{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T23:43:14Z","timestamp":1780789394137,"version":"3.54.1"},"reference-count":46,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T00:00:00Z","timestamp":1700784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Systemic sclerosis (SSc) patients face an elevated risk of cardiovascular disease (CVD), even when classic cardiovascular risk factors are considered. Plasma dephosphorylated-uncarboxylated Matrix Gla-protein (dp-ucMGP), an inactive form of MGP, is associated with increased CVD risk. Smooth muscle cells, implicated in SSc\u2019s development, are the primary dp-ucMGP producers. This study assessed dp-ucMGP levels and initial CVD events in early-diagnosed SSc patients, investigating its potential as a CVD and all-cause mortality predictor over time. Methods: In a cohort of 87 SSc patients (excluding those with pre-existing CVD or on dialysis), baseline dp-ucMGP levels were measured, along with cardiovascular risk factors. Validation involved assessing dp-ucMGP in a subset of treatment-naive SSc patients. Results: A significantly elevated median dp-ucMGP level of 634 pmol\/L (IQR 301) compared with healthy controls (dp-ucMGP &lt; 393 pmol\/L; p &lt; 0.001) was observed. Validation in a treatment-naive SSc patient subset yielded similar results (median 589 pmol\/L; IQR 370). During a median 10.5-year follow-up among 78 SSc patients, 33.3% experienced their first CVD event, independent of traditional risk factors. Elevated dp-ucMGP levels (&gt;634 pmol\/L) correlated with a higher risk of CVD and\/or death (log-rank test: p &lt; 0.01). Conclusions: In summary, dp-ucMGP emerges as a novel biomarker in SSc patients, with elevated levels indicating an increased risk of CVD and\/or mortality in this population.<\/jats:p>","DOI":"10.3390\/diagnostics13233526","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T10:10:39Z","timestamp":1700820639000},"page":"3526","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Plasma Dephosphorylated-Uncarboxylated Matrix Gla-Protein in Systemic Sclerosis Patients: Biomarker Potential for Vascular Calcification and Inflammation"],"prefix":"10.3390","volume":"13","author":[{"given":"Judith","family":"Potjewijd","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division Clinical and Experimental Immunology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachid","family":"Tobal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division Clinical and Experimental Immunology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1519-8147","authenticated-orcid":false,"given":"Karin A.","family":"Boomars","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa V. P. M.","family":"van Empel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Femke","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, 6211 LK Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4007-6985","authenticated-orcid":false,"given":"Jan G. M. C.","family":"Damoiseaux","sequence":"additional","affiliation":[{"name":"Central Diagnostic Laboratory, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7867-6957","authenticated-orcid":false,"given":"Leon J.","family":"Schurgers","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, 6211 LK Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9366-7995","authenticated-orcid":false,"given":"Pieter","family":"van Paassen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division Clinical and Experimental Immunology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Barrett, H., O\u2019Keeffe, M., Kavanagh, E., Walsh, M., and O\u2019Connor, E.M. 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