Abstract
Pathological calcification generally consists of the formation of solid deposits of hydroxyapatite (calcium phosphate) in soft tissues. Supersaturation is the thermodynamic driving force for crystallization, so it is believed that higher blood levels of calcium and phosphate increase the risk of cardiovascular calcification. However several factors can promote or inhibit the natural process of pathological calcification. This cross-sectional study evaluated the relationship between physiological levels of urinary phytate and heart valve calcification in a population of elderly out subjects. A population of 188 elderly subjects (mean age: 68 years) was studied. Valve calcification was measured by echocardiography. Phytate determination was performed from a urine sample and data on blood chemistry, end-systolic volume, concomitant diseases, cardiovascular risk factors, medication usage and food were obtained. The study population was classified in three tertiles according to level of urinary phytate: low (<0.610 μM), intermediate (0.61–1.21 μM), and high (>1.21 μM). Subjects with higher levels of urinary phytate had less mitral annulus calcification and were less likely to have diabetes and hypercholesterolemia. In the multivariate analysis, age, serum phosphorous, leukocytes total count and urinary phytate excretion appeared as independent factors predictive of presence of mitral annulus calcification. There was an inverse correlation between urinary phytate content and mitral annulus calcification in our population of elderly out subjects. These results suggest that consumption of phytate-rich foods may help to prevent cardiovascular calcification evolution.
Highlights
Numerous mechanisms regulate calcium levels in the body, and blood levels of calcium in healthy individuals usually occur within a narrow range
The prevalence of diabetes type II is significantly higher at lower phytate tertiles (36.5%, 29.0% and 17.5%; p = 0.048)
Analysis of cardiovascular calcification indicated a trend for decreased aortic valve calcification as phytate urinary concentration increased (Fig 1)
Summary
Numerous mechanisms regulate calcium levels in the body, and blood levels of calcium in healthy individuals usually occur within a narrow range. Deposition of solid can occur in a controlled manner, such as during teeth or bone formation, or can be associated with pathological processes such as the formation of dental calculi, dental tartar, kidney stones, chondrocalcinosis, calcinosis cutis, and cardiovascular calcification (CVC). Pathological calcification generally consists of the formation of solid deposits of hydroxyapatite (calcium phosphate) in soft tissues. The extent of CVC in subjects at 90 years old is 30-fold equal or greater than in their twenties [4], and dialysis subjects have calcification scores 2 to 5-fold greater than age matched individuals with normal renal function and angiographically proven coronary artery disease [5]. The extent and rate of progression of CVC are strong predictors of cardiovascular events and mortality in the general population, the elderly, subjects with diabetes, and subjects with chronic kidney disease (CKD) who are undergoing dialysis [6,7,8]. A study of 4 ethnic groups indicated that CVC was a stronger predictor of cardiovascular risk than other classical risk factors such as hypertension and elevated cholesterol [9]
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