Department of Medical Biochemistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Clin Chem Lab Med. 2013 May;51(5):1115-23. doi: 10.1515/cclm-2012-0329.
Carotid calcification is an independent marker for future ischemic events, which are more frequently encountered in postmenopausal women as the prevalence of type 2 diabetes mellitus (T2DM) and hypertension (HT) increases. Matrix Gla protein (MGP) is a major inhibitor of vascular calcification. Here, we report on the prospect of serum MGP to become an identifying tool for minor carotid stenosis (minCAS) with calcification in a risk population.
Based on carotid ultrasound examination, out of 72 enrolled postmenopausal women, 33 had minCAS with carotid calcification (minCAS group) and 39 were without minCAS and carotid calcification (non-minCAS group). Serum total MGP, high-sensitivity C-reactive protein (hs-CRP), bone mineral density (BMD) and carotid intima-media thickness (CIMT) were determined.
We found significantly elevated serum MGP levels in the minCAS compared to the non-minCAS group (p < 0.05). MGP was independently associated with hs-CRP (unstandardized β -regression coefficient = 2.6; 95 % CI 0.007 – 5.3; p = 0.049) and CIMT ( β = – 611.3; 95 % CI – 1172.6 – – 49.9; p = 0.034) within the minCAS group, but not with BMD. Furthermore, significantly higher MGP levels were determined in two minCAS subgroups (one with HT or T2DM and second with both diseases) compared to a non-minCAS subgroup with HT or T2DM (p < 0.05 and p < 0.01, respectively). A threshold of 87.9 μ g/L serum MGP (area under the receiver operating characteristic = 0.72 } 0.06; 95 % CI 0.60 – 0.84; p = 0.001) may identify minCAS with calcification in postmenopausal women with 63 % precision.
Higher circulating MGP levels could help identify minCAS with calcification in a relatively homogenous risk population (i.e., postmenopausal women), regardless of underlying cardiovascular risk factors.
颈动脉钙化是未来发生缺血性事件的独立标志物，随着 2 型糖尿病（T2DM）和高血压（HT）患病率的增加，绝经后妇女更常发生这种事件。基质 Gla 蛋白（MGP）是血管钙化的主要抑制剂。在这里，我们报告了血清 MGP 有望成为伴钙化的小颈动脉狭窄（minCAS）的鉴别工具。
基于颈动脉超声检查，在 72 名入组的绝经后妇女中，33 名患有伴钙化的 minCAS（minCAS 组），39 名无 minCAS 和颈动脉钙化（非 minCAS 组）。测定血清总 MGP、高敏 C 反应蛋白（hs-CRP）、骨密度（BMD）和颈动脉内膜中层厚度（CIMT）。
我们发现 minCAS 组的血清 MGP 水平明显高于非 minCAS 组（p<0.05）。MGP 与 hs-CRP 独立相关（未标准化β回归系数=2.6；95%置信区间 0.007-5.3；p=0.049）和 minCAS 组内的 CIMT（β=-611.3；95%置信区间-1172.6--49.9；p=0.034），但与 BMD 无关。此外，在两个 minCAS 亚组（一个伴有 HT 或 T2DM，另一个同时伴有两种疾病）中，MGP 水平明显高于 HT 或 T2DM 的非 minCAS 亚组（p<0.05 和 p<0.01）。血清 MGP 阈值为 87.9μg/L（受试者工作特征曲线下面积=0.72{0.06}；95%置信区间 0.60-0.84；p=0.001），可在绝经后妇女中以 63%的准确率识别伴钙化的 minCAS。
较高的循环 MGP 水平可能有助于识别伴钙化的 minCAS 在相对同质的风险人群（即绝经后妇女）中，无论潜在的心血管危险因素如何。
