Association between urine calcium creatinine ratio and arterial stiffness among Chinese adults undergoing health screening with normal renal function
Abstract
Arterial stiffness is a significant precursor of cardiovascular diseases (CVD), influenced by calcium metabolic homeostasis. The urinary calcium-to-creatinine ratio (UCa/Cr) reflects calcium excretion status and may be associated with arterial stiffness. This study included 21,834 subjects from annual health check-ups (2017–2020) and a prospective cohort of 3219 subjects followed from 2020 to 2024 at the Third Xiangya Hospital in Hunan, China. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV) and classified as normal-to-mild (baPWV ≤ 1700 cm/s) or moderate-to-severe arterial stiffness (moderate-to-severe AS). Logistic regression models were used for cross-sectional analysis, and Cox proportional hazards models were used for the cohort analysis. In the cross-sectional study, a significant nonlinear association was observed between UCa/Cr and moderate-to-severe AS ( P overall < 0.001, P nonlinearity = 0.010). Compared with the lowest UCa/Cr group (< 0.049), the highest group (≥ 0.109) had a 36% higher odds of moderate‑to‑severe AS (aOR = 1.36, 95% CI: 1.11, 1.65). In the cohort study, over 7144 person-years of follow-up, 145 individuals developed moderate-to-severe AS. A significant overall association was observed between UCa/Cr and the risk of moderate-to-severe AS ( P overall = 0.014). Compared with the lowest UCa/Cr group (< 0.049), the highest group (≥ 0.109) had more than a two-fold higher risk of incident moderate‑to‑severe AS (aHR = 2.12, 95% CI: 1.18, 3.82). Further adjustment for continuous SBP and DBP attenuated both associations, which were no longer statistically significant. In the primary analyses, UCa/Cr was associated with both prevalent and incident moderate-to-severe AS, with the association most evident at higher UCa/Cr levels, but the findings were sensitive to adjustment for SBP.
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BibTeX
@article{li2026association,
title = {{Association between urine calcium creatinine ratio and arterial stiffness among Chinese adults undergoing health screening with normal renal function}},
author = {Ying Li and Wenbin Ouyang and Hao Wu and Zhiqing Zhao and Pingting Yang and Yuexiang Qin and Jing Deng and Xin Huang},
journal = {Scientific Reports},
year = {2026},
month = oct,
doi = {10.1038/s41598-026-76582-x},
url = {https://www.nature.com/articles/s41598-026-76582-x},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association between urine calcium creatinine ratio and arterial stiffness among Chinese adults undergoing health screening with normal renal function
AU - Ying Li
AU - Wenbin Ouyang
AU - Hao Wu
AU - Zhiqing Zhao
AU - Pingting Yang
AU - Yuexiang Qin
AU - Jing Deng
AU - Xin Huang
PY - 2026
DA - 2026/10/21
JO - Scientific Reports
DO - 10.1038/s41598-026-76582-x
UR - https://www.nature.com/articles/s41598-026-76582-x
AB - Arterial stiffness is a significant precursor of cardiovascular diseases (CVD), influenced by calcium metabolic homeostasis. The urinary calcium-to-creatinine ratio (UCa/Cr) reflects calcium excretion status and may be associated with arterial stiffness. This study included 21,834 subjects from annual health check-ups (2017–2020) and a prospective cohort of 3219 subjects followed from 2020 to 2024 at the Third Xiangya Hospital in Hunan, China. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV) and classified as normal-to-mild (baPWV ≤ 1700 cm/s) or moderate-to-severe arterial stiffness (moderate-to-severe AS). Logistic regression models were used for cross-sectional analysis, and Cox proportional hazards models were used for the cohort analysis. In the cross-sectional study, a significant nonlinear association was observed between UCa/Cr and moderate-to-severe AS ( P overall < 0.001, P nonlinearity = 0.010). Compared with the lowest UCa/Cr group (< 0.049), the highest group (≥ 0.109) had a 36% higher odds of moderate‑to‑severe AS (aOR = 1.36, 95% CI: 1.11, 1.65). In the cohort study, over 7144 person-years of follow-up, 145 individuals developed moderate-to-severe AS. A significant overall association was observed between UCa/Cr and the risk of moderate-to-severe AS ( P overall = 0.014). Compared with the lowest UCa/Cr group (< 0.049), the highest group (≥ 0.109) had more than a two-fold higher risk of incident moderate‑to‑severe AS (aHR = 2.12, 95% CI: 1.18, 3.82). Further adjustment for continuous SBP and DBP attenuated both associations, which were no longer statistically significant. In the primary analyses, UCa/Cr was associated with both prevalent and incident moderate-to-severe AS, with the association most evident at higher UCa/Cr levels, but the findings were sensitive to adjustment for SBP.
SN - 2045-2322
ER -