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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
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Gla-Rich Protein, Magnesium and Phosphate Associate with Mitral and Aortic Valves Calcification in Diabetic Patients

Ana P Silva1,2, Carla S B Viegas3,4, Patrícia Guilherme5

  • 1Department of Nephrology, Centro Hospitalar Universitário do Algarve, 8000-386 Faro, Portugal.

Diagnostics (Basel, Switzerland)
|February 25, 2022
PubMed

Insights

Low Gla-rich protein (GRP) levels are linked to heart valve calcification in chronic kidney disease (CKD) patients. This finding suggests GRP may aid in early cardiovascular risk assessment for CKD individuals.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • Cardiovascular calcification, particularly valvular calcification (VC), is prevalent and a significant mortality predictor in chronic kidney disease (CKD) patients.
  • Early diagnosis of VC is challenging due to a lack of validated biomarkers.
  • Gla-rich protein (GRP) is identified as a potential inhibitor of cardiovascular calcification.

Purpose of the Study:

  • To investigate the association between serum Gla-rich protein (GRP) levels and the presence of mitral and aortic valve calcification (VC) in diabetic patients with CKD stages 2-4.
  • To evaluate GRP as a potential diagnostic biomarker for VC in this high-risk population.

Main Methods:

  • A cohort of 80 diabetic patients with CKD stages 2-4 was studied.
  • Serum GRP levels were measured and correlated with the presence of mitral and aortic valve calcification.
  • Statistical analyses, including univariate, multivariate, and Poisson regression, were performed, alongside Receiver Operating Characteristic (ROC) curve analysis.

Main Results:

  • Valvular calcification (VC) was detected in 36.2% (mitral) and 34.4% (aortic) of patients.
  • Lower serum GRP levels were significantly associated with both mitral and aortic VC, independent of age and gender.
  • Low GRP and magnesium (Mg), and high phosphate (P) levels were associated with VC. GRP demonstrated higher diagnostic value (AUC for mitral: 0.762, aortic: 0.802) compared to Mg and P.

Conclusions:

  • Low serum GRP levels, along with low magnesium and high phosphate, are independent and cumulative risk factors for valvular calcification (VC) in diabetic CKD patients.
  • GRP shows potential as a useful biomarker for cardiovascular risk assessment in this population.
  • Further research is warranted to validate GRP's role in predicting VC and cardiovascular outcomes in CKD.

Keywords:
Gla-rich proteincardiovascular calcificationcardiovascular diseasecardiovascular risk assessmentchronic kidney diseasevalvular calcificationvascular calcification

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