Kidney function, bone-mineral metabolism markers, and calcification of coronary arteries, aorta, and cardiac valves in older adults.
Calcification
Older adults
Phosphorus
Journal
Atherosclerosis
ISSN: 1879-1484
Titre abrégé: Atherosclerosis
Pays: Ireland
ID NLM: 0242543
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
received:
10
11
2022
accepted:
10
01
2023
pmc-release:
01
03
2024
pubmed:
9
2
2023
medline:
8
3
2023
entrez:
8
2
2023
Statut:
ppublish
Résumé
The contribution of kidney dysfunction, especially at mild-to-moderate stages, and bone-mineral metabolism (BMM) markers to vascular calcification remains controversial or unclear. We comprehensively evaluated the association of kidney and BMM markers with coronary artery calcification (CAC) and extra-coronary calcification (ECC). In 1931 ARIC participants (age 73-95 years) without coronary heart disease at visit 7 (2018-19), we investigated the associations of estimated glomerular filtration rate (eGFR) (with creatinine, cystatin C, and both) and five serum BMM markers (calcium, fibroblast growth factor 23, magnesium, parathyroid hormone, and phosphorus) with high CAC and ECC (sex-race specific ≥75th vs. <75th percentile Agatston score) or any vs. zero CAC and ECC using multivariable logistic regression. For eGFR and BMM markers, we took their weighted cumulative averages from visit 1 (1987-89) to visit 5 (2011-13). Lower eGFR, regardless of equations used, was not robustly associated with high CAC or ECC. Among BMM markers, only higher phosphorus levels, even within the normal range, showed robust associations with high CAC (only when modeled continuously) and ECC, independently of kidney function (e.g., odds ratio 1.94 [95%CI 1.38-2.73] for high aortic valve calcification, in the highest vs. lowest quartile). Results were generally consistent when analyzing any CAC or ECC, although cystatin C-based eGFR <60 mL/min/1.73 m Among kidney and BMM measures tested, only serum phosphorus demonstrated robust associations with both CAC and ECC, supporting a key role of phosphorus in the pathophysiology of vascular calcification.
Sections du résumé
BACKGROUND AND AIMS
The contribution of kidney dysfunction, especially at mild-to-moderate stages, and bone-mineral metabolism (BMM) markers to vascular calcification remains controversial or unclear. We comprehensively evaluated the association of kidney and BMM markers with coronary artery calcification (CAC) and extra-coronary calcification (ECC).
METHODS
In 1931 ARIC participants (age 73-95 years) without coronary heart disease at visit 7 (2018-19), we investigated the associations of estimated glomerular filtration rate (eGFR) (with creatinine, cystatin C, and both) and five serum BMM markers (calcium, fibroblast growth factor 23, magnesium, parathyroid hormone, and phosphorus) with high CAC and ECC (sex-race specific ≥75th vs. <75th percentile Agatston score) or any vs. zero CAC and ECC using multivariable logistic regression. For eGFR and BMM markers, we took their weighted cumulative averages from visit 1 (1987-89) to visit 5 (2011-13).
RESULTS
Lower eGFR, regardless of equations used, was not robustly associated with high CAC or ECC. Among BMM markers, only higher phosphorus levels, even within the normal range, showed robust associations with high CAC (only when modeled continuously) and ECC, independently of kidney function (e.g., odds ratio 1.94 [95%CI 1.38-2.73] for high aortic valve calcification, in the highest vs. lowest quartile). Results were generally consistent when analyzing any CAC or ECC, although cystatin C-based eGFR <60 mL/min/1.73 m
CONCLUSIONS
Among kidney and BMM measures tested, only serum phosphorus demonstrated robust associations with both CAC and ECC, supporting a key role of phosphorus in the pathophysiology of vascular calcification.
Identifiants
pubmed: 36754659
pii: S0021-9150(23)00008-4
doi: 10.1016/j.atherosclerosis.2023.01.007
pmc: PMC9992265
mid: NIHMS1870443
pii:
doi:
Substances chimiques
Cystatin C
0
Biomarkers
0
Phosphorus
27YLU75U4W
Minerals
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
35-43Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL136592
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92022D00003
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92022D00001
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92022D00005
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL103706
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92022D00002
Pays : United States
Organisme : NHLBI NIH HHS
ID : K24 HL159246
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92022D00004
Pays : United States
Informations de copyright
Copyright © 2023 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
Lancet. 2010 Jun 12;375(9731):2073-81
pubmed: 20483451
Kidney Int. 2004 Nov;66(5):2017-21
pubmed: 15496174
Arterioscler Thromb Vasc Biol. 2017 Aug;37(8):1431-1445
pubmed: 28663256
J Am Soc Nephrol. 2008 Mar;19(3):579-85
pubmed: 18235089
J Am Heart Assoc. 2019 May 7;8(9):e010930
pubmed: 31023134
Atherosclerosis. 2010 Feb;208(2):406-11
pubmed: 19781704
JACC Cardiovasc Imaging. 2010 Jun;3(6):595-604
pubmed: 20541715
J Am Soc Nephrol. 2014 Feb;25(2):349-60
pubmed: 24158986
Adv Prev Med. 2021 Apr 9;2021:6686597
pubmed: 33927901
Kidney Int Suppl. 2011 Apr;(121):S20-3
pubmed: 21346722
Hypertension. 2005 Jul;46(1):38-43
pubmed: 15956113
Sci Rep. 2018 Feb 1;8(1):2069
pubmed: 29391410
J Am Soc Nephrol. 2006 Feb;17(2):521-7
pubmed: 16382018
Am J Kidney Dis. 2007 Sep;50(3):412-20
pubmed: 17720520
J Am Heart Assoc. 2022 Aug 2;11(15):e023024
pubmed: 35904204
Am J Kidney Dis. 2008 Jun;51(6):952-65
pubmed: 18423809
J Am Soc Nephrol. 2009 Feb;20(2):381-7
pubmed: 19073826
N Engl J Med. 2004 Sep 23;351(13):1296-305
pubmed: 15385656
BMC Med. 2020 Nov 9;18(1):300
pubmed: 33161898
BMC Nephrol. 2017 Apr 6;18(1):129
pubmed: 28385153
Circulation. 2007 May 29;115(21):2722-30
pubmed: 17502571
Nutrition. 2000 Jul-Aug;16(7-8):564-6
pubmed: 10906557
PLoS One. 2021 Jun 18;16(6):e0253592
pubmed: 34143857
Am J Cardiol. 2008 Aug 15;102(4):440-3
pubmed: 18678302
Kidney Int. 2005 Oct;68(4):1815-24
pubmed: 16164659
N Engl J Med. 2000 May 18;342(20):1478-83
pubmed: 10816185
PLoS One. 2016 Mar 18;11(3):e0151007
pubmed: 26992166
Kidney Int Suppl (2011). 2017 Jul;7(1):1-59
pubmed: 30675420
Blood Purif. 2018;45(1-3):173-178
pubmed: 29478069
Atherosclerosis. 2014 Apr;233(2):331-337
pubmed: 24530958
Clin J Am Soc Nephrol. 2009 Dec;4(12):1968-73
pubmed: 19965546
Eur J Clin Invest. 2019 Mar 13;:e13101
pubmed: 30866052
J Am Coll Cardiol. 2019 Jun 25;73(24):e285-e350
pubmed: 30423393
J Am Heart Assoc. 2021 Aug 17;10(16):e020196
pubmed: 34387090
J Am Coll Cardiol. 1990 Mar 15;15(4):827-32
pubmed: 2407762
Am J Clin Nutr. 2011 Dec;94(6):1465-70
pubmed: 22030227
Mol Biol Rep. 2014 Sep;41(9):5645-63
pubmed: 24903972
Kidney Int. 2007 Nov;72(10):1255-61
pubmed: 17805238
Aging (Albany NY). 2019 Jun 26;11(12):4274-4299
pubmed: 31241466
Am J Kidney Dis. 2011 Oct;58(4):519-26
pubmed: 21783289
Kidney Int. 2013 Jun;83(6):1159-68
pubmed: 23389416
J Nutr. 2001 Dec;131(12):3182-8
pubmed: 11739863
JACC Basic Transl Sci. 2020 Apr 27;5(4):398-412
pubmed: 32368697
Circulation. 2008 Jun 3;117(22):2938-48
pubmed: 18519861
Matrix Biol. 2004 Nov;23(7):421-32
pubmed: 15579309
Nutr Metab Cardiovasc Dis. 2015 Nov;25(11):1056-61
pubmed: 26472514
Kidney Int. 2009 Nov;76(9):991-8
pubmed: 19692998
Nutr J. 2016 Mar 01;15:22
pubmed: 26931571
J Am Soc Nephrol. 2009 Feb;20(2):397-404
pubmed: 18987306
Kidney Int. 2018 Sep;94(3):567-581
pubmed: 30078514
Circulation. 2018 Feb 13;137(7):665-679
pubmed: 29142010
Nephrol Dial Transplant. 2009 Mar;24(3):834-40
pubmed: 18840892
Nephrol Dial Transplant. 2010 Aug;25(8):2679-85
pubmed: 20176609
J Am Coll Cardiol. 2011 Jul 12;58(3):291-7
pubmed: 21737022
J Am Coll Cardiol. 2012 Jul 17;60(3):200-7
pubmed: 22703926
Clin Cardiol. 2017 Dec;40(12):1309-1315
pubmed: 29243272
Arterioscler Thromb Vasc Biol. 2014 Aug;34(8):1763-9
pubmed: 24925973
Eur J Heart Fail. 2019 Apr;21(4):402-424
pubmed: 30859669
Nephrol Dial Transplant. 2007 May;22 Suppl 2:ii45-87
pubmed: 17507426
J Am Soc Nephrol. 2005 Feb;16(2):507-13
pubmed: 15601745
Kidney Int. 2002 Jul;62(1):245-52
pubmed: 12081584
Nature. 1997 Nov 6;390(6655):45-51
pubmed: 9363890
Am J Kidney Dis. 2020 Sep;76(3 Suppl 1):S1-S107
pubmed: 32829751
J Clin Endocrinol Metab. 2007 Jun;92(6):2363-9
pubmed: 17374704
Clin Chem Lab Med. 2010 Nov;48(11):1619-21
pubmed: 21034257
Bone. 2017 Jul;100:87-93
pubmed: 27847254
Clin Nephrol. 2007 Oct;68(4):222-7
pubmed: 17969489
Eur Heart J. 2012 Nov;33(22):2873-81
pubmed: 22719023
J Am Coll Cardiol. 2002 Feb 20;39(4):695-701
pubmed: 11849871