Recent advances in multifactorial regulation of vascular calcification

Calcification presents important clinical implications in cardiovascular di seases, especially in coronary arteries. Epidemiological evidence has shown the coexistence of vascular calcification with both atherosclerosis and os teoporosis, and increasing evidence has shown the role of hyperlipidemia an d atherogenic phospholipids in vascular calcification. The etiology of vasc ular calcification is also increasingly recognized as an active process. Va scular calcification initiates with matrix vesicle formation and mineraliza tion following a process similar to that in bone. In addition, many bone re gulatory factors have been shown to be present in calcified atherosclerotic lesions. In this review, we focus on the new developments emerging during the past year in regulation of vascular calcification. Regulatory factors i nclude matrix GLA protein, the phosphate cotransporter Pit-1, a calcium-sen sing receptor related factor, osteoprotegerin, leptin, bisphosphonates and oxidized lipids. Some of these, including oxidized lipids, osteoprotegerin, and bisphosphonates, appear to regulate mineralization in both bone and va sculature and may account for the co-existence of osteoporosis and atherosc lerotic calcification that is independent of age. Curr Opin Lipidol 12:555- 560. (C) 2001 Lippincott Williams & Wilkins.