Biomarkers of mineral metabolism and progression of aortic valve and mitral annular calcification

The Multi-Ethnic Study of Atherosclerosis

Anna Bortnick, Shuo (Kathy) Xu, Ryung S. Kim, Bryan Kestenbaum, Joachim H. Ix, Nancy S. Jenny, Ian H. de Boer, Erin D. Michos, George Thanassoulis, David S. Siscovick, Matthew J. Budoff, Jorge Kizer

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and aims: Previous research has implicated dysregulation of phosphate metabolism and calcium-phosphate solubilization in cardiovascular calcification, but epidemiologic studies evaluating longitudinal associations with valvular or annular calcification by computed tomography (CT), a highly sensitive imaging modality, are lacking. Our primary aim was to investigate the associations of mineral biomarkers with incidence and progression of aortic valve calcification (AVC)and mitral annular calcification (MAC). Methods: We evaluated the associations of serum FGF-23 (n = 6547 participants), phosphate (n = 6547), and fetuin-A (n = 2550)measured at baseline in the community-based Multi-Ethnic Study of Atherosclerosis with AVC and MAC on CT performed at baseline and at a median of 2.4 (1.6, 3.1)years later. We used linear mixed-effects models to account simultaneously for prevalence, incidence and progression of AVC and MAC. Results: After adjustment for demographic and clinical characteristics, a significant association was documented for FGF-23 with accelerated annual progression of MAC (2.83 Agatston units (AU), 95% CI = 0.49, 5.17 AU, per standard deviation (18.46 pg/mL)of FGF-23), but this was not seen for phosphate or fetuin-A. None of these biomarkers was associated with accelerated annual progression of AVC. Conclusions: This study provides evidence relating serum FGF-23 to accelerated annual MAC progression. Whether this mineral regulator is a risk marker or is involved in pathogenesis merits further investigation.

Original languageEnglish (US)
Pages (from-to)79-86
Number of pages8
JournalAtherosclerosis
Volume285
DOIs
StatePublished - Jun 1 2019

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Aortic Valve
Minerals
Atherosclerosis
Biomarkers
alpha-2-HS-Glycoprotein
Phosphates
Tomography
Incidence
Serum
Epidemiologic Studies
Demography
Calcification of Aortic Valve
Research

Keywords

  • Fetuin-A
  • Fibroblast growth factor
  • Metabolism
  • Mineral
  • Valve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Biomarkers of mineral metabolism and progression of aortic valve and mitral annular calcification : The Multi-Ethnic Study of Atherosclerosis. / Bortnick, Anna; Xu, Shuo (Kathy); Kim, Ryung S.; Kestenbaum, Bryan; Ix, Joachim H.; Jenny, Nancy S.; de Boer, Ian H.; Michos, Erin D.; Thanassoulis, George; Siscovick, David S.; Budoff, Matthew J.; Kizer, Jorge.

In: Atherosclerosis, Vol. 285, 01.06.2019, p. 79-86.

Research output: Contribution to journalArticle

Bortnick, Anna ; Xu, Shuo (Kathy) ; Kim, Ryung S. ; Kestenbaum, Bryan ; Ix, Joachim H. ; Jenny, Nancy S. ; de Boer, Ian H. ; Michos, Erin D. ; Thanassoulis, George ; Siscovick, David S. ; Budoff, Matthew J. ; Kizer, Jorge. / Biomarkers of mineral metabolism and progression of aortic valve and mitral annular calcification : The Multi-Ethnic Study of Atherosclerosis. In: Atherosclerosis. 2019 ; Vol. 285. pp. 79-86.
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abstract = "Background and aims: Previous research has implicated dysregulation of phosphate metabolism and calcium-phosphate solubilization in cardiovascular calcification, but epidemiologic studies evaluating longitudinal associations with valvular or annular calcification by computed tomography (CT), a highly sensitive imaging modality, are lacking. Our primary aim was to investigate the associations of mineral biomarkers with incidence and progression of aortic valve calcification (AVC)and mitral annular calcification (MAC). Methods: We evaluated the associations of serum FGF-23 (n = 6547 participants), phosphate (n = 6547), and fetuin-A (n = 2550)measured at baseline in the community-based Multi-Ethnic Study of Atherosclerosis with AVC and MAC on CT performed at baseline and at a median of 2.4 (1.6, 3.1)years later. We used linear mixed-effects models to account simultaneously for prevalence, incidence and progression of AVC and MAC. Results: After adjustment for demographic and clinical characteristics, a significant association was documented for FGF-23 with accelerated annual progression of MAC (2.83 Agatston units (AU), 95{\%} CI = 0.49, 5.17 AU, per standard deviation (18.46 pg/mL)of FGF-23), but this was not seen for phosphate or fetuin-A. None of these biomarkers was associated with accelerated annual progression of AVC. Conclusions: This study provides evidence relating serum FGF-23 to accelerated annual MAC progression. Whether this mineral regulator is a risk marker or is involved in pathogenesis merits further investigation.",
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T1 - Biomarkers of mineral metabolism and progression of aortic valve and mitral annular calcification

T2 - The Multi-Ethnic Study of Atherosclerosis

AU - Bortnick, Anna

AU - Xu, Shuo (Kathy)

AU - Kim, Ryung S.

AU - Kestenbaum, Bryan

AU - Ix, Joachim H.

AU - Jenny, Nancy S.

AU - de Boer, Ian H.

AU - Michos, Erin D.

AU - Thanassoulis, George

AU - Siscovick, David S.

AU - Budoff, Matthew J.

AU - Kizer, Jorge

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background and aims: Previous research has implicated dysregulation of phosphate metabolism and calcium-phosphate solubilization in cardiovascular calcification, but epidemiologic studies evaluating longitudinal associations with valvular or annular calcification by computed tomography (CT), a highly sensitive imaging modality, are lacking. Our primary aim was to investigate the associations of mineral biomarkers with incidence and progression of aortic valve calcification (AVC)and mitral annular calcification (MAC). Methods: We evaluated the associations of serum FGF-23 (n = 6547 participants), phosphate (n = 6547), and fetuin-A (n = 2550)measured at baseline in the community-based Multi-Ethnic Study of Atherosclerosis with AVC and MAC on CT performed at baseline and at a median of 2.4 (1.6, 3.1)years later. We used linear mixed-effects models to account simultaneously for prevalence, incidence and progression of AVC and MAC. Results: After adjustment for demographic and clinical characteristics, a significant association was documented for FGF-23 with accelerated annual progression of MAC (2.83 Agatston units (AU), 95% CI = 0.49, 5.17 AU, per standard deviation (18.46 pg/mL)of FGF-23), but this was not seen for phosphate or fetuin-A. None of these biomarkers was associated with accelerated annual progression of AVC. Conclusions: This study provides evidence relating serum FGF-23 to accelerated annual MAC progression. Whether this mineral regulator is a risk marker or is involved in pathogenesis merits further investigation.

AB - Background and aims: Previous research has implicated dysregulation of phosphate metabolism and calcium-phosphate solubilization in cardiovascular calcification, but epidemiologic studies evaluating longitudinal associations with valvular or annular calcification by computed tomography (CT), a highly sensitive imaging modality, are lacking. Our primary aim was to investigate the associations of mineral biomarkers with incidence and progression of aortic valve calcification (AVC)and mitral annular calcification (MAC). Methods: We evaluated the associations of serum FGF-23 (n = 6547 participants), phosphate (n = 6547), and fetuin-A (n = 2550)measured at baseline in the community-based Multi-Ethnic Study of Atherosclerosis with AVC and MAC on CT performed at baseline and at a median of 2.4 (1.6, 3.1)years later. We used linear mixed-effects models to account simultaneously for prevalence, incidence and progression of AVC and MAC. Results: After adjustment for demographic and clinical characteristics, a significant association was documented for FGF-23 with accelerated annual progression of MAC (2.83 Agatston units (AU), 95% CI = 0.49, 5.17 AU, per standard deviation (18.46 pg/mL)of FGF-23), but this was not seen for phosphate or fetuin-A. None of these biomarkers was associated with accelerated annual progression of AVC. Conclusions: This study provides evidence relating serum FGF-23 to accelerated annual MAC progression. Whether this mineral regulator is a risk marker or is involved in pathogenesis merits further investigation.

KW - Fetuin-A

KW - Fibroblast growth factor

KW - Metabolism

KW - Mineral

KW - Valve

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