| Title: | Serum Levels of Calcium, Phosphate, and Vitamin D and Incident Arrhythmias: A Prospective Cohort Study of 348,094 UK Biobank Participants |
| Journal: | Nutrients |
| Published: | 12 Dec 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41470840/ |
| DOI: | https://doi.org/10.3390/nu17243895 |
| URL: | https://www.mdpi.com/2072-6643/17/24/3895/pdf?version=1765551612 |
Publication 17184
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Abstract
Background/Objectives: Evidence of associations between serum calcium, phosphate, and vitamin D concentrations and development of arrhythmias is limited and inconsistent. This study aimed to investigate the quantification and characterization of the dose-response relationship between serum mineral levels and arrhythmia subtypes in a general population cohort. Methods: We included 348,094 UK Biobank participants without prevalent cardiovascular disease or arrhythmias in whom serum calcium, phosphate, and vitamin D concentrations were available. Serum calcium and phosphate levels were multiplied to derive calcium-phosphate product. Incident outcomes were all arrhythmias and subtypes: AF, other (non-AF) arrhythmias, bradyarrhythmia, and ventricular arrhythmias. Cox proportional hazards regression models were conducted. Results: Compared with the lowest quartile, participants in the highest quartile of serum calcium had a significantly lower risk of all arrhythmias (hazard ratio [HR] 0.92, 95% confidence interval [CI], 0.88-0.95), particularly AF (0.89, 0.85-0.93). Negative associations were found between serum vitamin D and arrhythmias, especially ventricular arrhythmias (HR 0.68, 95% CI 0.57-0.81). Higher serum phosphate and calcium-phosphate product were associated with higher risk of all outcomes. Restricted cubic splines revealed nonlinear associations for calcium and vitamin D but linear associations for phosphate and calcium-phosphate product. The associations were not modified by kidney function. Conclusions: Lower calcium and vitamin D concentrations and higher serum phosphate and calcium-phosphate product were associated with increased risk of arrhythmias and presented a dose-response manner. These findings may indicate that maintaining optimal serum calcium, phosphate, and vitamin D may be important for reducing arrhythmic risk, emphasizing the need for targeted monitoring and management, particularly in high-risk populations.</p>
14 Keywords
- Adult
- Aged
- Arrhythmias, Cardiac
- Calcium
- Female
- Humans
- Incidence
- Male
- Middle Aged
- Phosphates
- Prospective Studies
- UK Biobank
- United Kingdom
- Vitamin D
4 Authors
- Pei Qin
- Frederick K. Ho
- Carlos A. Celis-Morales
- Jill P. Pell
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