Serum calcification propensity is associated with HbA1c in type 2 diabetes mellitus

Abstract

IntroductionSerum calcification propensity is emerging as an independent predictor for cardiovascular outcomes in high-risk populations. Calcification propensity can be monitored by the maturation time of calciprotein particles in serum (T50 test). A low T50 value is an independent determinant of cardiovascular morbidity and mortality in various populations. Aim was to investigate the T50 and its relationship to type 2 diabetes mellitus.Research design and methodsUsing nephelometry, serum T50 was cross-sectionally measured in 932 stable patients with type 2 diabetes mellitus (55% male) with a median age of 66 (62–75) years, diabetes duration of 6.5 (3.0–10.2) years and hemoglobin A1c (HbA1c) of 49 (44–54) mmol/mol.ResultsSerum T50 was normally distributed with a mean value of 261±66 min. In linear regression, serum T50 was lower in women and current smokers. A lower T50 value was found in patients with a higher HbA1c or higher systolic blood pressure, insulin users and patients with a longer history of diabetes. The association with HbA1c was independent of other determinants in multivariable analysis. There was no association between T50 and previous macrovascular events or the presence of microvascular disease.ConclusionsSerum calcification propensity is independently associated with glycemic control, suggesting that a lower HbA1c may be associated with better cardiovascular outcomes. Retrospective analysis could not establish an association between a history of macrovascular events and T50, and prospective studies will have to be performed to address this hypothesis.Trial registration numberNCT01570140.

Gender-Related Differences in Chronic Kidney Disease-Associated Vascular Calcification Risk and Potential Risk Mediators: A Scoping Review

“…Findings from large populationbased cohorts identified a VC prevalence of 40% to 60% and 30% to 40% among older [1,2] and middle-aged adults [3]. Meta-analyses revealed that the VC prevalence rose to 60% among patients with CKD regardless of age [4] and also increased in those with DM [5]. Calcifications affecting conduit arteries lead to vessel stiffening, increased peripheral resistance and the risk of hypertension, cardiac hypertrophy, heart failure and cardiovascular mortality.…”

Serum Calcification Propensity and Calcification of the Abdominal Aorta in Patients With Primary Aldosteronism

“…The T 50 test depends on calcification promoters and inhibitors present in the serum and is associated with cardiovascular mortality ( 23 ). Several studies have indicated that T 50 -values decrease in chronic renal failure or diabetes ( 23 , 32 ). T 50 -values of patients on dialysis are lower than in pre-dialysis patient, and associate with clinical outcomes ( 24 – 26 ).…”

Phosphate and fibroblast growth factor 23 in diabetes

“…Across many studies, plasma phosphate was consistently the strongest determinant of serum T50, even after multivariable adjustment [ 131 , 132 ]. Recently we performed a study in 932 patients with type 2 diabetes and discovered that glycosylated hemoglobin (HbA1c), reflecting long-term glycemic control, was inversely associated with serum T50 levels upon multivariate analysis [ 133 ]. Low serum T50 levels have also been associated with markers of inflammatory stress (such as TNF-α), as well as with markers of bone resorption [ 131 ].…”