Calcium Metabolism in Adults With Severe Aortic Valve Stenosis and Preserved Renal Function

Data suggest a link of aortic stenosis (AS) with calcium and bone metabolism. To further investigate this, the following parameters were analyzed in 38 patients with severe AS and in 38 age- and gender-matched controls, without obstructive coronary artery disease and with preserved renal function: calcium, phosphate, 1,25(OH2)-vitamin D3, intact parathyroid hormone (iPTH), and osteoprotegerin. Patients with AS had significantly higher serum levels of calcium (2.63 ± 0.28 vs 2.48 ± 0.23 mmol/L, p <0.01) and phosphate (1.56 ± 0.33 vs 1.38 ± 0.26 mmol/L, p <0.01) and increased calcium-phosphorus products (4.16 ± 1.13 vs 3.44 ± 0.89 mmol/L2, p = 0.003). Notably, the iPTH concentration in the AS group was lower, and significantly more patients in the AS group had levels less than the study median of 60 ng/L. Osteoprotegerin was elevated in patients with AS, confirming reports in other populations (9.94 ± 5.96 vs 6.73 ± 4.28 pmol/L, p = 0.009). The relations of several parameters to iPTH were also altered (AS vs controls): calcium and iPTH, 0.071 ± 0.034 versus 0.046 ± 0.023, p <0.0001; phosphate and iPTH, 0.042 ± 0.020 versus 0.025 ± 0.013, p <0.0001; vitamin D and iPTH, 0.99 ± 0.61 versus 0.63 ± 0.46, p = 0.006; and osteoprotegerin and iPTH, 0.24 ± 0.15 versus 0.12 ± 0.09, p <0.0001. In conclusion, these data support a hypothesis connecting (severe) AS to altered calcium and bone homeostasis.