title: Relationship between renal stone formation, mitral annular calcification and bone resorption markers.
abstract: OBJECTIVE
  Mitral annular calcification (MAC) is associated with osteoporosis and there is evidence of reduced bone mineral density (BMD) in patients with renal stone formation (RSF). Therefore, we designed this study to test if RSF was associated with MAC and if this association could be linked to bone resorption.
  
  
  METHODS
  Fifty-nine patients (mean age, 41.5 years) with RSF and 40 healthy subjects (mean age, 44.2 years) underwent screening for MAC and BMD, and measurements were taken of serum and urine electrolytes, parathyroid hormone, alkaline phosphatase and urine dypyridoline.
  
  
  RESULTS
  MAC was diagnosed in 11 (18%) patients with RSF compared with 1 (2.5%) control (P=.01). Urine phosphorus, magnesium, sodium, potassium and chloride levels were lower (P<.001, P=.02, P<.001, P<.001 and P<.001, respectively), but serum alkaline phosphatase, calcium and potassium levels were higher (P=.008, P=.007 and P=.001, respectively) in patients with RSF versus those without RSF. None of these abnormalities were found in patients or subjects with MAC. Urine pyridoline levels were higher and T-scores were more negative (more osteopenic) in patients and subjects with MAC than in those without MAC (P=.01 and P=.004, respectively). In a multivariate analysis, only T-scores and urine dipyridoline level were predictive of MAC (P=.03 and P=.04, respectively).
  
  
  CONCLUSIONS
  Screening for MAC and bone resorption markers in patients with RSF demonstrated a high incidence of MAC in these patients. The presence of MAC in patients with RSF was associated with bone resorption markers. This seemingly complex interrelationship between RSF, MAC and bone loss needs to be clarified in further studies.
authors.affiliation: Department of Cardiology, Gaziantep University, School of Medicine, Gaziantep, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Celik
authors.forename: Vedat
authors.initials: V
authors.lastname: Davutoglu
authors.forename: Kemal
authors.initials: K
authors.lastname: Sarica
authors.forename: Sakip
authors.initials: S
authors.lastname: Erturhan
authors.forename: Orhan
authors.initials: O
authors.lastname: Ozer
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Sari
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Baltaci
authors.forename: Murat
authors.initials: M
authors.lastname: Akcay
authors.forename: Behcet
authors.initials: B
authors.lastname: Al
authors.forename: Murat
authors.initials: M
authors.lastname: Yuce
authors.forename: Necat
authors.initials: N
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001862:Bone Resorption / Q000209:etiology*; D002114:Calcinosis / Q000209:etiology*; D016022:Case-Control Studies; D004573:Electrolytes / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology*; D015999:Multivariate Analysis
chemical_list: D015415:Biomarkers; D004573:Electrolytes