Elevated levels of plasma osteoprotegerin are associated with all-cause mortality risk and atherosclerosis in patients with stages 3 to 5 chronic kidney disease
Tipo
Artigo
Data de publicação
2014
Periódico
Brazilian Journal of Medical and Biological Research
Citações (Scopus)
34
Autores
Nascimento M.M.
Hayashi S.Y.
Riella M.C.
Lindholm B.
Hayashi S.Y.
Riella M.C.
Lindholm B.
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Membros da banca
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Resumo
© 2014, Associacao Brasileira de Divulgacao Cientifica. All rights reserved.Osteoprotegerin (OPG) regulates bone mass by inhibiting osteoclast differentiation and activation, and plays a role in vascular calcification. We evaluated the relationship between osteoprotegerin levels and inflammatory markers, atherosclerosis, and mortality in patients with stages 3-5 chronic kidney disease. A total of 145 subjects (median age 61 years, 61% men; 36 patients on hemodialysis, 55 patients on peritoneal dialysis, and 54 patients with stages 3-5 chronic kidney disease) were studied. Clinical characteristics, markers of mineral metabolism (including fibroblast growth factor-23 [FGF-23]) and inflammation (high-sensitivity C-reactive protein [hsCRP] and interleukin-6 [IL-6]), and the intima-media thickness (IMT) in the common carotid arteries were measured at baseline. Cardiac function was assessed by color tissue Doppler echocardiography. After 36 months follow-up, the survival rate by Kaplan-Meier analysis was significantly different according to OPG levels (Χ2=14.33; P=0.002). Increased OPG levels were positively associated with IL-6 (r=0.38, P<0.001), FGF-23 (r=0.26, P<0.001) and hsCRP (r=0.0.24, P=0.003). In addition, OPG was positively associated with troponin I (r=0.54, P<0.001) and IMT (r=0.39, P<0.0001). Finally, in Cox analysis, only OPG (HR=1.07, 95%CI=1.02-1.13) and hsCRP (HR=1.02, 95%CI=1.01-1.04) were independently associated with increased risk of death. These results suggested that elevated levels of serum OPG might be associated with atherosclerosis and all-cause mortality in patients with chronic kidney disease.
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Assuntos Scopus
Adolescent , Adult , Aged , Aged, 80 and over , Atherosclerosis , Biomarkers , Brazil , C-Reactive Protein , Carotid Intima-Media Thickness , Cause of Death , Echocardiography, Doppler , Female , Fibroblast Growth Factors , Heart Function Tests , Humans , Interleukin-6 , Kaplan-Meier Estimate , Male , Middle Aged , Multivariate Analysis , Osteoprotegerin , Renal Insufficiency, Chronic , Risk , Severity of Illness Index , Young Adult