Comparative Analysis of Adjusted Calcium and Free Ionized Calcium in Patients with Calcium Derangement in Clinical Setting

Background: Calcium derangements, including hypocalcaemia and hypercalcemia, are significant clinical conditions that affect multiple physiological processes. While adjusted calcium and free ionized calcium are both used to assess calcium status, their comparative utility remains a topic of investigation. This study evaluates the demographic patterns, prevalence, and biochemical characteristics of these conditions, focusing on the relationship between adjusted and free ionized calcium levels. Method: This cross-sectional study included 166 patients diagnosed with either hypocalcaemia or hypercalcemia based on hospital laboratory reference values. Venous blood samples were analysed for free ionized calcium using an ion-selective electrode method and O-cresolphthalin complexone method for Total calcium. Adjusted calcium was derived with a formular. Demographic data, including age and gender, were recorded. Results: Among the 166 patients studied, hypocalcaemia was observed in 45% of the participants, while 55% were diagnosed with hypercalcemia, reflecting a slightly higher prevalence of the latter. Gender distribution showed no significant difference between the groups (p = 0.898), with hypocalcaemia affecting 40% males and 60% females, and hypercalcemia affecting 39.6% males and 60.4% females. The highest prevalence was observed in individuals aged 60 and above, comprising 40% of hypocalcaemia and 49.5% of hypercalcemia cases, with no significant differences in age distribution between groups (p = 0.455). The mean ionized calcium in hypocalcaemia was 0.9 ± 0.6 mmol/L, significantly lower than the 1.9 ± 0.9 mmol/L observed in hypercalcemia. Adjusted calcium levels were also significantly lower in the hypocalcaemia group (1.1 ± 0.9 mmol/L) compared to the hypercalcemia group (3.1 ± 1.1 mmol/L). Conclusion: This study demonstrates that free ionized calcium is a reliable indicator of calcium disorders, so also adjusted total calcium particularly in diagnosing hypocalcemia and hypercalcemia. The findings show strong correlation between adjusted calcium and ionized calcium in both groups