title: Serum fetuin-A levels and abdominal aortic calcification in healthy men - The STRAMBO study.
abstract: Vascular calcification results from an imbalance between increased extracellular levels of calcium and phosphate, reduced solubility, and low levels of calcification inhibitors in blood or the vascular wall. Fetuin-A is a major circulating calcification inhibitor. Rodent models of fetuin-A deficit indicate its calcification inhibiting potential. Clinical studies suggest its role as a biomarker in vascular disease. This cross-sectional study was performed in a cohort of 974 men aged ≥ 40 years (average 68 years) consisting of men holding health insurance cover with Mutuelle des Travailleurs de la Région Lyonnaise. Abdominal aortic calcification (AAC) was assessed semi-quantitatively on lateral dual energy X-ray absorptiometry (DXA) spine scans. Serum fetuin-A was measured by an immunoassay. After adjustment for confounders (age, lifestyle, body composition, health status, treatment, glomerular filtration rate [GFR], hormones, and cytokines), prevalence of severe AAC (AAC score>4) decreased with increasing fetuin-A levels (OR=0.68 per SD increase, 95% CI: 0.54-0.84, p<0.001). After adjustment for confounders, low fetuin-A and hypertension were each associated with higher odds of AAC>4. Coexistence of low serum fetuin-A levels and heavy smoking, elevated fibroblast growth factor 23 levels or low serum dickkopf-1 levels were associated with higher odds of AAC>4. Similar results were obtained for 789 men with GFR>60 mL/min/1.73 m(2). Similar results were obtained when severe AAC was defined as AAC score >3 or AAC>5. Thus, lower serum fetuin-A levels are associated with severe AAC, suggesting that poor calcification inhibitory potential contributes to vascular calcification, independently of renal impairment.
authors.affiliation: Department of Internal Medicine and Cardiology, Philipps-University, D-35043 Marburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Schoppet
authors.affiliation: Division of Endocrinology, Diabetes, and Bone Diseases, Technische Universität Dresden Medical Center, D-01307 Dresden, Germany; Center for Regenerative Therapies, D-01307 Dresden, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Rauner
authors.affiliation: The Antibody Lab, Divischgasse 4, A-1210 Vienna, Austria.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Benner
authors.affiliation: INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, F-69437 Lyon, France.
authors.forename: Roland
authors.initials: R
authors.lastname: Chapurlat
authors.affiliation: Division of Endocrinology, Diabetes, and Bone Diseases, Technische Universität Dresden Medical Center, D-01307 Dresden, Germany; Center for Regenerative Therapies, D-01307 Dresden, Germany.
authors.forename: Lorenz C
authors.initials: LC
authors.lastname: Hofbauer
authors.affiliation: INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, F-69437 Lyon, France. Electronic address: pawel.szulc@inserm.fr.
authors.forename: Pawel
authors.initials: P
authors.lastname: Szulc
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology*; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061205:Vascular Calcification / Q000097:blood*; D055815:Young Adult; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis*
chemical_list: C556354:AHSG protein, human; D015415:Biomarkers; D060749:alpha-2-HS-Glycoprotein
keywords: Abdominal aorta calcification; Calcification inhibitor; Fetuin-A; Men; Mineral homeostasis