title: The association of uncarboxylated matrix Gla protein with mitral annular calcification differs by diabetes status: The Heart and Soul study.
abstract: OBJECTIVE
  Mitral annular calcification (MAC) and aortic stenosis (AS) are associated with systemic calcification and cardiovascular disease (CVD) events. Matrix Gla protein (MGP) is an inhibitor of vascular calcification and lower levels of its precursor - uncarboxylated MGP (ucMGP) - are associated with vascular calcification in pilot studies.
  
  
  RESULTS
  In this cross-sectional study of 839 outpatients with stable CVD, we measured serum ucMGP, and evaluated MAC and AS by echocardiography. The association of ucMGP with MAC differed by diabetes status (interaction P<0.001). Among participants without diabetes (n=615), higher ucMGP (per standard deviation [1178nM] increase) was associated with lower odds of MAC (odds ratio [OR] 0.73; 95% confidence interval [CI] 0.55-0.97) in models adjusted for traditional CVD risk factors, C-reactive protein, and kidney function. Among persons with diabetes (n=221), higher ucMGP was associated with higher odds of MAC (OR 1.89; 95% CI 1.29-2.78). Results were qualitatively similar for the association of ucMGP with AS although not statistically significant.
  
  
  CONCLUSIONS
  Among outpatients with stable CVD, higher ucMGP is associated with lower odds of MAC in persons without diabetes, and higher odds of MAC in persons with diabetes. Future studies should determine whether ucMGP levels are associated with CVD events, and whether such associations differ by diabetes status.
authors.affiliation: Department of Medicine, Division of Nephrology, University of California, San Diego, United States.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Parker
authors.forename: Leon J
authors.initials: LJ
authors.lastname: Schurgers
authors.forename: Cees
authors.initials: C
authors.lastname: Vermeer
authors.forename: Nelson B
authors.initials: NB
authors.lastname: Schiller
authors.forename: Mary A
authors.initials: MA
authors.lastname: Whooley
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000473:pathology*; D002135:Calcium-Binding Proteins / Q000097:blood*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood / Q000473:pathology*; D016326:Extracellular Matrix Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology*; D010865:Pilot Projects; D014463:Ultrasonography; D000097568:Matrix Gla Protein
chemical_list: D002135:Calcium-Binding Proteins; D016326:Extracellular Matrix Proteins; D000097568:Matrix Gla Protein