Estimation of serum calcitonin, phosphate, and calcium in type 2 diabetes mellitus


  • Zahraakhan Maaroof Taher Department of Clinical biochemistry, College of Health Science, Hawler Medical University, Erbil, Iraq.
  • Sardar Nouri Ahmed Department of Clinical biochemistry, College of Medicine, Hawler Medical University, Erbil, Iraq.



Type two diabetes mellitus, Calcitonin, Calcium, Phosphate


Background and objective: Type two diabetes is known as insulin-independent diabetes mellitus due to body’s inability to respond to insulin and can be managed by lifestyle change and hypoglycemic tablets. This study aimed to compare serum levels of calcitonin, calcium, and phosphate between type two diabetic patients and controls.

Methods: The cross-sectional study included 50 patients who have already been diagnosed with type two diabetes mellitus and 50 control subjects without clinical signs of any diseases. The level of serum calcitonin, calcium, and phosphate was estimated for all participants.

Results: The mean serum level of calcitonin was (2.35 ± 1.18) pg/mL in the case group, while the mean was (32.91 ± 3.88) pg/mL in the control group (P-value = 0.001). The mean level of serum phosphate was (3.93 ± 0.08) mg/dL and (3.73 ± 0.09) mg/dL in the case and control groups, respectively (P-value = 0.117). The mean serum calcium level was (9.68 ± 0.10) mg/dL in the case group, and it was about (9.67 ± 0.14) mg/dL (P-value = 0.955) in healthy persons. Serum calcitonin was negatively correlated with glycated hemoglobin and serum glucose level.

Conclusion: The calcitonin serum level in diabetic patients was significantly lower than in healthy individuals. The level of bone minerals (calcium and phosphate) was not altered in type two diabetic patients when compared with control participants.


Metrics Loading ...


Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of type 2 diabetes mellitus. Int J Mol Sci. 2020; 21(17):6275.

Abdullah N, Attia J, Oldmeadow C, Scott RJ, Holliday EG. The architecture of risk for type 2 diabetes: understanding Asia in the context of global findings. Int J Endocrinol. 2014.

Lal BS. Diabetes: causes, symptoms and treatments. Public health environment and social issues in India. 2016;1.

Serbis A, Giapros V, Kotanidou EP, Galli-Tsinopoulou A, Siomou E. Diagnosis, treatment and prevention of type 2 diabetes mellitus in children and adolescents. World J Diabetes. 2021; 12(4):344.

Punthakee Z, Goldenberg R, Katz P. Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Can J Diabetes. 2018; 42:S10–5.

Danila R, Livadariu R, Branisteanu D. Calcitonin revisited in 2020. Acta Endocrinol (Buchar). 2019; 15(4):544.

Rigoldi F, Metrangolo P, Redaelli A, Gautieri A. Nanostructure and stability of calcitonin amyloids. J Biol Chem. 2017; 292(18):7348–57.

Hamdy RC, Daley DN. Oral calcitonin. Int J Womens Health. 2012; 4:471.

Hsiao CY, Chen TH, Chu TH, Ting YN, Tsai PJ, Shyu JF. Calcitonin induces bone formation by increasing expression of Wnt10b in osteoclasts in ovariectomy-induced osteoporotic rats. Front Endocrinol. 2020; 613.

Wongdee K, Rodrat M, Teerapornpuntakit J, Krishnamra N, Charoenphandhu N. Factors inhibiting intestinal calcium absorption: hormones and luminal factors that prevent excessive calcium uptake. J Physiol Sci. 2019; 69(5):683–96.

Gosink J, AG E. Parathyroid hormone, calcitonin and vitamin D testing in calcium and bone metabolic disorders. Medlab magazine 2015; 2:26–8.

Pu F, Chen N, Xue S. Calcium intake, calcium homeostasis and health. Food Sci Hum Wellness. 2016; 5(1):8–16.

Zhou Y, Xue S, Yang JJ. Calciomics: integrative studies of Ca2+-binding proteins and their interactomes in biological systems. Metallomics. 2013; 5(1):29–42.

Veldurthy V, Wei R, Oz L, Dhawan P, Jeon YH, Christakos S. Vitamin D, calcium homeostasis and aging. Bone Res. 2016; 4(1):1–7.

Raskh S. The importance and role of calcium on the growth and development of children and its complications. Int J Res Appl Sci Biotechnol. 2020; 7(6):162–7.

Schwarz EC, Qu B, Hoth M. Calcium, cancer and killing: the role of calcium in killing cancer cells by cytotoxic T lymphocytes and natural killer cells. Biochim Biophys Acta. 2013; 1833(7):1603–11.

Varghese E, Samuel SM, Sadiq Z, Kubatka P, Liskova A, Benacka J, et al. Anti-cancer agents in proliferation and cell death: the calcium connection. Int J Mol Sci. 2019; 20(12):3017.

Raina R, Garg G, Sethi SK, Schreiber MJ, Simon JF, Thomas GJ. Phosphorus metabolism. J Nephrol Ther. 2012; 1:S4.

Shobeiri N, Adams MA, Holden RM. Phosphate: an old bone molecule but new cardiovascular risk factor. Br J Clin Pharmacol. 2014 ; 77(1):39–54.

Penido MG, Alon US. Phosphate homeostasis and its role in bone health. Pediatr Nephrol. 2012; 27(11):2039–48.

Dobenecker B, Kienzle E, Siedler S. The Source Matters–Effects of High Phosphate Intake from Eight Different Sources in Dogs. Animals. 2021; 11(12):3456.

Gupta R, Laxman S. Cycles, sources, and sinks: Conceptualizing how phosphate balance modulates carbon flux using yeast metabolic networks. Elife. 2021; 10:e63341.

Wongdee K, Krishnamra N, Charoenphandhu N. Derangement of calcium metabolism in diabetes mellitus: negative outcome from the synergy between impaired bone turnover and intestinal calcium absorption. J Physiol Sci. 2017; 67(1):71–81.

Hegedüs L, Moses AC, Zdravkovic M, Le Thi T, Daniels GH. GLP-1 and calcitonin concentration in humans: lack of evidence of calcitonin release from sequential screening in over 5000 subjects with type 2 diabetes or nondiabetic obese subjects treated with the human GLP-1 analog, liraglutide. J Clin Endocrinol Metab. 2011; 96(3):853–60.

Ahn C, Kang JH, Jeung EB. Calcium homeostasis in diabetes mellitus. J Vet Sci. 2017; 18(3):261–6.

Zhu J, Xun P, Bae JC, Kim JH, Kim DJ, Yang K, et al. Circulating calcium levels and the risk of type 2 diabetes: a systematic review and meta-analysis. Br J Nutr. 2019; 122(4):376–87.

Bora GK, Rajkakati R, Kakati S, Yadav S. Serum Inorganic Phosphate Concentration and Glycated Haemoglobin Percent in Type 2 Diabetes Mellitus-A Hospital Based Study. 2016; 6(10):96–104.

Roden M, Shulman GI. The integrative biology of type 2 diabetes. Nature. 2019; 576(7785):51–60.

Błasiak M, Kuska J, Kokot F, Woch W. Serum levels of calcitonin, parathyroid hormone and 25-hydroxycholecalciferol in patients with diabetes mellitus. Endokrynol Pol. 1989; 40(5):241–50.

Al-Attaby AK, Al-Lami MQ. Effects of duration and complications of type 2 diabetes mellitus on diabetic related parameters, adipocytokines and calcium regulating hormones. Iraqi J Med Sci. 2019:2335–61.

Hamad NA, Eltayeb LB, Brair SL, Hussein K. A clinical study of serum calcium, phosphorus, and alkaline phosphates level in type II Diabetes mellitus among Sudanese population in Khartoum State, 2012. Neelain Med J. 2013; 3:42–50.

Revathi R, Amaldas J. A clinical study of serum phosphate and magnesium in type II diabetes mellitus. Int J Med Res Health Sci. 2014; 3(4):808–12.

Yousif AA, Ahmed SO. Estimation of Serum Calcium and Phosphorus Levels in Sudanese Patients with Type 2 Diabetes Mellitus (Doctoral dissertation, Sudan University of Science and Technology). 2014.

Hassan SA, Elsheikh WA, Rahman N, ElBagir NM. Serum calcium levels in correlation with glycated hemoglobin in type 2 diabetic sudanese patients. Advances Diabetes Metab. 2016; 4(4):59–6.

Raikou VD, Kyriaki D, Gavriil S. Importance of serum phosphate in elderly patients with diabetes mellitus. World J Diabetes. 2020; 11(10):416.

Kanchana N, Saikumar P. Serum calcium levels in type 2 diabetes mellitus. J Dent Med Sci. 2014; 13(8):01–3.




How to Cite

Maaroof Taher, Z., & Nouri Ahmed, S. . (2023). Estimation of serum calcitonin, phosphate, and calcium in type 2 diabetes mellitus. Zanco Journal of Medical Sciences (Zanco J Med Sci), 27(2), 205–212.



Original Articles