Abstract
Calcium and phosphate may play an important role in cardio-metabolic abnormalities, including type 2 diabetes; however, epidemiological evidence of the association of calcium and phosphate status with glucose metabolism among Asians is limited. In the current study, we performed a cross-sectional analysis of the association of serum calcium, phosphate, and calcium-phosphate product concentrations with glucose metabolism markers among Japanese individuals. Overall, 1701 workers (aged 18-78 years) who participated in a health survey were enrolled in this study. Multivariable linear regression models were used to estimate means of homeostatic model assessment of insulin resistance (HOMA-IR), homeostatic model assessment of β-cell function (HOMA-β), and glycated hemoglobin (HbA1c). Serum calcium concentration was positively associated with HOMA-IR and HbA1c (p for trend < 0.01). Multivariable-adjusted means (95% confidence interval (CI)) of HOMA-IR for the lowest and highest quartiles of serum calcium were 0.78 (0.75-0.82) and 1.01 (0.96-1.07), respectively. The corresponding values for HbA1c were 5.24 (5.22-5.27) and 5.29 (5.26-5.32), respectively. Serum phosphate and calcium-phosphate product concentrations were inversely associated with HOMA-IR (p for trend < 0.01). Multivariable-adjusted means (95% CI) of HOMA-IR for the lowest and highest quartiles of serum phosphate were 1.04 (0.99-1.09) and 0.72 (0.69-0.76), respectively. The corresponding values for calcium-phosphate product were 1.04 (0.99-1.09) and 0.73 (0.69-0.77), respectively. The current findings suggest that higher serum calcium and lower serum phosphate concentrations are associated with IR among apparently healthy adults.