Reduced Fetuin A Serum Level is Associated with Faster Stenosis Progression and Increased Valvular Calcification in Elderly Patients with Aortic Stenosis
Bibliographic record
Abstract
Background: Fetuin A is a circulating calcium-regulatory glycoprotein that inhibits ectopic and vascular calcification. Aortic stenosis (AS) is a disease process involving an active calcification of the aortic valve (AV). Its prevalence increases markedly with aging. We examined the associations between serum level of Fetuin A with AV calcification, and disease progression rate of AS, in function of age. Methods: 226 patients operated for AS, were divided into 2 groups according to the median value of age: the younger group (<70 years) and the elderly group (=70 years). Serum fetuin A levels and calcium content of AV were determined respectively by Elisa method and 0-cresolphtalein complexone method. The annualized progression rate of AS was calculated for the subset of patients (n=113) in whom at least 2 transthoracic Doppler-echocardiographic exams separated by at least 6 months were available pre-operatively. Results: There was no correlation between fetuin A level and AV calcium content or AS progression rate in the subset of younger patients. On the other hand, in the elderly group, the preoperative progression rate of the peak transvalvular gradient was 2-fold faster in patients with serum fetuin A level <0.36 g/L (median value) when compared to those with higher level of fetuin A (9±1 mmHg/year vs. 5±1 mmHg/year, p=0.02). Moreover, there was a negative correlation between calcium content of the AV explanted at the time of surgery and fetuin A serum level (r=-0.22, p=0.05). After adjusting for age, male gender, triglycerides and the morphology of the AV (bicuspid vs. tricuspid), fetuin A remained significantly and inversely associated with AV calcification (r20.09, β=-67.5, p== 0.04) and AS progression rate (r2=0.30, β=-10.4, p=0.02). Conclusion: In the elderly patients, reduced level of Fetuin A is associated with enhanced valvular calcification and faster stenosis progression rate. These findings also support that the determinants and mechanisms of the progression of AS may be different in younger patients.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".