Low calcidiol levels and risk of progression of aortic calcification

Abstract

Introduction: The aim of this study was to investigate the relationship between serum calcidiol levels and the onset and progression of aortic calcifications in a communitybased sample of ambulatory subjects. Methods: 302 men and women aged 50 and over underwent two lateral X-rays and were followed-up for 4 years. Abdominal aortic calcifications were classified as absent, mild-moderate, and severe. The biochemical measurements of serum calcium, phosphorus, PTH, total alkaline phosphatase, tartrate-resistant acid phosphatase, creatinine, calcidiol, calcitriol and osteocalcin were determined. Subjects who had received anti-osteoporotic treatments were excluded from the analysis. Results: Subjects with progression of aortic calcifications had significantly lower serum calcidiol levels than those without progression. In the multivariate analysis, using the agreed upon serum levels for calcidiol (> 30 ng/mL) as the reference, those subjects with calcidiol levels between 10 to 20 ng/mL showed a higher risk of progression of aortic calcification (OR = 3.95; 95% CI = 1.16 to 13.40). An even higher OR was observed in subjects with calcidiol values < 10 ng/mL (OR = 4.10; 95%CI = 1.12 to 14.99). In addition, an increase by 1 ng/mL in osteocalcin levels was associated with a 17% reduction of the risk of aortic calcification progression. Conclusions: An increase by 10 ng/mL of calcidiol was associated with a decrease in the risk of aortic calcifications progression by 44%. This figure was even higher than that observed if we increased age by 10 years. Levels of calcidiol higher than 30 ng/mL seem to be desirable to reduce the progression of aortic calcification and to maintain bone turnover.