The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Serum osteoprotegerin is associated with vascular stiffness and the onset of new cardiovascular events in hemodialysis patients

  • Lee, Jung Eun (Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Hyung Jong (Department of Internal Medicine, CHA Bundang Medical Center, CHA University) ;
  • Moon, Sung Jin (Department of Internal Medicine, Myongji Hospital) ;
  • Nam, Ji Sun (Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Jwa-Kyung (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Seung Kyu (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Yun, Gi Young (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Ha, Sung Kyu (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Hyeong Cheon (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • Received : 2012.09.18
  • Accepted : 2012.12.04
  • Published : 2013.11.01
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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.

Keywords

References

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