Mechanisms of ectopic calcification: implications for diabetic vasculopathy

Vascular calcification (VC) is the deposition of calcium/phosphate crystals in the vascular system. The link between VC and increased mortality is well established: the presence of aortic valve sclerosis, as well VC in other arterial beds, has been associated with increased risk of mortality for cardiovascular disease (CVD) (1). VC portends a worse clinical outcome and predicts major adverse cardiovascular events: the prevalence of calcification increase with age, with evidence of VC present in more than 90% of men and 67% of women over the age of 70 (2). Several conditions such as diabetes mellitus, dyslipidemia and renal diseases are identified as major predisposing factors. However, it is incorrect to consider VC as an equivalent of atherosclerosis. The reason for this is twofold. In ancient cultures, VC has been found in several arterial districts: this not only challenges the fact that that atherosclerosis is a modern disease caused by present day risk factors, but also implies that VC might be associated with other conditions such as certain types of infection (3). An autopsy of an ancient Egyptian teenage male found that he was infected with four parasites (4). Modern day patients with chronic inflammatory diseases experience premature atherosclerosis and VC. These observations suggest that atherosclerosis and, specifically, VC, are the results of interplay between genes and environment