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Association Between Blood Calcium, Magnesium, and Non-alcoholic Fatty Liver Disease in Adults: a Cohort-Based Case-Control Study

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Abstract

Previous studies have shown that calcium (Ca), magnesium (Mg), and Ca/Mg ratio are associated with inflammation and metabolic disorders, but their relationship with non-alcoholic fatty liver disease (NAFLD) is unclear. Thus, we aimed to explore the association between Ca, Mg, Ca/Mg ratio, and NAFLD in Chinese adults. We conducted a case-control study based on the Kailuan Cohort in China, including 1816 cases and 1111 gender- and age-matched controls. Dose-response relationships between blood Ca, Mg, Ca/Mg ratio, and NAFLD were evaluated using restricted cubic splines. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated by logistic regression models. A negative association between blood Ca (overall association P < 0.001 and linear association P < 0.001) and NAFLD as well as Ca/Mg ratio (overall association P = 0.002 and linear association P = 0.024) and NAFLD was observed. Compared with the highest quartile, the adjusted OR (95% CI) for the lowest quartile of Ca and Ca/Mg ratio was 2.116 (1.679–2.667) and 1.358 (1.076–1.713), respectively. A U-shaped relationship was found for blood Mg and NAFLD, with the highest OR of 1.685 in the lowest quartile group when using the second quartile as a reference. Additionally, we observed the interaction between alanine aminotransferase and blood Ca (P = 0.024), total cholesterol (P = 0.017), low-density lipoprotein-cholesterol (P = 0.013), and blood Mg, as well as total cholesterol and Ca/Mg ratio (P = 0.014). Lower blood Ca and Ca/Mg ratio were significantly associated with the risk of NAFLD. Liver function or lipid metabolism parameters may modify their association, suggesting an individualized prevention strategy for NAFLD.

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Data Availability

The data of this study are based on the population data of Linxi Hospital in Kailuan queue, which cannot be disclosed due to the limitation of data confidentiality.

Abbreviations

ALT:

Alanine aminotransferase

Ca:

Calcium

CI:

Confidence interval

HDL-C:

High-density lipoprotein-cholesterol

LDL-C:

Low-density lipoprotein-cholesterol

Mg:

Magnesium

NAFLD:

Non-alcoholic fatty liver disease

OR:

Odds ratio

RCS:

Restricted cubic spline

TC:

Total cholesterol

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Acknowledgements

Thanks to all the authors and participants for their contribution to this study.

Funding

This work was supported by the Beijing Municipal Health Commission Capital Health Development Research Project (2022-1-2021) and CAMS Innovation Fund for Medical Sciences (CIFMS) (2021-I2M-1-023).

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, 5 Dong Dan San Tiao, 100005, Beijing, China

    Chenlu Yang, Yanqi Lan, Di Zhang, Yanhong Wang, Yuanyuan Sun, Wei Liao & Li Wang

  2. Department of Cardiology, Kailuan General Hospital, Tangshan, China

    Shouling Wu & Shuohua Chen

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  1. Chenlu Yang
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Contributions

LW designed the study. SLW and SHC collected the data. YHW and YQL processed the data. CLY performed the statistical analysis. CLY, LW, YHW, YQL, WL, and DZ interpreted the data. CLY drafted the manuscript. LW and YYS revised the manuscript critically. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Li Wang.

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Ethics Approval

This study was carried out according to the tenets of the Declaration of Helsinki. Our research is registered on this website (http://www.chictr.org.cn/), and the ID is ChiCTR-TNRC-11001489. The Ethics Committee of the Kailuan General Hospital and Institute of Basic Medicine Chinese Academy of Medical Sciences approved this study.

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Yang, C., Wu, S., Lan, Y. et al. Association Between Blood Calcium, Magnesium, and Non-alcoholic Fatty Liver Disease in Adults: a Cohort-Based Case-Control Study. Biol Trace Elem Res 201, 4625–4636 (2023). https://doi.org/10.1007/s12011-022-03543-6

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