Serum myostatin levels are negatively associated with abdominal aortic calcification in older men: the STRAMBO study

Objective: To assess the association between abdominal aortic calcification (AAC) and serum levels of myostatin, a negative regulator of skeletal muscle mass, which has been implicated in the development of atherosclerotic lesions in mice. Design and patients: We assessed AAC semiquantitatively from the lateral spine scans obtained using dual energy X-ray absorptiometry in 1071 men aged 20-87 years. Serum myostatin levels were measured by an immunoassay that detects all myostatin forms. Results: Total myostatin serum levels did not differ between men with or without self-reported ischemic heart disease, hypertension, or diabetes mellitus. Total serum myostatin levels were higher in men with higher serum calcium levels and lower in men with higher serum concentrations of highly sensitive C-reactive protein. Men with AAC had lower myostatin levels compared with men without AAC. Prevalence of AAC (AAC score >0) was lower in the highest myostatin quartile compared with the three lower quartiles (P < 0.05). After adjustment for confounders, odds of AAC (AAC score >0) were lower (OR=0.62; 95% confidence interval (95% CI), 0.45-0.85; P < 0.005) for the fourth myostatin quartile vs the three lower quartiles combined. In the sub-analysis of 745 men aged >= 60 years, the results were similar: AAC prevalence was lower in the highest myostatin quartile compared with the three lower quartiles combined (OR=0.54; 95% CI, 0.38-0.78; P < 0.001). Conclusions: In older men, total myostatin serum levels are inversely correlated with AAC. Further studies are needed to investigate mechanisms underlying this association and to assess utility of myostatin as a cardiovascular marker.