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Associations of Serum Calcium, Magnesium Levels, and Their Ratio with Apolipoproteins in Chinese Adults with Coronary Artery Disease: a Cross-Sectional Study

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Abstract

Former evidence regarding the associations of serum calcium (Ca) and magnesium (Mg) levels with apolipoproteins (Apos) in Chinese adults with coronary artery disease (CAD) were scarce. A total of 6781 patients with CAD were included in this cross-sectional study; mean age was 61.0 years. The associations of serum Ca, Mg, and Ca/Mg ratio with Apos (e.g., ApoA1, ApoB, and ApoB/A1 ratio) were determined using multivariate analysis of covariance. Serum Ca, Mg, and Ca/Mg ratio tended to have positive associations with ApoA1, while negative associations of serum Ca, Mg, and Ca/Mg ratio with ApoB and ApoB/A1 ratio were detected. In multivariate analysis, serum Ca, Mg, and Ca/Mg ratio were positively associated with ApoA1 levels (Q [quintile] 5 vs. Q1: 1.245 vs. 1.151 g/L for Ca, 1.207 vs. 1.188 g/L for Mg, 1.202 vs. 1.171 g/L for Ca/Mg ratio). In contrast, negative associations of serum Mg and Ca/Mg ratio with ApoB and ApoB/A1 ratio were shown. The corresponding ApoB and ApoB/A1 ratio values were 0.856 (vs. 0.887 g/L) and 0.728 (vs. 0.771) for Mg, and 0.814 (vs. 0.854 g/L) and 0.695 (vs. 0.751) for Ca/Mg ratio in Q5 compared with Q1. Serum Ca was inversely associated with ApoB and ApoB/A1 ratio (Q5 vs. Q4: 0.804 vs. 0.847 g/L for ApoB; Q5 vs. Q1: 0.662 vs. 0.732 for ApoB/A1 ratio). Path analysis showed that mediating effects of BMI on the “Ca or Mg-Apos” associations were not found. In summary, serum Ca and Mg tended to have positive associations with ApoA1 levels in patients with CAD, but had inverse associations with ApoB levels and ApoB/A1 ratio. Serum Ca/Mg ratio may be a more precise marker than serum Mg or serum Ca measures alone in assessing Apos measures of CAD risk.

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Data Availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

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The code is available from the corresponding author on request.

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Acknowledgements

We thank other participants and staff who contributed to the present study.

Funding

This study was jointly supported by the Hubei Provincial Natural Science Foundation of China (No. 2020CFB407), the Nantong Health Committee Foundation (No. QA2020031), and the 2020 Innovation and Entrepreneurship Program of Jiangsu Province (Doctor Funds of the Innovation and Entrepreneurship Program). The funders had no role in the design, analysis, or writing of this article.

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Authors and Affiliations

  1. Scientific Education Section and Department of Child Healthcare, Affiliated Maternity & Child Health Care Hospital of Nantong University, Nantong, 226018, Jiangsu, People’s Republic of China

    Hongli Dong

  2. Image Center, Wuhan Asia Heart Hospital, Wuhan, 430022, Hubei, People’s Republic of China

    Ping Hu, Jie Wang & Nan Lu

  3. Finance Section, Affiliated Traditional Chinese Medicine Hospital of Nantong University, Nantong, 226018, Jiangsu, People’s Republic of China

    Yaju Zhang

  4. Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Guangdong, 515041, Shantou, People’s Republic of China

    Nan Lu

  5. Department of Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, Chaoyang District, China

    Nan Lu

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  1. Hongli Dong
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Nan Lu designed the research. Hongli Dong, Ping Hu, Jie Wang, and Yaju Zhang conducted research. Hongli Dong analyzed the data and wrote the paper. Nan Lu and Yaju Zhang critically revised the manuscript. Nan Lu had primary responsibility for the final content. All authors read and approved the final manuscript.

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Correspondence to Nan Lu.

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The study was approved by the Ethics Committee of Wuhan Asia Heart Hospital (2016–B008) and performed in accordance with the 1964 Declaration of Helsinki and its later amendments.

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Dong, H., Hu, P., Wang, J. et al. Associations of Serum Calcium, Magnesium Levels, and Their Ratio with Apolipoproteins in Chinese Adults with Coronary Artery Disease: a Cross-Sectional Study. Biol Trace Elem Res 200, 4221–4229 (2022). https://doi.org/10.1007/s12011-021-03015-3

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