Vascular calcification: from pathophysiology to biomarkers

Clin Chim Acta. 2015 Jan 1:438:401-14. doi: 10.1016/j.cca.2014.08.034. Epub 2014 Sep 16.

Abstract

The link between vascular calcification (VC) and increased mortality is now well established. Over time, as clinical importance of this phenomenon has begun to be fully considered, scientists have highlighted more and more physiopathological mechanisms and signaling pathways that underlie VC. Several conditions such as diabetes, dyslipidemia and renal diseases are undoubtedly identified as predisposing factors. But even if the process is better understood, many questions still remain unanswered. This review briefly develops the various theories that attempt to explain mineralization genesis. Nonetheless, the main purpose of the article is to provide a profile of the various existing biomarkers of VC. Indeed, in the past years, a lot of inhibitors and promoters, which form a dense and interconnected network, were identified. Given importance to assess and control mineralization process, a focusing on accumulated knowledge of each marker seemed to be necessary. Therefore, we tried to define their respective role in the physiopathology and how they can contribute to calcification risk assessment. Among these, Klotho/fibroblast growth factor-23, fetuin-A, Matrix Gla protein, Bone morphogenetic protein-2, osteoprotegerin, osteopontin, osteonectin, osteocalcin, pyrophosphate and sclerostin are specifically discussed.

Keywords: Bone morphogenetic protein-2; Fetuin-A; Fibroblast growth factor-23; Matrix Gla protein; Osteoprotegerin; Vascular calcification.

Publication types

  • Review

MeSH terms

  • Biomarkers / metabolism
  • Bone Morphogenetic Protein 2 / genetics
  • Bone Morphogenetic Protein 2 / metabolism
  • Calcium-Binding Proteins / genetics
  • Calcium-Binding Proteins / metabolism
  • Diabetes Complications
  • Diabetes Mellitus / genetics
  • Diabetes Mellitus / metabolism*
  • Diabetes Mellitus / physiopathology
  • Dyslipidemias / complications
  • Dyslipidemias / genetics
  • Dyslipidemias / metabolism*
  • Dyslipidemias / physiopathology
  • Extracellular Matrix Proteins / genetics
  • Extracellular Matrix Proteins / metabolism
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / genetics
  • Fibroblast Growth Factors / metabolism
  • Gene Expression Regulation
  • Humans
  • Matrix Gla Protein
  • Osteoprotegerin / genetics
  • Osteoprotegerin / metabolism
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / genetics
  • Renal Insufficiency, Chronic / metabolism*
  • Renal Insufficiency, Chronic / physiopathology
  • Risk Assessment
  • Signal Transduction
  • Vascular Calcification / etiology
  • Vascular Calcification / genetics
  • Vascular Calcification / metabolism*
  • Vascular Calcification / physiopathology
  • alpha-2-HS-Glycoprotein / genetics
  • alpha-2-HS-Glycoprotein / metabolism

Substances

  • BMP2 protein, human
  • Biomarkers
  • Bone Morphogenetic Protein 2
  • Calcium-Binding Proteins
  • Extracellular Matrix Proteins
  • Osteoprotegerin
  • TNFRSF11B protein, human
  • alpha-2-HS-Glycoprotein
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23