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

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.

The impact of fetuin-A on predicting aortic arch calcification: secondary analysis of a community-based survey

“…According to the STRAMBO study, lower levels of fetuin-A are associated with severe abdominal aorta calcification, but the study was restricted to men over 40 years of age, and the focus was on the abdominal aorta ( 20 ). Likewise, another study found a significant negative correlation between fetuin-A levels and the degree of abdominal aortic calcification among stone farmers ( 24 ). Chen et al concluded that patients with lower fetuin-A showed higher percentages of AAC on a plain chest x-ray defined posterior–anterior profile compared with patients with higher fetuin-A ( 25 ).…”

Relationship between Arterial Calcification and Fetuin-A Levels in Patients with Chronic Kidney Disease at the Onset of Hemodialysis

“…One of them failed to demonstrate the clear protective relationship of fetuin [20]. More recently, a study correlated fetuin levels with bone porosity in stone formers [21]. In children with chronic kidney disease, a study observed the relationship between fetuin levels and other risk factors for vascular calcification [22].…”