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Background  Previous evidence regarding the associations between serum calcium concentrations, dietary calcium intake, and type 2 diabetes (T2D) is limited. We investigated the longitudinal associations of serum calcium levels and dietary calcium intake with T2D development.    Methods  This study used data from the Ansung–Ansan cohort, a community-based, prospective cohort that was followed up for 10 years. Cox regression models adjusted for potential confounders were used to evaluate the associations of serum calcium levels (mean, 9.41 mg/dL) and dietary calcium intake (median, 389.59 mg/day) with T2D incidence. Association between dietary calcium intake and serum calcium levels was assessed using linear regression models.    Results  Albumin-adjusted serum calcium levels were not associated with T2D risk (hazard ratio [HR] = 1.07, 95% confidence interval [CI] 0.96, 1.19,  p -value = 0.2333). A one-unit increase in log-transformed, energy-adjusted dietary calcium intake was associated with a decreased risk of T2D (HR = 0.88, 95% CI 0.77, 1.00,  p -value = 0.0460) and lower albumin-adjusted serum calcium levels ( β  = − 0.04, 95% CI − 0.07, − 0.02,  p -value = 0.0014). The associations did not differ according to sex (all  p -values for interaction > 0.10).    Conclusions  Serum calcium levels were not associated with T2D risk, while higher dietary calcium intake was associated with a decreased risk of T2D development. These results have public health implications for predicting and preventing T2D development, as well as providing guidelines for diet and calcium supplementation.

diabetology and metabolic syndrome

Associations of serum calcium levels and dietary calcium intake with incident type 2 diabetes over 10 years: the Korean Genome and Epidemiology Study (KoGES)