title: Association of serum phosphate levels with aortic valve sclerosis and annular calcification: the cardiovascular health study.
abstract: OBJECTIVE
  This study was conducted to evaluate mineral metabolism markers as potential risk factors for calcific aortic valve disease.
  
  
  BACKGROUND
  Mineral metabolism disturbances are common among older people and may contribute to cardiac valvular calcification. Associations of serum mineral metabolism markers with cardiac valvular calcification have not been evaluated in a well-characterized general population of older adults.
  
  
  METHODS
  We measured serum levels of phosphate, calcium, parathyroid hormone, and 25-hydroxyvitamin D in 1,938 Cardiovascular Health Study participants who were free of clinical cardiovascular disease and who underwent echocardiographic measurements of aortic valve sclerosis (AVS), mitral annular calcification (MAC), and aortic annular calcification (AAC). We used logistic regression models to estimate associations of mineral metabolism markers with AVS, MAC, and AAC after adjustment for relevant confounding variables, including kidney function.
  
  
  RESULTS
  The respective prevalences of AVS, MAC, and AAC were 54%, 39%, and 44%. Each 0.5 mg/dl higher serum phosphate concentration was associated with greater adjusted odds of AVS (odds ratio [OR]: 1.17, 95% confidence interval [CI]: 1.04 to 1.31, p = 0.01), MAC (OR: 1.12, 95% CI: 1.00 to 1.26, p = 0.05), and AAC (OR: 1.12, 95% CI: 0.99 to 1.25, p = 0.05). In contrast, serum calcium, parathyroid hormone, and 25-hydroxyvitamin D concentrations were not associated with aortic or mitral calcification.
  
  
  CONCLUSIONS
  Higher serum phosphate levels within the normal range were associated with valvular and annular calcification in a community-based cohort of older adults. Phosphate may be a novel risk factor for calcific aortic valve disease and warrants further study.
authors: Health Services Research and Development Northwest Center for Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, Washington 98195-6422, USA. linefsky@u.washington.edu
authors: Jason P
authors: JP
authors: Linefsky
authors: Kevin D
authors: KD
authors: O'Brien
authors: Ronit
authors: R
authors: Katz
authors: Ian H
authors: IH
authors: de Boer
authors: Eddy
authors: E
authors: Barasch
authors: Nancy S
authors: NS
authors: Jenny
authors: David S
authors: DS
authors: Siscovick
authors: Bryan
authors: B
authors: Kestenbaum
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000473:pathology*; D002114:Calcinosis / Q000097:blood* / Q000473:pathology; D002118:Calcium / Q000097:blood; D005260:Female; D006349:Heart Valve Diseases / Q000097:blood* / Q000473:pathology; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood*; D012307:Risk Factors; D012598:Sclerosis; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium