Dietary calcium intake and the risk of stroke: Meta-analysis of cohort studies |
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| Institution: | 1. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China;2. Department of Pediatric, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210036, Jiangsu Province, China;3. Jiangsu Center for Safety Evaluation of Drugs, School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing 210009, Jiangsu Province, China;4. Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215000, Jiangsu Province, China;5. Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China;1. Cardiology Department, First Affiliated Hospital of Sun Yat-Sen University, China;2. NHC Key Laboratory of Assisted Circulation Sun Yat-Sen University, China;1. Department of Cardiology, Shaanxi Provincial People''s Hospital, Xi''an, Shaanxi, 710000, China;2. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China;3. Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China;4. Department of Cardiology, The Third Affiliated Hospital of Xi''an Jiaotong University, Xi''an, Shaanxi, 710000, China;5. Department of Intensive Care Unit, The Third People''s Hospital of Chengdu, 82 Qinglong Road, Chengdu, Sichuan, China;1. The Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, PR China;2. Department of Hospital Infection Control, First Affiliated Hospital of Nanchang University, Nanchang University, No. 17 Yong wai zheng street, Nanchang City, Jiangxi Province, 330006, PR China;1. Primary Care/Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden;2. Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;3. Section for Endocrinology and Diabetology, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden;4. Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden;5. Department of Surgery, Sahlgrenska University hospital, Gothenburg, Sweden;6. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;7. Region Västra Götaland, Sahlgrenska University Hospital, Department of Surgery, Gothenburg, Sweden;1. Yanjing Medical College, Capital Medical University, Beijing 101300, China;2. School of Public Health, Capital Medical University, Beijing 100069, China;3. Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China;4. Department of Mathematics and Statistics, La Trobe University, Melbourne 3086, Australia;5. Department of Information, Beijing Physical Examination Center, Beijing 100077, China;6. Centre for Precision Health, Edith Cowan University, Perth, WA 6027, Australia |
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| Abstract: | Background and aimsProspective cohorts are inconsistent regarding the association between dietary calcium intake and the risk of stroke. The aim was to perform a meta-analysis to determine whether an association exists between them in cohort studies.Methods and resultsRelevant studies were identified by searching PubMed, EMBASE and Web of Science databases that published before December 2022. Prospective cohort studies that provided relative risk (RR) estimates with 95% confidence intervals (CIs) for the association were included. Study-specific risk estimates were combined by using a random effects model. Eighteen prospective studies, including 19,557 stroke cases among 882,181 participants, were pooled in the meta-analysis. We observed a nonlinear association between calcium intake and risk of stroke (Pnonlinearity < 0.003). Compared with the lowest value of zero assumed as the reference, the RRs (95% CI) of stroke across levels of calcium intake were 0.95 (0.92, 0.98) for 200 mg/day, 0.94 (0.90, 0.98) for 300 mg/day, 0.95 (0.90, 0.99) for 500 mg/day, 0.98 (0.93, 1.03) for 700 mg/day, and 1.04 (0.97, 1.11) for 1000 mg/day. The stratified analyses by geographic region showed nonlinear associations and indicated that the protective effect was observed in Asian countries (Pnonlinearity = 0.001) but not in non-Asian regions (Pnonlinearity = 0.047).ConclusionThis meta-analysis suggests that dietary calcium intake might play an effective role in the prevention of stroke, especially in Asian countries. Future research among Asia population should attempt to establish whether this association is causal.Systematic review registrationPROSPERO CRD42022357710. |
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| Keywords: | Calcium intake Dose-response Meta-analysis Prospective studies Stroke |
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