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These intermediates are metabolic precursors of amino acids, nucleotides, fatty acids, hemes, and porphyrins, which are essential components for synthesizing cell membranes, DNA, proteins, and other macromolecules ( It is appropriate to mention that similar to glycolysis, the TCA cycle can generate two ATPs from substrate-level phosphorylation, which occurs when the succinic CoA synthetase enzyme catalyzes the reversible reaction of succinyl CoA to succinate (Martnez-Reyes and Chandel, 2020)

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The osteoblastic differentiation of VSMCs is currently considered responsible for the formation of vascular calcification