Background
Materials and methods
Ethics statement
Patient selection
Study protocol
Laboratory tests
Imaging for calculation of the below-knee arterial calcification score
Statistical analyses
Odds ratio (95% confidence interval) | p | |
---|---|---|
Age | 1.07 (1.03; 1.11) | <0.0001 |
Ln [t-ucMGP] | 0.27 (0.11; 0.63) | 0.003 |
Ln [dp-ucMGP] | 1.88 (1.21; 2.91) | 0.005 |
Gender | 2.56 (1.36; 4.75) | 0.006 |
Previous CVD | 2.56 (1.36; 4.75) | 0.004 |
Odds ratio (95%confidence interval) | p | |
---|---|---|
Age per 1 year |
1.06 (1.02; 1.11)
|
0.006
|
Ln [t-ucMGP] | 0.44 (0.17; 1.15) | 0.092 |
Ln [dp-ucMGP] |
1.88 (1.14; 3.11)
|
0.014
|
Male gender |
3.84 (1.66; 8.88)
|
0.002
|
Previous CVD |
2.56 (1.20; 4.85)
|
0.013
|
Results
Baseline characteristics
All | [dp-ucMGP] ≤ 559.5 pM | [dp-ucMGP] > 559.5 pM | p | |
---|---|---|---|---|
n = 198 | n = 99 | n = 99 | ||
Age (years)
|
64 ± 8
|
63 ± 9
|
66 ± 8
|
0.002
|
Diabetes duration (years) | 15 ± 10 | 14 ± 10 | 15 ± 9 | 0.358 |
Male gender n (%) | 158 (80) | 82 (83) | 76 (77) | 0.288 |
Body mass index (kg/m
2
)
|
29 ± 5
|
28 ± 5
|
30 ± 5
|
<0.0001
|
SBP (mmHg) | 127 ± 17 | 126 ± 17 | 128 ± 17 | 0.377 |
DBP (mmHg) | 73 ± 9 | 73 ± 9 | 72 ± 8 | 0.487 |
Smoking habit n (%) | 119 (60) | 58 (59) | 61 (62) | 0.663 |
Previous CVD n (%) | 139 (70) | 66 (67) | 73 (74) | 0.277 |
Glycaemia (mmol/l) | 8.2 ± 2.8 | 8.0 ± 2.6 | 8.3 ± 2.9 | 0.401 |
(7.8) | (7.6) | (8.0) | ||
HbA1c (%) | 7.8 ± 1.5 (7.5) | 7.7 ± 1.4 | 7.9 ± 1.5 | 0.572 |
(7.5) | (7.5) | |||
GFR MDRD (mmol/l)
|
80 ± 19
|
82 ± 19
|
70 ± 19
|
<0.0001
|
Microalbuminuria (mg/l)
|
166 ± 840
|
169 ± 1132
|
162 ± 373
|
<0.0001
|
(23)
|
(14)
|
(33)
| ||
Calcium (mmol/l) | 2.30 ± 0.10 | 2.30 ± 0.10 | 2.34 ± 0.10 | 0.055 |
Phosphate (mmol/l) | 1.02 ± 0.15 | 1.04 ± 0.20 | 1.00 ± 0.20 | 0.164 |
Intact PTH
|
54.5 ± 27.5
|
50.8 ± 26.0
|
58.5 ± 28.9
|
0.030
|
(pg/mL)
|
(46.9)
|
(45.2)
|
(52.0)
| |
25(OH)Vit D (ng/ml) | 13.8 ± 8.4 | 14.4 ± 8.2 | 13.2 ± 8.5 | 0.175 |
(12.0) | (13.0) | (11.0) | ||
CRP | 2.2 ± 1.5 | 2.2 ± 2.6 | 2.2 ± 2.5 | 0.725 |
(mg/l) | (1.2) | (1.3) | (1.1) | |
Triglycerides
|
1.6 ± 1.1
|
1.4 ± 1.1
|
1.6 ± 0.9
|
0.039
|
(mmol/L)
|
(1.3)
|
(1.2)
|
(1.4)
| |
Total cholesterol (mmol/l) | 3.7 ± 0.9 | 3.7 ± 0.8 | 3.8 ± 0.9 | 0.283 |
LDL cholesterol | 1.9 ± 0.7 | 1.9 ± 0.7 | 2.0 ± 0.8 | 0.403 |
(mmol/L) | (1.8) | (1.8) | (1.8) | |
Total cholesterol/HDL | 3.7 ± 1.6 | 3.5 ± 1.1 | 3.9 ± 1.8 | 0.053 |
cholesterol | (3.5) | (3.3) | (3.5) | |
Peripheral calcification score
|
2528 ± 5779
|
1609 ± 3983
|
3447 ± 7040
|
<0.0001
|
(524)
|
(274)
|
(1096)
| ||
t-ucMGP (nM) | 4868 ± 1613 | 4815 ± 1689 | 4921 ± 1539 (4787) | 0.460 |
(4741) | (4616) | |||
dp-ucMGP (pM) | 627 ± 451 | 342 ± 142 | 912 ± 474 | NA |
(559) | (352) | (755) | ||
VKA treatment n (%)
|
6 (3)
|
0 (0)
|
6 (6)
|
0.013
|
MGP values as a function of the calcification score
Associations between dp-ucMGP and calcification
dp-ucMGP levels | t-ucMGP levels | |||
---|---|---|---|---|
r | p | r | p | |
Age
|
0.294
|
<0.0001
|
-0.306
|
<0.001
|
Diabetes duration | 0.077 | 0.278 | -0.133 | 0.062 |
Body mass index
|
0.250
|
<0.0001
|
0.291
|
<0.0001
|
SBP | 0.027 | 0.710 |
0.171
|
0.016
|
DBP | -0.105 | 0.142 | 0.324 |
<0.0001
|
Glycaemia | 0.046 | 0.520 | 0.130 | 0.069 |
HbA1c | 0.034 | 0.638 | 0.105 | 0.141 |
GFR MDRD
|
-0.410
|
<0.0001
|
0.211
|
0.003
|
Microalbuminuria
|
0.307
|
<0.0001
| -0.021 | 0.766 |
Calcium
|
0.145
|
0.042
|
0.255
|
<0.0001
|
Phosphate | -0.089 | 0.214 | -0.095 | 0.182 |
Intact PTH (pg/mL)
|
0.197
|
0.005
|
-0.256
|
<0.0001
|
25(OH)D | -0.095 | 0.181 | -0.009 | 0.903 |
C-reactive protein | 0.137 | 0.055 | 0.110 | 0.120 |
Triglycerides
|
0.215
|
0.002
|
0.312
|
<0.0001
|
Total cholesterol | 0.084 | 0.240 | 0.079 | 0.268 |
Total cholesterol/HDL cholesterol
|
0.188
|
0.008
|
0.202
|
0.004
|
t-ucMGP | 0.052 | 0.467 | 1.000 |
<0.0001
|
Peripheral calcification score
|
0.260
|
<0.0001
|
-0.272
|
<0.0001
|