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Open Access Highly Accessed Original investigation

Vascular calcification in patients with type 2 diabetes: the involvement of matrix Gla protein

Sophie Liabeuf12, Bourron Olivier3, Cees Vemeer4, Elke Theuwissen4, Elke Magdeleyns4, Carole Elodie Aubert3, Michel Brazier1, Romuald Mentaverri1, Agnes Hartemann3 and Ziad A Massy15*

Author Affiliations

1 INSERM U1088, Jules Verne University of Picardy, F-80000 Amiens, France

2 Clinical Research Centre, Division of Clinical Pharmacology, Amiens University Hospital, Jules Verne University of Picardy, F-80000 Amiens, France

3 Diabetology Department, AP-HP, Pitie-Salpétrière Hospital and Pierre, Marie Curie University of Paris, F-75005 Paris, France

4 VitaK, Maastricht University, Maastricht, Netherlands

5 Division of Nephrology, Ambroise Paré Hospital, Paris-Ile-de-France-Ouest University (UVSQ), 9 avenue Charles de Gaulle, F-92104 Boulogne-Billancourt, France

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Cardiovascular Diabetology 2014, 13:85  doi:10.1186/1475-2840-13-85

Published: 24 April 2014

Abstract

Background

Matrix Gla protein (MGP) is an important inhibitor of calcification. The objective of the present study of patients with type 2 diabetes and normal or slightly altered kidney function was to evaluate levels of inactive, dephospho-uncarboxylated MGP(dp-ucMGP) and total uncarboxylated MGP(t-ucMGP) and assess their links with biological and clinical parameters (including peripheral vascular calcification).

Methods

The DIACART study is a cross-sectional cohort study of 198 patients with type 2 diabetes and normal or slightly altered kidney function. Matrix Gla protein levels were measured with an ELISA and all patients underwent multislice spiral computed tomography scans to score below-knee arterial calcification.

Results

In the study population as a whole, the mean dp-ucMGP and t-ucMGP levels were 627 ± 451 pM and 4868 ± 1613 nM, respectively. Glomerular filtration rate, age and current vitamin K antagonist use were independently associated with dp-ucMGP levels. When the study population was divided according to the median peripheral arterial calcification score, patients with the higher score displayed significantly lower t-ucMGP and significantly higher dp-ucMGP levels. Furthermore, plasma dp-ucMGP was positively associated with the peripheral arterial calcification score (independently of age, gender, previous cardiovascular disease and t-ucMGP levels).

Conclusions

High dp-ucMGP levels were independently associated with below-knee arterial calcification score in patients with type 2 diabetes and normal or slightly altered kidney function. The reversibility of the elevation of dp-ucMGP levels and the latter’s relationship with clinical events merit further investigation.

Keywords:
Matrix gla protein; Type 2 diabetes; Peripheral calcification