Parathyroid Hormone and Vitamin D Levels Are Independently Associated With Calcific Aortic Stenosis

Circ J. 2008 Feb;72(2):245-50. doi: 10.1253/circj.72.245.

Abstract

Background: In calcific aortic valve disease, the early lesion is similar to atherosclerotic plaque, but later calcification prevails. Parathyroid hormone (PTH) and vitamin D are the principal calcium pool regulators, so the present study was designed to assess their association with aortic stenosis (AS) in patients with significant coronary artery disease (CAD), and preserved renal function.

Methods and results: The 122 consecutive patients with AS (mean gradient > or =30 mmHg) plus CAD, and 101 patients with nonobstructive aortic sclerosis (mean gradient < or =10 mmHg) plus CAD, as controls, were prospectively enrolled. The AS patients were older (71+/-7 vs 66+/-7 years; p<0.001), had higher serum intact (i)PTH (51.4 [39-70] vs 37.4 [27-50] pg/ml; p<0.001), and lower plasma vitamin D (32.0 [25-40] vs 35.8 [27-55] nmol/L; p=0.003) levels than those with aortic sclerosis. The groups did not differ significantly in creatinine level (93 [82-105] vs 96 [85-107] micromol/L, p=0.19), calcium - phosphate product, occurrence of hypertension, smoking, diabetes, dyslipidemia, or body mass index. The iPTH (odds ratio (OR) 1.04, 95% confidence interval (CI) 1.02-1.05; p<0.001) and vitamin D levels (OR 0.97, 95% CI 0.95-0.99; p=0.003) were independently associated with AS.

Conclusion: Higher serum iPTH with lower vitamin D levels were independently associated with calcific AS in CAD patients.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aortic Valve Stenosis / blood*
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / physiopathology
  • Calcinosis / blood*
  • Calcinosis / complications
  • Calcinosis / physiopathology
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / physiopathology
  • Female
  • Humans
  • Kidney / physiopathology
  • Male
  • Middle Aged
  • Parathyroid Hormone / blood*
  • Prospective Studies
  • Vitamin D / blood*

Substances

  • Parathyroid Hormone
  • Vitamin D