Association of Serum Phosphate Levels With Aortic Valve Sclerosis and Annular Calcification The Cardiovascular Health Study

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:58

Article

Linefsky, Jason P.^1,2  O'Brien, Kevin D.¹  Katz, Ronit³  de Boer, Ian H.⁴  Barasch, Eddy⁵  Jenny, Nancy S.⁶  Siscovick, David S.⁷  Kestenbaum, Bryan⁴ 

[1] Univ Washington, Div Cardiol, Seattle, WA 98195 USA

[2] Vet Affairs Puget Sound Hlth Care Syst, NW Ctr Excellence, Hlth Serv Res & Dev, Seattle, WA USA

[3] Univ Washington, Dept Biostat, Collaborat Hlth Studies Coordinating Ctr, Seattle, WA 98195 USA

[4] Univ Washington, Kidney Res Inst, Div Nephrol, Harborview Med Ctr, Seattle, WA 98195 USA

[5] St Francis Hosp, Dept Res & Educ, Roslyn, NY USA

[6] Univ Vermont, Dept Pathol, Burlington, VT 05405 USA

[7] Univ Washington, Dept Med & Epidemiol, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA

关键词: aortic valve;    calcification;    epidemiology;    mitral valve;    phosphate;   

DOI  :  10.1016/j.jacc.2010.11.073

来源: Elsevier

【 摘 要 】

Objectives This study was conducted to evaluate mineral metabolism markers as potential risk factors for calcific aortic valve disease. Background Mineral metabolism disturbances are common among older people and may contribute to cardiac valvular calcification. Associations of serum mineral metabolism markers with cardiac valvular calcification have not been evaluated in a well-characterized general population of older adults. Methods We measured serum levels of phosphate, calcium, parathyroid hormone, and 25-hydroxyvitamin D in 1,938 Cardiovascular Health Study participants who were free of clinical cardiovascular disease and who underwent echo-cardiographic measurements of aortic valve sclerosis (AVS), mitral annular calcification (MAC), and aortic annular calcification (AAC). We used logistic regression models to estimate associations of mineral metabolism markers with AVS, MAC, and AAC after adjustment for relevant confounding variables, including kidney function. Results The respective prevalences of AVS, MAC, and AAC were 54%, 39%, and 44%. Each 0.5 mg/dl higher serum phosphate concentration was associated with greater adjusted odds of AVS (odds ratio [OR]: 1.17, 95% confidence interval [CI]: 1.04 to 1.31, p = 0.01), MAC (OR: 1.12, 95% CI: 1.00 to 1.26, p = 0.05), and AAC (OR: 1.12, 95% CI: 0.99 to 1.25, p = 0.05). In contrast, serum calcium, parathyroid hormone, and 25-hydroxyvitamin D concentrations were not associated with aortic or mitral calcification. Conclusions Higher serum phosphate levels within the normal range were associated with valvular and annular calcification in a community-based cohort of older adults. Phosphate may be a novel risk factor for calcific aortic valve disease and warrants further study. (J Am Coll Cardiol 2011;58:291-7) (C) 2011 by the American College of Cardiology Foundation

【 授权许可】

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