Dietary calcium intake is related to elevated risk of type ۲ diabetes mellitus: A systematic review and dose-response meta-analysis of epidemiologic studies

Background: Several epidemiological studies investigated the relation of Ca intake with type ۲ diabetes mellitus (T۲DM), but there were inconsistencies in their findings. So, we conducted a systematic review and dose-response meta-analysis to quantify the relation of dietary Ca intake with the risk of T۲DM/hyperglycemia in adults.Methods: A systematic search was conducted up to May ۲۰۲۱, in MEDLINE (Pubmed), Web of Science (WOS), Scopus electronic databases and Google Scholar, for epidemiological studies that investigated the relation of dietary Ca intake (as the exposure) and T۲DM/hyperglycemia (as the outcome) in adults, without restriction in publication date and language. Finally, ۸ cohort and ۹ cross-sectional studies were included in the analysis. The body of evidence was assessed by the GRADE approach.Results: Combining effect sizes from prospective cohort studies included ۲۵۵,۷۴۴ general adult population illustrated that highest level of dietary Ca intake, compared to lowest category, was related to an ۱۸% reduced risk of T۲DM (RR: ۰.۸۲; ۹۵%CI: ۰.۷۴-۰.۹۲). Based on linear dose-response analysis (including ۲۵۵,۷۴۴ healthy individuals and ۱۳,۵۳۱ patients with T۲DM), each ۳۰۰, ۶۰۰ and ۱۰۰۰ mg/day increment in dietary Ca intake was respectively associated to ۷, ۱۴ and ۲۳% reduced risk of T۲DM. There was a steeper reduction in risk of T۲DM when dietary Ca intake increased from low levels to ۷۵۰ mg/day. Nevertheless, metaanalysis of cross-sectional studies revealed an inverse significant association between dietary Ca intake and T۲DM/hyperglycemia only in the female population (OR: ۰.۶۶; ۹۵%CI: ۰.۵۰-۰.۸۸).Conclusion: This meta-analysis illustrated an inverse association between dietary Ca intake and risk of T۲DM in general adult populations in prospective cohort studies, in a dose-response manner. It seems that increasing dietary Ca intake from low levels to around ۷۵۰ mg/day was inversely related to risk of T۲DM. In cross-sectional studies, an inverse relation between dietary Ca intake and T۲DM/hyperglycemia was found only in females.

کلیدواژه ها:

Calcium ، Diabetes Mellitus ، Type ۲ ، Hyperglycemia ، Systematic review ، Metaanalysis