Korean J Intern Med.  2013 Nov;28(6):668-677. 10.3904/kjim.2013.28.6.668.

Serum osteoprotegerin is associated with vascular stiffness and the onset of new cardiovascular events in hemodialysis patients

• Lee JE
• Kim HJ
• Moon SJ
• Nam JS
• Kim JK
• Kim SK
• Yun GY
• Ha SK
• Park HC

• KMID: 1780127
• DOI: http://doi.org/10.3904/kjim.2013.28.6.668

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.

Keyword

Osteprotegerin; Vascular stiffness; Cardiovascular diseases

MeSH Terms

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
Biological Markers
Osteoprotegerin
alpha-2-HS-Glycoprotein