Serum osteoprotegerin in prevalent hemodialysis patients : associations with mortality, atherosclerosis and cardiac function
Collado, S. (Institut Hospital del Mar d'Investigacions Mèdiques)
Coll, Elisabet (Institut d'Investigació Biomèdica Sant Pau)
Nicolau, Carlos (Hospital Clínic i Provincial de Barcelona)
Azqueta, Manel (Hospital Clínic i Provincial de Barcelona)
Pons, Mercedes (CETIRSA Barcelona)
Cruzado, Josep María (Institut Hemodiàlisi Barcelona)
de la Torre, Bernat (Diaverum, Barcelona)
Deulofeu, Ramón (Hospital Clínic i Provincial de Barcelona)
Mojal, Sergi (Institut Hospital del Mar d'Investigacions Mèdiques)
Pascual Santos, Julio (Institut Hospital del Mar d'Investigacions Mèdiques)
Cases Amenós, Aleix (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Universitat Autònoma de Barcelona

Date:	2017
Abstract:	To assess whether serum osteoprotegerin (OPG) and/or fetuin-A predict mortality and cardiovascular (CV) morbidity and mortality in hemodialysis patients. Multicenter, observational, prospective study that included 220 hemodialysis patients followed up for up to 6 years. Serum OPG and fetuin-A levels were measured at baseline and their possible association with clinical characteristics, CV risk biomarkers, carotid ultrasonographic findings, as well as their association with overall and CV mortality and CV events were assessed. During a mean follow-up of 3. 22 ± 1. 91 years, there were 74 deaths (33. 6%) and 86 new cardiovascular events. In the Kaplan-Meier survival analysis, the highest tertile of OPG levels was associated with higher overall mortality (p = 0. 005), as well as a higher, although non-significant, incidence of CV events and CV mortality. In contrast, fetuin-A levels did not predict any of these events. OPG levels were directly associated with age, the Charlson comorbidity index (CCI), prevalent cardiovascular disease, carotid intima-media thickness, adiponectin, troponin-I and brain natriuretic peptide (BNP). OPG showed a negative correlation with left ventricular ejection fraction (LVEF) and phosphate levels. In the multivariate Cox proportional hazard analysis, all-cause mortality was associated with the highest tertile of OPG (HR:1. 957, p = 0. 018), age (HR:1. 031, p = 0. 036), smoking history (HR:2. 122, p = 0. 005), the CCI (HR:1. 254, p = 0. 004), troponin-I (HR:3. 894, p = 0. 042), IL-18 (HR:1. 061, p < 0. 001) and albumin levels (HR:0. 886, p < 0. 001). In the bootstrapping Cox regression analysis, the best cut-off value of OPG associated with mortality was 17. 69 pmol/L (95%CI: 5. 1-18. 02). OPG, but not fetuin-A levels, are independently associated with overall mortality, as well as clinical and subclinical atherosclerosis and cardiac function, in prevalent hemodialysis patients. The online version of this article (10. 1186/s12882-017-0701-8) contains supplementary material, which is available to authorized users.
Grants:	Instituto de Salud Carlos III FIS03/0791
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Cardiovascular disease ; Cardiac dysfunction ; Fetuin-a ; Hemodialysis ; Mortality ; Osteoprotegerin
Published in:	BMC Nephrology, Vol. 18 (september 2017) , ISSN 1471-2369

DOI: 10.1186/s12882-017-0701-8
PMID: 28882110

10 p, 788.5 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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