Serum phosphate is associated with aortic valve calcification in the Multi-ethnic Study of Atherosclerosis (MESA)

Jason P. Linefsky, Kevin D. O'Brien, Michael Sachs, Ronit Katz, John Eng, Erin D. Michos, Matthew J. Budoff, Ian De Boer, Bryan Kestenbaum

Research output: Contribution to journalArticlepeer-review


Objectives: This study sought to investigate associations of phosphate metabolism biomarkers with aortic valve calcification (AVC). Background: Calcific aortic valve disease (CAVD) is a common progressive condition that involves inflammatory and calcification mediators. Currently there are no effective medical treatments, but mineral metabolism pathways may be important in the development and progression of disease. Methods: We examined associations of phosphate metabolism biomarkers, including serum phosphate, urine phosphate, parathyroid hormone (PTH) and serum fibroblast growth factor (FGF)-23, with CT-assessed AVC at study baseline and in short-term follow-up in 6814 participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Results: At baseline, AVC prevalence was 13.2%. Higher serum phosphate levels were associated with significantly greater AVC prevalence (relative risk 1.3 per 1mg/dL increment, 95% confidence incidence: 1.1 to 1.5, p<0.001). Serum FGF-23, serum PTH, and urine phosphate were not associated with prevalent AVC. Average follow-up CT evaluation was 2.4 years (range 0.9-4.9 years) with an AVC incidence of 4.1%. Overall, phosphate metabolism biomarkers were not associated with incident AVC except in the top FGF-23 quartile. Conclusions: Serum phosphate levels are significantly associated with AVC prevalence. Further study of phosphate metabolism as a modifiable risk factor for AVC is warranted.

Original languageEnglish (US)
Pages (from-to)331-337
Number of pages7
Issue number2
StatePublished - Apr 2014


  • Aortic valve
  • Calcification
  • Phosphate

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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