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KMID : 0882420070720050443
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Korean Journal of Medicine
2007 Volume.72 No. 5 p.443 ~ p.445
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Coronary artery calcification and serum markers
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Kim Soon-Bae
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Abstract
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Coronary artery calcification is associated with the increased cardiovascular mortality and the extent of
atheromatous plaque, especially in the hemodialysis patients. Vascular calcification was in the past considered a
passive process, a degenerative consequence of aging or the result of disrupted mineral balance in the patients
with chronic renal failure. It is now understood that calcium deposition in the vasculature is an active and
regulated process similar to bone formation. In this issue of JKMS, Kim et al. investigate the clinical association
between osteoprotegerin, an osteoclast inhibitory factor which was reported to be associated with coronary artery
calcification, and fetuin-A, a systemic ectopic calcification inhibitory factor, with coronary artery calcification
(CAC) score obtained from multi-slice CT. They showed that the high serum osteoprotegerin level is associated
with increased CAC score and serum fetuin-A level is significantly lowered in the severe CAC score group. These
results show that serum osteoprotegerin or fetuin-A level might be used as serum markers for the determination
of the severity of coronary artery calcification. However, the role of serum osteoprotegerin in the formation of
vascular calcification is uncertain and the pathophysiologic mechanism is not uncovered yet. Some studies
suggested that the osteoprotegerin level is associated with vascular stiffness. Lower fetuin-A level is known to
be a prognostic factor of cardiovascular disease mortality from several epidemiologic studies and a confirmed
anti-calcifying agents in vitro experiments. In interpreting this issue of Kim et al., it is important that increased
serum osteoprotegerin level might be associated with not vascular calcification but other vascular malfunction
such as arterial stiffness. In conclusion, more sophisticated study needed for the clarification of the role of
calcification-associated serum markers in the process of vascular calcification.(Korean J Med 72:443-445, 2007)
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KEYWORD
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coronary artery calcification, osteoprotegerin, fetuin-A
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