title: Severe abdominal aortic calcification in older men is negatively associated with DKK1 serum levels: the STRAMBO study.
abstract: BACKGROUND
  Experimental data show that dickkopf-1 (DKK1) may be involved in the regulation of arterial calcification. However, clinical data on the association between serum DKK1 levels and severity of abdominal aortic calcification (AAC) are scarce.
  
  
  OBJECTIVE
  Our aim was to determine the association between serum DKK1 concentration and AAC severity in men.
  
  
  METHODS
  This is a cross-sectional analysis in the STRAMBO cohort.
  
  
  METHODS
  The cohort was recruited from the general population.
  
  
  METHODS
  We examined 1139 male volunteers aged 20 to 87 years. No specific exclusion criteria were used.
  
  
  METHODS
  We collected blood samples and assessed AAC severity on the lateral spine scans obtained by a Discovery A Hologic device using the semiquantitative Kauppila score.
  
  
  METHODS
  We tested the hypothesis that low DKK1 levels are associated with AAC severity in men.
  
  
  RESULTS
  In men aged 20 to 60 years, serum DKK1 levels were not associated with other variables. In men aged 60 years and older, lower DKK1 levels were associated with higher odds of severe AAC (AAC score >5). After adjustment for confounders, odds of severe AAC increased with decreasing DKK1 levels (odds ratio = 1.42, 95% confidence interval = 1.13-1.79, P < .005) and was higher below vs above the median DKK1 level (odds ratio = 2.19, 95% confidence interval = 1.37-3.49, P < .005). Heavy smoking, hypertension, ischemic heart disease, and elevated levels of fibroblast growth factor 23 were associated with severe AAC significantly, independently of DKK1 and additively with low DKK1 levels.
  
  
  CONCLUSIONS
  In older men, lower serum DKK1 levels are associated with severe AAC regardless of age and other potential confounders.
authors.affiliation: Inserm Unité Mixte de Recherche 1033 (P.S., R.C.), University of Lyon, Hospices Civils de Lyon, F-69437 Lyon, France; Department of Internal Medicine and Cardiology (M.S.), Philipps-University, D-35043 Marburg, Germany; Division of Endocrinology, Diabetes, and Bone Diseases (T.D.R., L.C.H.), Dresden University Medical Center, Dresden, Germany; and Center for Regenerative Therapies (L.C.H.), D-01307 Dresden, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Szulc
authors.forename: M
authors.initials: M
authors.lastname: Schoppet
authors.forename: T D
authors.initials: TD
authors.lastname: Rachner
authors.forename: R
authors.initials: R
authors.lastname: Chapurlat
authors.forename: L C
authors.initials: LC
authors.lastname: Hofbauer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging; D011859:Radiography; D012907:Smoking / Q000009:adverse effects; D013131:Spine / Q000000981:diagnostic imaging; D061205:Vascular Calcification / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology
chemical_list: C501126:DKK1 protein, human; D036341:Intercellular Signaling Peptides and Proteins; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23