Coronary artery calcification and aortic valve calcification in patients with kidney failure: a sex-disaggregated study
Abstract Background Chronic kidney disease (CKD) is linked to an increased cardiovascular disease (CVD) burden. Albeit underappreciated, sex differences are evident in CKD with females being more prone to CKD development, but males progressing more rapidly to kidney failure (KF). Cardiovascular remo...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Biology of Sex Differences |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13293-023-00530-x |
| _version_ | 1797779104780517376 |
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| author | Liam J. Ward Agne Laucyte-Cibulskiene Leah Hernandez Jonaz Ripsweden GOING-FWD Collaborators Peter Stenvinkel Karolina Kublickiene |
| author_facet | Liam J. Ward Agne Laucyte-Cibulskiene Leah Hernandez Jonaz Ripsweden GOING-FWD Collaborators Peter Stenvinkel Karolina Kublickiene |
| author_sort | Liam J. Ward |
| collection | DOAJ |
| description | Abstract Background Chronic kidney disease (CKD) is linked to an increased cardiovascular disease (CVD) burden. Albeit underappreciated, sex differences are evident in CKD with females being more prone to CKD development, but males progressing more rapidly to kidney failure (KF). Cardiovascular remodelling is a hallmark of CKD with increased arterial and valvular calcification contributing to CKD. However, little is known regarding sex differences in calcific cardiovascular remodelling in KF patients. Thus, we hypothesise that sex differences are present in coronary artery calcification (CAC) and aortic valve calcification (AVC) in patients with KF. Methods KF patients, males (n = 214) and females (n = 107), that had undergone computer tomography (CT) assessment for CAC and AVC were selected from three CKD cohorts. All patients underwent non-contrast multi-detector cardiac CT scanning, with CAC and AVC scoring based on the Agatston method. Baseline biochemical measurements were retrieved from cohort databases, including plasma analyses for inflammation markers (IL-6, TNF, hsCRP) and oxidative stress by skin autofluorescence measuring advanced glycation end-products (AGE), amongst other variables. Results Sex-disaggregated analyses revealed that CAC score was associated with age in both males and females (both p < 0.001). Age-adjusted analyses revealed that in males CAC was associated with diabetes mellitus (DM) (p = 0.018) and CVD (p = 0.011). Additionally, for females CAC associated with IL-6 (p = 0.005) and TNF (p = 0.004). In both females and males CAC associated with AGE (p = 0.042 and p = 0.05, respectively). CAC was associated with mortality for females (p = 0.015) independent of age. AVC in females was not reviewed due to low AVC-positive samples (n = 14). In males, in multivariable regression AVC was associated with age (p < 0.001) and inflammation, as measured by IL-6 (p = 0.010). Conclusions In female KF patients inflammatory burden and oxidative stress were associated with CAC. Whereas in male KF patients oxidative stress and inflammation were associated with CAC and AVC, respectively. Our findings suggest a sex-specific biomarker signature for cardiovascular calcification that may affect the development of cardiovascular complications in males and females with KF. |
| first_indexed | 2024-03-12T23:26:56Z |
| format | Article |
| id | doaj.art-329463747f0041d9bc10064425673c6e |
| institution | Directory Open Access Journal |
| issn | 2042-6410 |
| language | English |
| last_indexed | 2024-03-12T23:26:56Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Biology of Sex Differences |
| spelling | doaj.art-329463747f0041d9bc10064425673c6e2023-07-16T11:04:00ZengBMCBiology of Sex Differences2042-64102023-07-0114111110.1186/s13293-023-00530-xCoronary artery calcification and aortic valve calcification in patients with kidney failure: a sex-disaggregated studyLiam J. Ward0Agne Laucyte-Cibulskiene1Leah Hernandez2Jonaz Ripsweden3GOING-FWD CollaboratorsPeter Stenvinkel4Karolina Kublickiene5Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska InstitutetDivision of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska InstitutetDivision of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska InstitutetUnit of Radiology, Department of Clinical Science, Intervention and Technology, Karolinska InstitutetDivision of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska InstitutetDivision of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska InstitutetAbstract Background Chronic kidney disease (CKD) is linked to an increased cardiovascular disease (CVD) burden. Albeit underappreciated, sex differences are evident in CKD with females being more prone to CKD development, but males progressing more rapidly to kidney failure (KF). Cardiovascular remodelling is a hallmark of CKD with increased arterial and valvular calcification contributing to CKD. However, little is known regarding sex differences in calcific cardiovascular remodelling in KF patients. Thus, we hypothesise that sex differences are present in coronary artery calcification (CAC) and aortic valve calcification (AVC) in patients with KF. Methods KF patients, males (n = 214) and females (n = 107), that had undergone computer tomography (CT) assessment for CAC and AVC were selected from three CKD cohorts. All patients underwent non-contrast multi-detector cardiac CT scanning, with CAC and AVC scoring based on the Agatston method. Baseline biochemical measurements were retrieved from cohort databases, including plasma analyses for inflammation markers (IL-6, TNF, hsCRP) and oxidative stress by skin autofluorescence measuring advanced glycation end-products (AGE), amongst other variables. Results Sex-disaggregated analyses revealed that CAC score was associated with age in both males and females (both p < 0.001). Age-adjusted analyses revealed that in males CAC was associated with diabetes mellitus (DM) (p = 0.018) and CVD (p = 0.011). Additionally, for females CAC associated with IL-6 (p = 0.005) and TNF (p = 0.004). In both females and males CAC associated with AGE (p = 0.042 and p = 0.05, respectively). CAC was associated with mortality for females (p = 0.015) independent of age. AVC in females was not reviewed due to low AVC-positive samples (n = 14). In males, in multivariable regression AVC was associated with age (p < 0.001) and inflammation, as measured by IL-6 (p = 0.010). Conclusions In female KF patients inflammatory burden and oxidative stress were associated with CAC. Whereas in male KF patients oxidative stress and inflammation were associated with CAC and AVC, respectively. Our findings suggest a sex-specific biomarker signature for cardiovascular calcification that may affect the development of cardiovascular complications in males and females with KF.https://doi.org/10.1186/s13293-023-00530-xCalcificationCalcific aortic valve diseaseCardiovascular diseaseChronic kidney diseaseInflammationOxidative stress |
| spellingShingle | Liam J. Ward Agne Laucyte-Cibulskiene Leah Hernandez Jonaz Ripsweden GOING-FWD Collaborators Peter Stenvinkel Karolina Kublickiene Coronary artery calcification and aortic valve calcification in patients with kidney failure: a sex-disaggregated study Biology of Sex Differences Calcification Calcific aortic valve disease Cardiovascular disease Chronic kidney disease Inflammation Oxidative stress |
| title | Coronary artery calcification and aortic valve calcification in patients with kidney failure: a sex-disaggregated study |
| title_full | Coronary artery calcification and aortic valve calcification in patients with kidney failure: a sex-disaggregated study |
| title_fullStr | Coronary artery calcification and aortic valve calcification in patients with kidney failure: a sex-disaggregated study |
| title_full_unstemmed | Coronary artery calcification and aortic valve calcification in patients with kidney failure: a sex-disaggregated study |
| title_short | Coronary artery calcification and aortic valve calcification in patients with kidney failure: a sex-disaggregated study |
| title_sort | coronary artery calcification and aortic valve calcification in patients with kidney failure a sex disaggregated study |
| topic | Calcification Calcific aortic valve disease Cardiovascular disease Chronic kidney disease Inflammation Oxidative stress |
| url | https://doi.org/10.1186/s13293-023-00530-x |
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