Bottom Line: Vascular calcification is especially prevalent and related to adverse outcome in patients with renal insufficiency and diabetes mellitus.We address the special circumstances and mechanisms in these patient groups.However, it remains to be proven that reduction of vascular calcification in itself leads to a reduced cardiovascular risk.
Affiliation: Department of Internal Medicine, Maastricht University Medical Centre (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands. email@example.comShow MeSH
Related in: MedlinePlus
Mentions: If there is an imbalance between the calcification protective and calcification inducing factors, progressive vascular calcification can be the result. Figure 1 depicts the different proteins and their role in the calcification process. First the conventional vascular risk factors result in intimal damage and sub-intimal lipid deposition. Subsequently, the inflammatory response induced leads to increased BMP-2. If not balanced by active (carboxylated) MGP, multipotent mesenchymal vascular cells are stimulated to differentiation into ‘osteoblast-like’ cells. At this point the presence of sufficient active MGP is important both for blocking the action of BMP-2 and for binding directly to calcium crystals in the vascular matrix [31, 39, 80, 81]. The use of vitamin K antagonists and/or a low vitamin K diet results in an increase of dysfunctional MGP and thus favouring calcification [41, 82]. In addition, the interactions among RANKL, OPN and OPG influence the rate of calcification. (Fig. 1)
Affiliation: Department of Internal Medicine, Maastricht University Medical Centre (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands. firstname.lastname@example.org