Serum osteoprotegerin is associated with vascular stiffness and the onset of new cardiovascular events in hemodialysis patients.
10.3904/kjim.2013.28.6.668
- Author:
Jung Eun LEE
1
;
Hyung Jong KIM
;
Sung Jin MOON
;
Ji Sun NAM
;
Jwa Kyung KIM
;
Seung Kyu KIM
;
Gi Young YUN
;
Sung Kyu HA
;
Hyeong Cheon PARK
Author Information
1. Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
- Publication Type:Original Article ; Observational Study ; Research Support, Non-U.S. Gov't
- Keywords:
Osteprotegerin;
Vascular stiffness;
Cardiovascular diseases
- MeSH:
Adult;
Aged;
Biological Markers/blood;
Cardiovascular Diseases/blood/diagnosis/*etiology/mortality/physiopathology;
Female;
Humans;
Kaplan-Meier Estimate;
Linear Models;
Male;
Middle Aged;
Multivariate Analysis;
Osteoprotegerin/*blood;
Predictive Value of Tests;
Prognosis;
Proportional Hazards Models;
Prospective Studies;
Pulse Wave Analysis;
*Renal Dialysis/adverse effects/mortality;
Renal Insufficiency, Chronic/complications/diagnosis/mortality/*therapy;
Risk Factors;
Up-Regulation;
*Vascular Stiffness;
alpha-2-HS-Glycoprotein/analysis
- From:The Korean Journal of Internal Medicine
2013;28(6):668-677
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Osteoprotegerin (OPG) and fetuin-A are vascular calcification regulators that may be related to high cardiovascular (CV) mortality in hemodialysis (HD) patients. We evaluated the relationship between OPG, fetuin-A, and pulse wave velocity (PWV), a marker of vascular stiffness, and determined whether OPG and fetuin-A were independent predictors of CV events in HD patients. METHODS: We conducted a prospective observational study in 97 HD patients. OPG and fetuin-A were measured at baseline and arterial stiffness was evaluated by PWV. All patients were stratified into tertiles according to serum OPG levels. RESULTS: A significant trend was observed across increasing serum OPG concentration tertiles for age, HD duration, systolic blood pressure, cholesterol, triglycerides, and PWV. Multiple linear regression analysis revealed that diabetes (beta = 0.430, p = 0.000) and OPG levels (beta = 0.308, p = 0.003) were independently associated with PWV. The frequency of new CV events was significantly higher in the upper OPG tertiles compared with those in the lower OPG tertiles. In Cox proportional hazards analysis, upper tertiles of OPG levels were significantly associated with CV events (hazard ratio = 4.536, p = 0.011). CONCLUSIONS: Serum OPG, but not fetuin-A, levels were closely associated with increased vascular stiffness, and higher OPG levels may be independent predictors of new CV events in HD patients.
