Mitral annular calcification and the serum osteocalcin level in patients with chronic kidney disease

Figures & data

Table 1. Demographic data of the patients.

	MAC (−) (n = 31)	MAC (+) (n = 29)	p
Age, (years)	42.87 ± 16.41	41.93 ± 15.83	0.739
BMI, (kg/m^2)	26.68 ± 2.63	26.36 ± 2.56	0.645
Male, n (%)	21 (67.7)	20 (69)	0.570
Smoke, n (%)	8 (25.)	11 (37.9)	0.232
Cardiovascular disease, n (%)	3 (9.7)	1 (3.4)	0.332
Diabetes mellitus, n (%)	8 (25.8)	5 (17.2)	0.313
Hypertension, n (%)	12 (38.7)	16 (55.2)	0.154
Medication usage
ACEI, ARB n (%)	23 (74.2)	16 (55.2)	0.101
Beta-blocker, n (%)	7 (22.6)	11 (37.9)	0.155

Note: MAC; Mitral annular calcification.

Table 2. Echocardiographic findings.

	MAC (−) (n = 31)	MAC (+) (n = 29)	p
IVSd, (mm)	10.35 ± 2.33	10.37 ± 1.54	0.962
LVIDd, (mm)	47.93 ± 4.21	49.10 ± 4.69	0.481
LVPWd, (mm)	10.48 ± 1.65	10.51 ± 1.50	0.493
LVEF, (%)	65.29 ± 4.56	64.86 ± 5.49	0.743
LA, (mm)	34.75 ± 5.18	35.02 ± 4.36	0.833
Mitral peak E velocity, (cm/sec)	73.24 ± 18.72	67.52 ± 15.25	0.201
Mitral peak A velocity, (cm/sec)	68.39 ± 18.00	72.72 ± 18.83	0.098
Mitral E/A ratio	1.15 ± 0.43	0.93 ± 0.28	0.039*
Mitral peak Ea velocity (cm/sec)	12.11 ± 3.53	10.07 ± 3.46	0.028*
Mitral E/Ea ratio	6.34 ± 1.71	7.27 ± 2.47	0.201
Tricuspid peak E velocity, (cm/sec)	57.09 ± 11.68	53.38 ± 10.87	0.209
Tricuspid peak A velocity, (cm/sec)	45.40 ± 10.43	52.32 ± 18.46	0.183
Tricuspid E/A ratio	1.30 ± 0.33	1.11 ± 0.35	0.068
Tricuspid peak Ea velocity (cm/sec)	11.81 ± 3.30	13.23 ± 4.11	0.145
Tricuspid E/Ea ratio	5.15 ± 1.60	4.46 ± 1.73	0.114
sTA (cm/sec)	15.05 ± 1.93	15.29 ± 2.62	0.685

Notes: MAC, Mitral annular calcification; IVSd, Interventricular septal thickness at diastole; LVIDd, Left ventricle end-diastolic internal diameter; LVPWd, Left ventricle posterior wall thickness at diastole; LVEF, Left ventricular ejection fraction; LA, Left atrium; sTA, peak systolic tricuspid annular velocity (*p < 0.05).

Table 3. Echocardiographic findings.

	MAC (−) (n = 31)	MAC (+) (n = 29)	p
Glucose	108.19 ± 50.00	94.31 ± 15.56	0.818
eGFR, (ml/dk)	50.33 ± 25.24	40.39 ± 19.83	0.097
Uric acid	6.81 ± 1.33	7.11 ± 1.53	0.418
GGT	35.70 ± 26.24	33.70 ± 13.70	0.651
LDL-C	167.83 ± 181.86	128.72 ± 37.82	0.589
Hemoglobin	13.06 ± 1.90	12.77 ± 2.57	0.621
Platelet	259.09 ± 70.68	237.65 ± 79.78	0.274
RDW	15.63 ± 1.74	15.81 ± 1.97	0.750
MCV	85.80 ± 6.63	88.09 ± 6.36	0.179
Erythrocyte sedimentation rate, (mm)	25.90 ± 25.67	29.28 ± 30.41	0.574
NLR	2.36 ± 1.28	2.57 ± 1.17	0.280
hsCRP	6.71 ± 9.25	19.32 ± 25.15	0.022*
Proteinuria, (mg)	2385.94 ± 3595.66	1377.57 ± 1335.79	0.882
Calcium	9.48 ± 0.91	9.72 ± 0.84	0.297
CaXP	38.05 ± 11.76	41.60 ± 10.27	0.093
Magnesium	2.10 ± 0.54	2.04 ± 0.33	0.762
Phosphate (PO4)	4.22 ± 1.31	4.45 ± 1.34	0.429
Parathyroid hormone	129.93 ± 151.24	134.57 ± 90.31	0.094
Vitamin D3	29.90 ± 31.15	30.31 ± 19.11	0.237
Osteocalsin	9.47 ± 6.64	26.80 ± 20.92	0.001*
Calcitonin	6.05 ± 7.51	8.90 ± 15.24	0.510

Notes: *p < 0.05; MAC, Mitral annular calcification; eGFR, estimated glommerular filtration rate; GGT, gamma-glutamyl transferase; LDL-C, low density lipoprotein cholesterol; RDW, Red cell distribution width; MCV, mean corpuscular volume; NLR, Neutrophil/lymphocyte rate; hs CRP, high-sensitivity C-reactive protein.

Table 4. Parameters correlated with mitral annular calcification.

Parameters	r	p
Mitral E/A ratio	−0.282	0.029*
Mitral peak Ea velocity	−0.285	0.029*
Tricuspid E/A ratio	−0.268	0.038*
hsCRP	0.322	0.013*
Osteocalcin	0.499	<0.001*

Notes: Mitral E/A ratio, mitral ratio of peak early to late diastolic filling; Tricuspid E/A ratio, tricuspid ratio of peak early to late diastolic filling; hsCRP, high sensitivity C-reactive protein (*p < 0.05).

Table 5. The effect of numerous variables on mitral annular calcification, based on multivariate logistic regression analysis.

Covariates	Adjusted OR	95% CI	p
Mitral E/A ratio	4.594	0.005–0.789	0.032*
hsCRP	3.434	0.997–1.117	0.064
Osteocalcin	6.205	1.034–1.320	0.013*
Calcium	3.233	0.861–32.666	0.072

Notes: Mitral E/A ratio, mitral ratio of peak early to late diastolic filling; hsCRP, high sensitivity C-reactive protein (*p < 0.05).