biostudies-literatureUnknown13(9)Li LThis retrospective cohort study aimed to characterize diabetes-stratified associations between serum calcium levels and all-cause, cardiovascular (CVD), and cancer mortality, addressing a critical gap in nutritional epidemiology. Leveraging the National Health and Nutrition Examination Survey (NHANES) database, we conducted Cox proportional hazards regression with restricted cubic splines to model non-linear calcium-mortality relationships. Mediation analysis was conducted in diabetes. The T2DM group presented a J-shaped relationship, with relatively stable and low mortality risk at lower calcium concentrations, followed by a significant increase at higher concentrations. In contrast, the group without diabetes exhibited a U-shaped relationship, indicating that both low and high serum calcFood science & nutritione71034https://www.ebi.ac.uk/biostudies/studies/S-EPMC12457720biostudies-literatureDiabetes-Specific Serum Calcium Thresholds for Mortality Risk: A NHANES Nutritional Epidemiology Study.PMC12457720Ran XLiu SLi LYang SfalseDiabetes-Specific Serum Calcium Thresholds for Mortality Risk: A NHANES Nutritional Epidemiology Study.This retrospective cohort study aimed to characterize diabetes-stratified associations between serum calcium levels and all-cause, cardiovascular (CVD), and cancer mortality, addressing a critical gap in nutritional epidemiology. Leveraging the National Health and Nutrition Examination Survey (NHANES) database, we conducted Cox proportional hazards regression with restricted cubic splines to model non-linear calcium-mortality relationships. Mediation analysis was conducted in diabetes. The T2DM group presented a J-shaped relationship, with relatively stable and low mortality risk at lower calcium concentrations, followed by a significant increase at higher concentrations. In contrast, the group without diabetes exhibited a U-shaped relationship, indicating that both low and high serum calc2025-01-01T00:00:00Z2025 Sep2026-06-03T20:20:07.386Z2026-05-01T03:10:48.829ZS-EPMC124577204100025610.1002/fsn3.71034