Evaluating dp-ucMGP, tMGP, and Fetuin-A as Markers of Combined Arterial Atherosclerotic Disease: A Cross-Sectional Study

Vascular calcification and atherosclerotic arterial disease are complex processes involving multiple inhibitory and pro-calcific mechanisms. Matrix Gla protein (MGP) is an important inhibitor of vascular calcification, and its inactive dephosphorylated-uncarboxylated form (dp-ucMGP) has been proposed as a biomarker of cardiovascular risk. The present study aimed to evaluate the association of circulating dp-ucMGP, total MGP (tMGP), and Fetuin-A concentrations as markers for calcification associated with the presence of fibrocalcific plaques and/or arterial stenosis. A total of 160 patients were included in this observational study. Patients were classified according to the presence of fibrocalcific plaques and/or arterial stenosis. The study group included 136 patients, whereas 24 patients without fibrocalcific plaques or stenosis served as the control group. dp-ucMGP concentrations were significantly higher in the study group [1.29 vs. 1.07, p = 0.047]. In contrast, no significant differences were observed for tMGP [15.79 vs. 12.67, p = 0.532] or Fetuin-A [388.50 vs. 403.05, p = 0.894]. Glucose concentrations were significantly higher in the study group (p < 0.001), together with significant differences in fibrinogen, urea, creatinine, LDL cholesterol, and uric acid. Spearman correlation analysis showed weak positive correlations between dp-ucMGP and urea (ρ = 0.175, p = 0.034), creatinine (ρ = 0.183, p = 0.026), and triglycerides (ρ = 0.197, p = 0.017). Higher circulating dp-ucMGP concentrations were associated with the presence of fibrocalcific plaques and/or arterial stenosis, whereas tMGP and Fetuin-A did not differ significantly between groups. These findings support the potential relevance of dp-ucMGP as a biomarker associated with fibrocalcific and stenotic arterial disease. Further studies are required to determine its independent predictive value and clinical utility.