Vascular Calcification Is Associated with Fetuin-A and Cortical Bone Porosity in Stone Formers

Author(s)

Rodrigues, Fernanda Guedes ; Carvalho Azambuja Neves, Rodrigo Fernandes ; Ormanji, Milene Subtil ; Goncalves Esper, Priscila Ligeiro ; Gaspar, Melissa ; Rodrigues Pereira, Rosa Maria ; Requiao-Moura, Lucio R. ; de Borst, Martin H. ; Heilberg, Ita Pfeferman

• Document type: Journal article
• Source: JOURNAL OF PERSONALIZED MEDICINE; v. 12, n. 7, p. 12-pg., 2022-07-01.

Abstract

Background: Nephrolithiasis has been associated with bone loss and vascular calcification (VC), reflecting abnormal extraosseous calcium deposition. Fetuin-A (Fet-A) acts as a potent inhibitor of ectopic mineralization. The aim of the present study was to evaluate the prevalence of VC in stone formers (SF) and non-stone formers (NSF) and to investigate potential determinants of VC among SF, including circulating levels of Fet-A and bone microarchitecture parameters. Methods: Abdominal aortic calcification (AAC) was assessed using available computed tomography in SF and in age-, sex-, and BMI-matched NSF (potential living kidney donors). Serum Fet-A was measured in stored blood samples from SF. Bone microarchitecture parameters were obtained as a post hoc analysis of a cross-sectional cohort from young SF evaluated by high-resolution peripheral quantitative computed tomography (HR-pQCT). Results: A total of 62 SF (38.0 [28.0-45.3] years old) and 80 NSF (40.0 [37.0-45.8] years old) were included. There was no significant difference in AAC scores between SF and NSF. However, when dividing SF according to mean AAC score, below <5.8% (n = 33) or above >= 5.8% (n = 29), SF with higher AAC presented significantly higher BMI and tibial cortical porosity (Ct.Po) and significantly lower serum HDL, klotho, Fet-A, and eGFR. Urinary calcium did not differ between groups, but fractional excretion of phosphate was higher in the former. Upon multivariate regression, BMI, serum Fet-A, and tibial Ct.Po remained independently associated with AAC. Conclusions: This study suggests an association between reduced circulating Fet-A levels and increased bone Ct.Po with VC in SF. (AU)

• FAPESP's process: 16/25359-0 - Evaluation of bone microarchitecture and finite element and their association with anthropometric, densitometric biochemical and hormonal parameters in hypercalciuric nephrolithiasis patients
• Grantee: Ita Pfeferman Heilberg
• Support Opportunities: Regular Research Grants