Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Izumo, Japan; Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
Atherosclerosis. 2018 Jun;273:145-152. doi: 10.1016/j.atherosclerosis.2018.03.035. Epub 2018 Mar 22.
Calcific aortic valve disease (CAVD) is the most common valve disease. Although micronutrients are known to contribute to cardiovascular disease, the relationship with CAVD remains poorly evaluated. We examined the association of serum levels of magnesium, phosphorus, and calcium with prevalence, incidence, and progression of aortic valve calcification (AVC).
We conducted a prospective study in a population-based sample of Japanese men aged 40-79 years without known cardiovascular disease and chronic kidney disease at baseline, and quantified AVC from serial computed tomographic images with the Agatston method.
Of 938 participants at baseline (mean age, 63.7 ± 9.9 years), AVC prevalence was observed in 173 (18.4%). Of 596 participants without baseline AVC at follow-up (median duration, 5.1 years), AVC incidence was observed in 138 (23.2%). After adjustment for demographics, behaviors and cardiovascular risk factors, relative risks (95% confidence intervals) in the highest versus lowest categories of serum magnesium, phosphorus, and calcium were 0.62 (0.44-0.86), 1.45 (1.02-2.04), and 1.43 (0.95-2.15), respectively, for AVC prevalence and 0.62 (0.42-0.92), 1.93 (1.28-2.91), and 1.09 (0.77-1.55), respectively, for AVC incidence. Their linear trends of serum magnesium and phosphorus were also all statistically significant. Of 131 participants with baseline AVC, there was no association of any serum micronutrients with AVC progression.
Serum magnesium was inversely associated, while serum phosphorus was positively associated with AVC prevalence and incidence, suggesting that these serum micronutrients may be potential candidates for risk prediction or prevention of CAVD, and warranting further studies.
钙化性主动脉瓣疾病（CAVD）是最常见的瓣膜疾病。尽管已知微量营养素会导致心血管疾病，但它们与 CAVD 的关系仍未得到充分评估。我们研究了血清镁、磷和钙水平与主动脉瓣钙化（AVC）患病率、发病率和进展的关系。
我们在一项基于人群的日本男性研究中进行了一项前瞻性研究，参与者年龄在 40-79 岁之间，基线时无已知心血管疾病和慢性肾脏病，并使用 Agatston 方法从连续的计算机断层扫描图像中定量 AVC。
在基线时的 938 名参与者（平均年龄 63.7±9.9 岁）中，有 173 名（18.4%）存在 AVC 患病率。在随访时无基线 AVC 的 596 名参与者（中位随访时间为 5.1 年）中，有 138 名（23.2%）出现 AVC 发病率。在校正人口统计学、行为和心血管危险因素后，血清镁、磷和钙最高与最低分类的相对风险（95%置信区间）分别为 0.62（0.44-0.86）、1.45（1.02-2.04）和 1.43（0.95-2.15），用于 AVC 患病率和 0.62（0.42-0.92）、1.93（1.28-2.91）和 1.09（0.77-1.55），分别用于 AVC 发病率。血清镁和磷的线性趋势也均具有统计学意义。在 131 名基线有 AVC 的参与者中，没有任何血清微量营养素与 AVC 进展相关。
血清镁呈负相关，而血清磷呈正相关，与 AVC 的患病率和发病率相关，这表明这些血清微量营养素可能是 CAVD 风险预测或预防的潜在候选物，值得进一步研究。
