BACKGROUND/OBJECTIVES Although dietary calcium intake is associated with a risk of cardiovascular disease (CVD), it has not been studied extensively in Asian populations. We therefore investigated the association between dietary calcium intake and CVD among Korean adults and the effect of obesity on this association. SUBJECTS/METHODS In total, 9186 participants were included in the analysis after excluding 844 with prevalent CVD/cancer or implausible energy intake. Nutrient intake, including dietary calcium, was estimated using a validated semi-quantitative food frequency questionnaire. CVD included myocardial infarction, coronary artery disease, and stroke per the World Health Organization criteria. Cox proportional hazards models were used to calculate multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS In the fully adjusted model, HRs of CVD across increasing quintiles of dietary calcium intake were 1.0 (reference), 0.85 (95% CI: 0.66-1.10), 0.77 (95% CI: 0.58-1.02), 0.59 (95% CI: 0.42-0.83), and 0.72 (95% CI: 0.48-1.08); a significant linear trend was detected (p for trend = 0.04). However, this association varied according to the obesity status. High dietary calcium intake was associated with a reduced CVD risk among nonobese participants (body mass index [BMI] < 25 kg/m2; p for trend = 0.02), whereas this was not significant among obese participants (BMI ≥ 25 kg/m2; p for trend = 0.88). CONCLUSIONS The association between dietary calcium intake and incident CVD may be influenced by obesity status. We provide evidence for developing dietary calcium intake guidelines for Koreans, allowing for the effects of obesity.

中文翻译：

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韩国成年人的饮食钙摄入量与心血管疾病风险之间的关联。

背景/目的尽管饮食中钙的摄入与心血管疾病（CVD）的风险有关，但尚未在亚洲人群中进行广泛的研究。因此，我们调查了韩国成年人中饮食钙摄入与CVD的关联以及肥胖对此关联的影响。受试者/方法排除了844名患有CVD /癌症或能量摄入不合理的患者后，总共有9186名参与者被纳入了分析。使用经过验证的半定量食物频率调查表估算包括膳食钙在内的营养摄入量。根据世界卫生组织的标准，CVD包括心肌梗塞，冠状动脉疾病和中风。使用Cox比例风险模型来计算多元调整风险比（HRs）和95％置信区间（CIs）。结果在完全调整的模型中，饮食钙摄入量增加的五分位数中的CVD HRs为1.0（参考值），0.85（95％CI：0.66-1.10），0.77（95％CI：0.58-1.02），0.59（95％CI） ：0.42-0.83）和0.72（95％CI：0.48-1.08）；检测到显着的线性趋势（趋势p = 0.04）。但是，这种联系因肥胖状况而异。非肥胖参与者饮食中高钙摄入与CVD风险降低相关（体重指数[BMI] <25 kg / m2；趋势p = 0.02），而在肥胖参与者中（BMI≥25 kg / m2；肥胖指数不显着）。趋势p = 0.88）。结论饮食中钙的摄入与心血管疾病的关系可能受到肥胖状况的影响。我们提供了为韩国人制定饮食钙摄入量指南的证据，可以考虑肥胖症的影响。