Calcium metabolism in adults with severe aortic valve stenosis and preserved renal function.
Data suggest a link of aortic stenosis (AS) with calcium and bone metabolism. To further investigate this, the following parameters were analyzed in 38 patients with severe AS and in 38 age- and gender-matched controls, without obstructive coronary artery disease and with preserved renal function: calcium, phosphate, 1,25(OH(2))-vitamin D(3), intact parathyroid hormone (iPTH), and osteoprotegerin. Patients with AS had significantly higher serum levels of calcium (2.63 +/- 0.28 vs 2.48 +/- 0.23 mmol/L, p <0.01) and phosphate (1.56 +/- 0.33 vs 1.38 +/- 0.26 mmol/L, p <0.01) and increased calcium-phosphorus products (4.16 +/- 1.13 vs 3.44 +/- 0.89 mmol/L(2), p = 0.003). Notably, the iPTH concentration in the AS group was lower, and significantly more patients in the AS group had levels less than the study median of 60 ng/L. Osteoprotegerin was elevated in patients with AS, confirming reports in other populations (9.94 +/- 5.96 vs 6.73 +/- 4.28 pmol/L, p = 0.009). The relations of several parameters to iPTH were also altered (AS vs controls): calcium and iPTH, 0.071 +/- 0.034 versus 0.046 +/- 0.023, p <0.0001; phosphate and iPTH, 0.042 +/- 0.020 versus 0.025 +/- 0.013, p <0.0001; vitamin D and iPTH, 0.99 +/- 0.61 versus 0.63 +/- 0.46, p = 0.006; and osteoprotegerin and iPTH, 0.24 +/- 0.15 versus 0.12 +/- 0.09, p <0.0001. In conclusion, these data support a hypothesis connecting (severe) AS to altered calcium and bone homeostasis.
Akat
Kemal
K
First Department of Medicine (Cardiology, Angiology, Pneumology, Intensive Care Medicine, Hemostaseology), Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany. kemal.akat@umm.de
Kaden
Jens Johannes
JJ
Schmitz
Fabian
F
Ewering
Silke
S
Anton
Anja
A
Klomfass
Sebastian
S
Hoffmann
Rainer
R
Ortlepp
Jan Rudolf
JR
D000368:Aged; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000503:physiopathology; D002118:Calcium / Q000097:blood*; D002762:Cholecalciferol / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D053244:Osteoprotegerin / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood
D053244:Osteoprotegerin; D010281:Parathyroid Hormone; D010710:Phosphates; D002762:Cholecalciferol; D003404:Creatinine; D002118:Calcium