June 2019 and June 2021 were retrospectively analyzed. Results A total of 383 patients were enrolled. According to the changing track of serum calcium in patients after acute type A aortic dissection, three potential category tracks were determined: high-level (n = 85), medium-level (n = 259), and continuous low-level groups (n = 39). Using the medium-level group as the control, regression analysis showed that poor prognosis risk was increased in the group with continuous low serum calcium (odds ratio = 2.454, P 48 h (odds ratio = 3.595, P

Objective Although high fusion rates have been reported for anterior cervical decompression and fusion (ACDF) in the medium and long term, the risk of nonfusion in the early period after ACDF remains substantial. This study investigates early risk factors for cage nonfusion in patients undergoing single‐ or multi‐level ACDF. Methods This was a retrospective study. From August 2020 to December 2021, 107 patients with ACDF, including 197 segments, were enrolled, with a follow‐up of 3 months. Among the 197 segments, 155 were diagnosed with nonfusion (Nonfusion group), and 42 were diagnosed with fusion (Fusion group) in the early period after ACDF. We assessed the significance of the patient‐specific factors, radiographic indicators, serum factors, and clinical outcomes. The Wilcoxon rank sum test, t‐tests, analysis of variance, and stepwise multivariate logistic regression were used for statistical analysis. Results Univariate analysis showed that smoking, insufficient improvement in the C2‐7 Cobb angle (p = 0.024) and the functional spinal unit Cobb angle (p = 0.022) between preoperative and postoperative stages and lower serum calcium (fusion: 2.34 ± 0.12 mmol/L; nonfusion: 2.28 ± 0.17 mmol/L, p = 0.003) β‐carboxyterminal telopeptide end of type 1 collagen (β‐CTX) (fusion: 0.51 [0.38, 0.71]; nonfusion: 0.43 [0.31, 0.57], p = 0.008), and N‐terminal fragment of osteocalcin (N‐MID‐BGP) (fusion: 18.30 [12.15, 22.60]; nonfusion: 14.45 [11.65, 18.60], p = 0.023) are risk factors for nonfusion in the early period after ACDF. Stepwise logistic regression analysis revealed that poor C2‐7 Cobb angle improvement (odds ratio [OR], 1.107 [1.019–1.204], p = 0.017) and lower serum calcium (OR, 3.700 [1.138–12.032], p = 0.030) are risk factors. Conclusions Patients with successful fusion after ACDF had higher preoperative serum calcium and improved C2‐7 Cobb angle than nonfusion patients at 3 months. These findings suggest that serum calcium could be used to identify patients at risk of nonfusion following ACDF and that correcting the C2‐7 Cobb angle during surgery could potentially increase fusion in the early period after ACDF.

In Romania, the highest incidence of tuberculosis (TB) within the European Union was reported in 2020, highlighting a significant health challenge. This is compounded by the COVID-19 pandemic, which has severely impacted healthcare services, including TB management. Both TB and COVID-19, diseases with considerable morbidity and mortality, have shown potential links to electrolyte imbalances. We conducted a prospective study at Victor Babes Hospital, Romania on 146 patients (74 with TB, 72 with COVID-19) between December 2021 and July 2023. This study assessed correlations between disease severity and serum calcium and magnesium levels, as well as pulmonary function. Adult patients with confirmed diagnoses and comprehensive medical records were included, excluding those with chronic respiratory diseases or unrelated electrolyte imbalances. Statistical analysis utilized the Kruskal–Wallis test and Dunn's procedure for non-normally distributed data. Low serum calcium and magnesium levels were significantly correlated with severe forms of TB and COVID-19, suggesting their potential as biomarkers of disease progression. Patients with more severe TB (i.e., multiple cavities) exhibited significantly lower serum calcium (p = 0.0049) and magnesium levels (p = 0.0004). ROC analysis revealed high AUC values for serum calcium and serum magnesium in predicting COVID-19 severity, indicating their potential as biomarkers. This study demonstrates a significant association between lower serum calcium and magnesium levels and increased TB severity. Similarly, these electrolytes show promise as predictive markers for COVID-19 severity. These findings could serve as biomarkers for predicting the severity of TB and COVID-19, offering potential utility in clinical decision-making. [ABSTRACT FROM AUTHOR]

The success rate of extracorporeal shock wave lithotripsy (ESWL) is influenced by various factors, including stone density, and is determined through computed tomography scans in terms of Hounsfield units (HU). Materials and Methods: This retrospective single-center study was conducted in the King Fahad Hospital. Sixty-seven adult patients with renal and ureteric stones were selected randomly and enrolled in the study. Their ages ranged from 20 to 69 years. The patients were examined with non-contrast enhancement (NCCT) to assess the HU of their stones and were consequently treated with ESWL. Results: Of the 67 patients, 37.3% had stones that were completely fragmented, while 62.7% had stones that were partially fragmented. The HU, location of the stone, multiplicity of the stone, and patient age were found to be significant factors contributing to stone fragility (p-values < 0.05). The HU data were found to have a positive significant linear correlation with serum calcium (r = 0.28, p-value = 0.036), while serum acid had a negative correlation (r = −0.55, p-value < 0.001). Thus, the probability of calcium-containing stone formation increases with increased HU. In contrast, uric acid stone formation likely develops with decreasing HU with serum uric acid. Renal stones in patients with diabetes mellitus and hypertension were not completely fragmented compared to those without clinical history. Conclusions: Mean HU, location of the stone, laterality, stone status, and the number of ESWL sessions are the most significant factors affecting stone fragility. CT attenuation values can predict the composition of stones from serum calcium and uric acid examinations. Hypertension and diabetes mellitus are risk factors for renal stone fragmentation. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis is characterized by microarchitectural disruption of the bone, decrease in bone mineral density, and increased skeletal fragility and risk of fracture. Osteoporosis occurs due to the decoupling of bone formation and bone resorption, with a significant increase in resorption. This review article focuses on the role of laboratory investigations in the diagnosis and monitoring of treatment in patients with osteoporosis. Methods: This review article collected literature from various databases using keywords such as 'Laboratory investigations', 'Osteoporosis', 'Diagnosis', 'Monitoring', and 'Bone turnover markers'. Results and Discussion: Laboratory investigations, including serum calcium, alkaline phosphatase, vitamin D, and parathormone, are commonly performed tests to exclude secondary causes of osteoporosis and monitor the response to therapy. The biochemical markers of bone turnover are newly emerged tests for monitoring individual patients with osteoporosis. These markers are classified as bone formation and resorption markers, measurable in both serum and urine. The use of these markers is limited by biological and analytical variability. The International Federation of Clinical Chemistry and Laboratory Medicine and the International Osteoporosis Foundation recommend serum procollagen type 1 amino-terminal propeptide as the bone formation marker and β-form of C-terminal cross-linked telopeptide of type I collagen (β-CTx-1/β-CrossLaps) as the marker of choice, using standardized procedures. However, in specific cases, such as patients with chronic renal disease, CTx-1 is replaced by the resorption marker tartrate-resistant acid phosphatase 5b, as its levels are not affected by renal excretion. Conclusion: Bone turnover markers have emerged as tools for the assessment of osteoporosis, using standardized procedures, and are useful in monitoring therapy and treatment compliance. [ABSTRACT FROM AUTHOR]

Hypocalcemia is an important and common complication following thyroid surgery. The development of postoperative hypocalcemia is likely to be multifactorial in nature. Patients with acute hypocalcemia may present with numbness of the distal extremities, circumoral paresthesia, and/or carpopedal spasm, laryngospasm, seizure and arrhythmias. In most cases, post-thyroidectomy hypocalcemia is temporary, but small percentage (0–12%) are permanent. The present study was a 1-year prospective interventional study conducted at tertiary care center, Jaipur, India. Total 42 patients who underwent thyroidectomy were included in study. Evaluation of Serum and Ionic Calcium Level done Preoperatively and Postoperative at 6, 12, 24 and 48 h and patients who develops hypocalcemia symptoms were recorded and data were analyzed. In our study hypocalcemia was seen in 13 (31%) out of 42 subjects. Ionic calcium in 'All patients' gradually decreased from pre operative 1.28 ± 0.04 mmol/l to 1.14 ± 0.08 mmol/l by 24 h. Highest incidence of hypocalcemia was seen in patients who had Total thyroidectomy + neck dissection (83.3%) compared to other type of thyroid surgery. we concluded that post thyroidectomy transient hypocalcemia is a frequent complication. Serial monitoring of calcium levels preoperatively and postoperatively combined with careful monitoring of signs and symptoms of hypocalcemia is an efficient and cost-effective tool to detect early post thyroidectomy hypocalcemia. [ABSTRACT FROM AUTHOR]

Calcium plays a key role in many bio-homeostasis functions. Previous studies indicated that serum calcium is associated with diseases such as anaemia. However, the evidence on the association between serum calcium levels and anaemia risk is limited. Thus, the purpose of our study is to investigate the relationship between serum calcium and anaemia in US adults. This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) including 15,519 participants, aged ≥18 years. The analyses were performed using multivariate logistic regression and a generalized additive model (GAM). Subgroup analysis, stratified by gender and age, was also performed. Among the sample of 15,519 individuals, 1565 (10.8%) had been diagnosed with anaemia. Both the univariate logistic regression model and multivariate logistic regression model showed a reverse relationship between serum calcium and anaemia risk. Moreover, a non-linear association between serum calcium and anaemia risk was observed using GAM and smooth curve fitting. The inflection point of serum calcium was at 2.3 mmol/L. GAM with penalized splines suggested a reverse association between serum calcium and the prevalence of anaemia when the concentration of serum calcium was below 2.3 mmol/L. In contrast, we found no statistically significant difference when serum calcium concentration was higher than the inflection point (2.3 mmol/L). Lower serum calcium levels were associated with increased risk of anaemia risk. Moreover, we observed non-linear associations between serum calcium and anaemia risk. Our results need to be confirmed in future prospective studies. [ABSTRACT FROM AUTHOR]

Symptoms of hypocalcemia are reported in up to 50% of patients undergoing leukapheresis procedures. There is no set standard of practice for administering calcium supplementation in the prevention or treatment of hypocalcemia symptoms. The goal of this descriptive, retrospective study was to determine the prevalence of baseline hypocalcemia and symptomatic hypocalcemia during leukapheresis with acid citrate dextrose solution A and to identify patient characteristics associated with symptomatic hypocalcemia. Three percent of patients were found to have hypocalcemia before leukapheresis with 35% experiencing hypocalcemia symptoms during leukapheresis. Older age, higher albumin levels, and longer procedure time were associated with increased risk of hypocalcemia symptoms. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to analyze the correlation between serum calcium changes and short-term prognosis of patients with acute type A aortic dissection. Methods: Patients who underwent acute type A aortic dissection surgery at Fujian Heart Medical Center between June 2019 and June 2021 were retrospectively analyzed. Results: A total of 383 patients were enrolled. According to the changing track of serum calcium in patients after acute type A aortic dissection, three potential category tracks were determined: high-level (n = 85), medium-level (n = 259), and continuous low-level groups (n = 39). Using the medium-level group as the control, regression analysis showed that poor prognosis risk was increased in the group with continuous low serum calcium (odds ratio = 2.454, P < 0.05) and in the group with continuous low serum calcium > 48 h (odds ratio = 3.595, P < 0.05). Age (odds ratio = 1.063, P < 0.001), body mass index (odds ratio = 1.138, P < 0.05), hypertension (odds ratio = 3.697, P < 0.05), and the highest lactic acid within 72 h after surgery(odds ratio = 1.093, P < 0.05) were independent risk factors for poor prognosis after aortic dissection. Conclusion: Continuous low serum calcium was an independent predictor of poor prognosis in patients with acute type A aortic dissection. Key points: Key Question What is the relationship between serum calcium and poor patient prognosis in acute type A aortic dissection (AAAD). Key finding(s) Of three categories, continuous low calcium for more than 48 h is related to poor prognosis of patients with AAAD. Take-home message Clinicians should determine causes of low calcium and prevent fluctuations postoperatively, thereby decreasing incidence of poor prognosis. [ABSTRACT FROM AUTHOR]

Background: Chronic diarrhea is difficult to prevent and treat due to its complex etiology and pathogenesis. It places a huge burden on patients and public healthcare. It is known that the regulation of body homeostasis relies heavily on calcium. However, in the general population, the relationship between calcium and chronic diarrhea remains uncertain. Methods: We assessed the association between serum calcium and diarrhea using data from the 2005–2010 National Health and Nutrition Examination Survey (NHANES). Serum calcium level was measured from collected blood samples. Diarrhea was assessed using the Bristol Stool Scale (BSFS) (types 1–7). The stability of the results was assessed using logistic regression and sensitivity analysis. The dose–response association between serum calcium and the risk of diarrhea was analyzed using a restricted cubic spline plot. Results: This study included 12,342 participants. In each of the five models, an increased calcium level was negatively associated with the incidence of diarrhea (OR[95%CI]:0.26 [0.13–0.53], 0.28 [0.14–0.58], 0.4 [0.19–0.82], 0.27 [0.11–0.64] and 0.24 [0.10–0.59], respectively). When serum calcium was analyzed as a categorical variable, a significant association between serum calcium and diarrhea prevalence was found. The restricted cubic spline plot showed a linear relationship between serum calcium and diarrhea. Sensitivity analysis confirmed that the results were stable. Conclusion: The results of our cross-sectional study suggest that a higher level of serum calcium may reduce the incidence of diarrhea. In the future, this finding should be further validated in a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Background: The occurrence of chronic kidney disease (CKD) a highly prevalent condition has been escalating in recent years. Electrolytes are the key to homeostasis and furthermore, their regulation is dependent upon renal function. CKD is associated with aberrations in the metabolism of electrolytes such as calcium, magnesium, sodium, and potassium. Aims and Objectives: The aim of this study is to study the correlation between estimated glomerular filtration rate (eGFR) and serum electrolytes in CKD patients. Materials and Methods: The present study was a cross-sectional study. One hundred patients with CKD aged 18 years or above were enrolled with inclusion and exclusion criteria. Complete blood investigations, urine analysis and ultrasonographic findings for detection of CKD were done and a semi-structured pro forma was used to record clinical profile in a cross-sectional study and patients were grouped into their respective CKD stages based on their eGFR. Results: The mean value of eGFR was 40.92±21.35 mL/min/1.73 m2. The mean value of serum sodium, calcium, magnesium, and potassium was 137.1±2.16 meq/L, 9.15±0.61 mg/dL, 3.16±0.93 mg/dL, and 4.65±0.96 meq/L, respectively. In the present study, we found that the mean serum magnesium levels in Stages 1, 2, 3, 4, and 5 of CKD were 2.10±0.20, 2.10±0.28, 2.74±0.50, 3.95±0.54, and 4.66±0.43 mg/dL, respectively. Mean serum magnesium levels were the mean serum potassium levels in Stages 1, 2, 3, 4, and 5 of CKD were 4.13±0.57, 4.15±0.68, 3.86±0.41, 5.55±0.39, and 6.25±0.08 meq/L, respectively. The mean serum calcium levels in Stages 1, 2, 3, 4, and 5 of CKD were 9.83±0.05, 9.79±0.20, 9.43±0.27, 8.72±0.38, and 7.8±0.10 mg/dL, respectively. The mean serum sodium levels in Stages 1, 2, 3, 4, and 5 of CKD were 137.33±0.57, 136.43±2.87, 136.92±2.15, 137.51±1.90, and 137.5±2.07 meq/L, respectively. Conclusion: There was significant rise in serum potassium and magnesium levels with decrease in eGFR in CKD patients. There was significant fall in serum calcium levels with decrease in eGFR in CKD patients. There was no significant correlation between serum sodium levels and eGFR in CKD patients.