Serum phosphate is associated with aortic valve calcification in the Multi-ethnic Study of Atherosclerosis (MESA)

• Type of Material: Article
• Authors: Jason Linefsky, Emory University; Kevin D. O'Brien, University of Washington; Michael Sachs, University of Washington; Ronit Katz, University of Washington; John Eng, Johns Hopkins University; Erin D. Michos, Johns Hopkins University; Matthew J. Budoff, Harbor-UCLA Medical Center; Ian de Boer, University of Washington; Bryan Kestenbaum, University of Washington
• Language: English
• Date: 2014-04-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014.Published by Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.atherosclerosis.2013.12.051
• Title of Journal or Parent Work: Atherosclerosis
• ISSN: 0021-9150
• Volume: 233
• Issue: 2
• Start Page: 331
• End Page: 337
• Grant/Funding Information: This research was supported by R01 HL096875, R01 HL071739; and contracts N01-HC-95159 through N01-HC-95165 and N01-HC-95169 from the National Heart, Lung, and Blood Institute.
• Keywords: Calcification; Phosphate; Cardiovascular System & Cardiology; FIBROBLAST GROWTH FACTOR-23; Aortic valve; LOW-DENSITY-LIPOPROTEIN; VALVULAR LESIONS; STENOSIS; Cardiac & Cardiovascular Systems; REPRODUCIBILITY; COMPUTED-TOMOGRAPHY; Life Sciences & Biomedicine; MUSCLE-CELL CALCIFICATION; Peripheral Vascular Disease; CALCIUM; Science & Technology; OXIDATIVE STRESS; CARDIOVASCULAR HEALTH
• Research Categories: Health Sciences, Radiology; Health Sciences, Medicine and Surgery

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 1mg/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.