Medial Arterial Calcification in a 4500-Year-Old Egyptian King: A Deep-Time View of a Vascular Calcification Continuum

作者：Patrick Eppenberger, Katherine D. Van Schaik, Irka Hajdas, Mahmoud Ibrahim, Anna Eugenia Wood, Frank Rühli, Moamen Othman · 发表于：Circulation · 年份：2026 · DOI：10.1161/circulationaha.126.079811 · 研究领域：Paleopathology and ancient diseases、Kidney Stones and Urolithiasis Treatments、Parathyroid Disorders and Treatments

Abstract Background Arterial calcification is increasingly recognized as a deep-rooted biological process, observed not only in modern patients but also in ancient human remains. While atherosclerosis has been widely studied, medial arterial calcification (MAC), a distinct entity associated with chronic kidney disease (CKD), diabetes, and aging, remains largely unexplored in early populations. This gap limits our understanding of MAC’s historical prevalence and etiologic drivers. During a paleopathological investigation of a mummified forearm attributed to King Unas (Old Kingdom Egypt), we identified arterial calcifications characteristic of MAC, offering a unique opportunity to examine this pathology in a deep-time context. Methods In situ planar digital radiographs were obtained at the Egyptian Museum in Cairo using a portable system. Arterial calcifications were evaluated according to diagnostic imaging criteria. Osteometric analysis was used to estimate biological sex and stature. AMS radiocarbon dating of associated cranial fragments confirmed Old Kingdom antiquity. Results Radiographs revealed continuous, tubular, rail-track calcifications along the radial and ulnar arteries, morphologically characteristic of medial arterial calcification (MAC) and distinct from the patchy intimal calcifications of atherosclerosis. Conclusions This case represents the earliest radiographic evidence of MAC in ancient human remains and demonstrates that medial and intimal calcification pr...