{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:52:59Z","timestamp":1791355979013,"version":"4.3.1"},"reference-count":58,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Aortic valve calcification (AVC) and mitral annual calcification (MAC) may progress to aortic and mitral stenosis in older adults. The role of major mineralization regulators MGP (matrix Gla protein), FGF\u201023 (fibroblast growth factor\u201023), and fetuin\u2010A in long\u2010term progression of AVC and MAC remains unexamined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We measured blood levels of dp\u2010ucMGP (n=2663) at study baseline and evaluated these concurrently with prior baseline measures of FGF\u201023 (n=6547) and fetuin\u2010A (n=2550) in relation to AVC and MAC quantified on \u22643 serial computed tomography scans over 9.4 (interquartile range, 9.0\u20139.8) years in MESA (Multi\u2010Ethnic Study of Atherosclerosis). We used linear mixed\u2010effects models to simultaneously assess the incidence and progression of AVC and MAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Our objective was to investigate the association of circulating dephosphorylated\u2013uncarboxylated (dp\u2010uc) MGP, reflecting vitamin K deficiency\/diminished MGP anticalcific capacity; FGF\u201023, a phosphaturic hormone; and fetuin\u2010A, a calcium\u2010phosphate solubilizer, with long\u2010term incidence and progression of AVC and MAC. After adjustment for demographic and clinical characteristics, dp\u2010ucMGP was associated with higher annual incidence\/progression of AVC (0.94 [95% CI, 0.42, 1.46] Agatston units\/y) and MAC (3.90 [95% CI, 1.06, 6.74] Agatston units\/y); FGF\u201023 with higher annual incidence\/progression of MAC (2.61 [95% CI, 0.50, 4.72] Agatston units\/y); and fetuin\u2010A with lower annual incidence\/progression of AVC (\u22120.89 [95% CI, \u22121.55, \u22120.23] Agatston units\/y (all per SD increment in regulator).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this multiethnic sample, dp\u2010ucMGP and FGF\u201023 were associated with higher, and fetuin\u2010A with lower, long\u2010term incidence\/progression of valvular or annular calcification. This has implications for therapeutic trials of calcific valvular disease, particularly targeting vitamin K supplementation to individuals with higher dp\u2010ucMGP levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.042370","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:33:16Z","timestamp":1790310796000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Regulators of Mineralization and Long\u2010Term Progression of Aortic Valve and Mitral Annular Calcification: MESA"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7983-5243","authenticated-orcid":false,"given":"Anna E.","family":"Bortnick","sequence":"first","affiliation":[{"name":"Montefiore Medical Center and Albert Einstein College of Medicine","place":["Bronx, USA"]},{"name":"Montefiore Medical Center and Albert Einstein College of Medicine","place":["Bronx, 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