[Assessment of the relation between bone mineral metabolism and mitral annular calcification or aortic valve sclerosis--the relation between mitral annular calcification and postmenopausal osteoporosis in elderly patients].

: We assessed the effect of bone mineral metabolism on mitral annular calcification (MAC) and aortic valve sclerosis or calcification (AVS) in elderly patients. Both MAC and AVS were derived by 2-D echocardiography, and bone mineral content (BMC) of vertebral bodies was obtained by quantitative computed tomography using a calibrated phantom system. The calcium (Ca), phosphate (P), parathyroid hormone (PTH-c), calcitonin (CLT), vitamin-D (25-(OH)D) and osteocalcin (OC) in serum were examined within a period of one month. The 265 patients were classified into three groups according to the echocardiographic findings. The control (CNT) group consisted of 122 patients (44 males, 78 females) without MAC or AVS, the MAC group consisted of 64 patients (16 males, 48 females) with MAC, and the AVS group consisted of 79 patients (31 males, 48 females) with AVS. 1) The incidences of MAC and AVS in both males and females were found to increase in proportion to aging. 2) The incidence of MAC in females (28%) was higher than that of males (18%). 3) AVS in males (34%) was more frequent than in females (27%). 4) In females of the eighth and ninth decade of age, BMC in the MAC group was significantly less than in the CNT group (eighth p less than 0.05, ninth p less than 0.01), but no difference was seen in males. 5) In both males and females, BMC in the AVS group was not significantly different from that in the CNT group. 6) In all subjects of the eighth and ninth decades, the serum levels of Ca and P were within normal ranges. PTH-c, CLT and 25-(OH)D showed subnormal or lower normal values, while OC showed supernormal or upper normal values. However, the was no difference among the three groups. These results suggest that MAC may be attributed to ectopic calcium deposit, probably related to decalcification from bone in postmenopausal osteoporosis. However, in the present study, there was no relation between the incidence of MAC and humoral factors of calcium metabolism. On the other hand, AVS may be caused by other factors, mainly prolonged and sustained pressure or stress loading.