The Circulating Inactive Form of Matrix Gla Protein is a Surrogate Marker for Vascular Calcification in Chronic Kidney Disease: a Preliminary Report

Overview

Journal Clin J Am Soc Nephrol

Specialty Nephrology

Date 2010 Feb 6

PMID 20133489

Citations 128

Authors

Leon J Schurgers

Daniela V Barreto

Fellype C Barreto

Sophie Liabeuf

Cedric Renard

Elke J Magdeleyns

Cees Vermeer

Gabriel Choukroun

Ziad A Massy

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Vitamin K-dependent matrix Gla protein (MGP) acts as a calcification inhibitor in vitro and in vivo. The present study was performed to (1) determine plasma levels of the inactive, dephosphorylated, uncarboxylated MGP (dp-ucMGP) in a cohort of patients at different stages of chronic kidney disease (CKD) and (2) evaluate the association between dp-ucMGP levels on one hand and aortic calcification and mortality on the other.

Design, Setting, Participants, & Measurements: 107 patients (67 +/- 13 years; 60% male; 32% at CKD stages 2 to 3, 31% at stages 4 to 5, 37% at stage 5D) were assayed for dp-ucMGP and underwent multislice spiral computed tomography scans to quantify aortic calcification at baseline. They were prospectively monitored for mortality.

Results: Plasma dp-ucMGP levels augmented progressively with CKD stage, with a significant difference from CKD stage 4. CKD stage, hemoglobin, age, and coumarin use were independently associated with plasma dp-ucMGP levels. Furthermore, plasma dp-ucMGP and age were positively and independently associated with the aortic calcification score. During follow-up (802 +/- 311 days), 34 patients died (20 from cardiovascular events). In a crude analysis, [plasma dp-ucMGP] > 921 pM was associated with overall mortality; this association was lost after adjusting for both age and the calculated propensity score.

Conclusions: Plasma dp-ucMGP increased progressively in a CKD setting and was associated with the severity of aortic calcification. Plasma dp-ucMGP could thus be a surrogate marker for vascular calcification in CKD.

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