02728nas a2200241 4500008004100000022001400041245010300055210006900158260001600227520198200243100002202225700002002247700001902267700002102286700002202307700001802329700001702347700001802364700002402382700002402406700002002430856003602450 2016 ENG d a1468-201X00aAssociation of inflammatory, lipid and mineral markers with cardiac calcification in older adults.0 aAssociation of inflammatory lipid and mineral markers with cardi c2016 Jul 133 a

OBJECTIVE: Calcification of the aortic valve and adjacent structures involves inflammatory, lipid and mineral metabolism pathways. We hypothesised that circulating biomarkers reflecting these pathways are associated with cardiac calcification in older adults.

METHODS: We investigated the associations of various biomarkers with valvular and annular calcification in the Cardiovascular Health Study. Of the 5888 participants, up to 3585 were eligible after exclusions for missing biomarker, covariate or echocardiographic data. We evaluated analytes reflecting lipid (lipoprotein (Lp) (a), Lp-associated phospholipase A2 (LpPLA2) mass and activity), inflammatory (interleukin-6, soluble (s) CD14) and mineral metabolism (fetuin-A, fibroblast growth factor (FGF)-23) pathways that were measured within 5 years of echocardiography. The relationships of plasma biomarkers with aortic valve calcification (AVC), aortic annular calcification (AAC) and mitral annular calcification (MAC) were assessed with relative risk (RR) regression.

RESULTS: Calcification was prevalent: AVC 59%, AAC 45% and MAC 41%. After adjustment, Lp(a), LpPLA2 mass and activity and sCD14 were positively associated with AVC. RRs for AVC per SD (95% CI) were as follows: Lp(a), 1.051 (1.022 to 1.081); LpPLA2 mass, 1.036 (1.006 to 1.066) and LpPLA2 activity, 1.037 (1.004 to 1.071); sCD14, 1.039 (1.005 to 1.073). FGF-23 was positively associated with MAC, 1.040 (1.004 to 1.078) and fetuin-A was negatively associated, 0.949 (0.911 to 0.989). No biomarkers were significantly associated with AAC.

CONCLUSION: This study shows novel associations of circulating FGF-23 and fetuin-A with MAC, and LpPLA2 and sCD14 with AVC, confirming that previously reported for Lp(a). Further investigation of Lp and inflammatory pathways may provide added insight into the aetiology of AVC, while study of phosphate regulation may illuminate the pathogenesis of MAC.

1 aBortnick, Anna, E1 aBartz, Traci, M1 aIx, Joachim, H1 aChonchol, Michel1 aReiner, Alexander1 aCushman, Mary1 aOwens, David1 aBarasch, Eddy1 aSiscovick, David, S1 aGottdiener, John, S1 aKizer, Jorge, R uhttps://chs-nhlbi.org/node/712003140nas a2200289 4500008004100000022001400041245015000055210006900205260001300274300000700287490000700294520224800301100002102549700001302570700002002583700002202603700001902625700002102644700002002665700001802685700002202703700002402725700002102749700002402770700002002794856003602814 2017 eng d a1862-351400aRelationship of bone mineral density with valvular and annular calcification in community-dwelling older people: The Cardiovascular Health Study.0 aRelationship of bone mineral density with valvular and annular c c2017 Dec a520 v123 a

Associations between bone mineral density and aortic valvular, aortic annular, and mitral annular calcification were investigated in a cross-sectional analysis of a population-based cohort of 1497 older adults. Although there was no association between continuous bone mineral density and outcomes, a significant association between osteoporosis and aortic valvular calcification in men was found.

INTRODUCTION: The process of cardiac calcification bears a resemblance to skeletal bone metabolism and its regulation. Experimental studies suggest that bone mineral density (BMD) and valvular calcification may be reciprocally related, but epidemiologic data are sparse.

METHODS: We tested the hypothesis that BMD of the total hip and femoral neck measured by dual-energy X-ray absorptiometry (DXA) is inversely associated with prevalence of three echocardiographic measures of cardiac calcification in a cross-sectional analysis of 1497 older adults from the Cardiovascular Health Study. The adjusted association of BMD with aortic valve calcification (AVC), aortic annular calcification (AAC), and mitral annular calcification (MAC) was assessed with relative risk (RR) regression.

RESULTS: Mean (SD) age was 76.2 (4.8) years; 58% were women. Cardiac calcification was highly prevalent in women and men: AVC, 59.5 and 71.0%; AAC 45.1 and 46.7%; MAC 42.8 and 39.5%, respectively. After limited and full adjustment for potential confounders, no statistically significant associations were detected between continuous BMD at either site and the three measures of calcification. Assessment of WHO BMD categories revealed a significant association between osteoporosis at the total hip and AVC in men (adjusted RR compared with normal BMD = 1.24 (1.01-1.53)). In graded sensitivity analyses, there were apparent inverse associations between femoral neck BMD and AVC with stenosis in men, and femoral neck BMD and moderate/severe MAC in women, but these were not significant.

CONCLUSION: These findings support further investigation of the sex-specific relationships between low BMD and cardiac calcification, and whether processes linking the two could be targeted for therapeutic ends.

1 aMassera, Daniele1 aXu, Shuo1 aBartz, Traci, M1 aBortnick, Anna, E1 aIx, Joachim, H1 aChonchol, Michel1 aOwens, David, S1 aBarasch, Eddy1 aGardin, Julius, M1 aGottdiener, John, S1 aRobbins, John, R1 aSiscovick, David, S1 aKizer, Jorge, R uhttps://chs-nhlbi.org/node/7488