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Updated: Mar 4, 2026
Analysis of Extracellular Vesicle-Mediated Vascular Calcification Using In Vitro and In Vivo Models
Published on: January 27, 2023
Relationships between vascular calcification, calcium metabolism, bone density, and fractures
Tom K M Wang1, Mark J Bolland, Niels C van Pelt
1Department of Medicine, University of Auckland, Auckland, New Zealand. kwan076@aucklanduni.ac.nz
Insights
Serum calcium and phosphate levels are linked to abdominal aortic calcification in older women. However, calcium intake and supplementation did not affect vascular calcification changes over time.
Area of Science:
- Cardiovascular Health
- Metabolic Bone Disease
- Vascular Biology
Background:
- Calcium metabolism factors are linked to vascular disease.
- Vascular calcification, including abdominal aortic calcification (AAC) and coronary artery calcification (CAC), is a marker of vascular disease.
- The role of calcium metabolism in vascular calcification requires further investigation.
Purpose of the Study:
- To investigate the association between calcium metabolism factors and vascular calcification.
- To assess if serum calcium, phosphate, dietary calcium, and calcium supplementation influence AAC and CAC.
- To examine the relationship between calcium metabolism and bone mineral density (BMD) and fracture incidence.
Main Methods:
- Analysis of data from two randomized, placebo-controlled trials involving postmenopausal women and middle-aged/older men.
- Assessment of abdominal aortic calcification (AAC) using vertebral morphometric images.
- Coronary artery calcification (CAC) assessed via computed tomography in men.
- Evaluation of serum calcium, phosphate, dietary calcium intake, and calcium supplementation.
Main Results:
- In elderly women, AAC was positively associated with serum calcium, phosphate, and the calcium-phosphate product.
- Changes in AAC over time and cardiovascular events were not related to these serum factors in women.
- AAC and CAC in men showed no consistent relationship with serum calcium and phosphate.
- Neither dietary calcium nor supplementation was associated with changes in AAC or CAC in either group.
- AAC and CAC were not associated with bone mineral density or fracture incidence.
Conclusions:
- Serum calcium and phosphate levels are associated with abdominal aortic calcification in older women.
- Dietary calcium intake and calcium supplementation do not appear to influence the progression of vascular calcification over 2-5 years.
- The findings suggest a complex interplay between calcium metabolism and vascular health, with specific factors influencing calcification differently across populations and calcification types.
Abstract:
Factors involved with calcium metabolism, such as serum calcium and phosphate and calcium intake, have been associated with vascular disease in different populations. We investigated whether this association is mediated via increased vascular calcification by assessing relationships between these factors and abdominal aortic calcification (AAC) and coronary artery calcification (CAC). A total of 1471 healthy postmenopausal women participated in a 5-year randomized, placebo-controlled trial of calcium 1 g/day, and 323 healthy middle-aged and older men participated in a 2-year randomized, placebo-controlled trial of calcium 600 or 1200 mg/day. AAC was assessed on vertebral morphometric images at baseline and follow-up. Based on computed tomography, 163 men had CAC assessed, on average, 1.5 years after study completion. In elderly women, AAC was positively related to serum calcium (p < .001), phosphate (p = .04), and the calcium-phosphate product (p = .003), but changes in AAC over time and incidence of cardiovascular events were not related to these variables. In middle-aged men, AAC and CAC were not consistently related to these variables. Neither dietary calcium intake nor calcium supplementation was associated with changes in the prevalence of AAC over time, and calcium supplementation also was not related to CAC scores in men. After adjusting for age, AAC was not associated with low bone mineral density (BMD) at baseline, changes in BMD over time, or fracture incidence. CAC also was not related to baseline BMD. In summary, serum calcium and phosphate are associated with AAC in older women, but dietary calcium intake and calcium supplementation were not associated with changes in AAC over 2 to 5 years.
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