Jason P Linefsky1, Kevin D O'Brien2, Michael Sachs3, Ronit Katz4, John Eng5, Erin D Michos6, Matthew J Budoff7, Ian de Boer3, Bryan Kestenbaum3. 1. Division of Cardiology, Emory University/Atlanta VA Medical Center, 1639 Pierce Drive, Suite 319, Atlanta, GA 30322, USA. Electronic address: jason.linefsky@emory.edu. 2. Division of Cardiology, University of Washington, Seattle, WA, USA. 3. University of Washington Kidney Research Institute and Division of Nephrology, Seattle, WA, USA. 4. Collaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, WA, USA. 5. Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 6. Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA. 7. Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA, USA.
Abstract
OBJECTIVES: This study sought to investigate associations of phosphate metabolism biomarkers with aortic valve calcification (AVC). BACKGROUND: Calcific aortic valve disease (CAVD) is a common progressive condition that involves inflammatory and calcification mediators. Currently there are no effective medical treatments, but mineral metabolism pathways may be important in the development and progression of disease. METHODS: We examined associations of phosphate metabolism biomarkers, including serum phosphate, urine phosphate, parathyroid hormone (PTH) and serum fibroblast growth factor (FGF)-23, with CT-assessed AVC at study baseline and in short-term follow-up in 6814 participants of the Multi-Ethnic Study of Atherosclerosis (MESA). RESULTS: At baseline, AVC prevalence was 13.2%. Higher serum phosphate levels were associated with significantly greater AVC prevalence (relative risk 1.3 per 1 mg/dL increment, 95% confidence incidence: 1.1 to 1.5, p<0.001). Serum FGF-23, serum PTH, and urine phosphate were not associated with prevalent AVC. Average follow-up CT evaluation was 2.4 years (range 0.9-4.9 years) with an AVC incidence of 4.1%. Overall, phosphate metabolism biomarkers were not associated with incident AVC except in the top FGF-23 quartile. CONCLUSIONS: Serum phosphate levels are significantly associated with AVC prevalence. Further study of phosphate metabolism as a modifiable risk factor for AVC is warranted. Published by Elsevier Ireland Ltd.
OBJECTIVES: This study sought to investigate associations of phosphate metabolism biomarkers with aortic valve calcification (AVC). BACKGROUND:Calcific aortic valve disease (CAVD) is a common progressive condition that involves inflammatory and calcification mediators. Currently there are no effective medical treatments, but mineral metabolism pathways may be important in the development and progression of disease. METHODS: We examined associations of phosphate metabolism biomarkers, including serum phosphate, urine phosphate, parathyroid hormone (PTH) and serum fibroblast growth factor (FGF)-23, with CT-assessed AVC at study baseline and in short-term follow-up in 6814 participants of the Multi-Ethnic Study of Atherosclerosis (MESA). RESULTS: At baseline, AVC prevalence was 13.2%. Higher serum phosphate levels were associated with significantly greater AVC prevalence (relative risk 1.3 per 1 mg/dL increment, 95% confidence incidence: 1.1 to 1.5, p<0.001). Serum FGF-23, serum PTH, and urine phosphate were not associated with prevalent AVC. Average follow-up CT evaluation was 2.4 years (range 0.9-4.9 years) with an AVC incidence of 4.1%. Overall, phosphate metabolism biomarkers were not associated with incident AVC except in the top FGF-23 quartile. CONCLUSIONS: Serum phosphate levels are significantly associated with AVC prevalence. Further study of phosphate metabolism as a modifiable risk factor for AVC is warranted. Published by Elsevier Ireland Ltd.
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