Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients
Abstract Galectin-3 levels have been studied as a potential biomarker for predicting cardiovascular (CV) risk and mortality in hemodialysis (HD) patients. Recently, a close relationship between galectin-3 and vascular calcification (VC) has been reported. Here, we investigated the role of VC as a me...
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| Format: | Article |
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Nature Portfolio
2024-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-024-51383-2 |
| _version_ | 1797355847925366784 |
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| author | Ji-Hwan Kim Hye-Mi Noh Hong Ji Song Sion Lee Sung Gyun Kim Jwa-Kyung Kim |
| author_facet | Ji-Hwan Kim Hye-Mi Noh Hong Ji Song Sion Lee Sung Gyun Kim Jwa-Kyung Kim |
| author_sort | Ji-Hwan Kim |
| collection | DOAJ |
| description | Abstract Galectin-3 levels have been studied as a potential biomarker for predicting cardiovascular (CV) risk and mortality in hemodialysis (HD) patients. Recently, a close relationship between galectin-3 and vascular calcification (VC) has been reported. Here, we investigated the role of VC as a mediating factor in the association between galectin-3 and mortality. Serum galectin-3 and baseline aortic arch calcification (AoAC) score were measured in 477 incident HD patients. Mortality data were obtained at a median follow-up of 40 months. Causal mediation analysis was performed to examine the effect of vascular risk factors on galectin-3-related mortality. The prevalence of AoAC in HD patients was 57% (n = 272), and elevated galectin-3 levels were associated with a significantly increased risk of AoAC. When the galectin-3 level was divided by the median level of 37 ng/mL, a higher galectin group increased the risk of all-cause mortality by 1.71-fold (95% CI 1.02–2.92, p = 0.048), even after adjustment for multiple CV risk factors. Mediation analysis showed that both the direct effect of the galectin-3 on mortality (β = 0.0368, bootstrapped 95% CI [0.0113–0.0622]) and the indirect effects were significant. AoAC score and high-sensitivity CRP levels significantly mediated the association between galectin-3 and mortality (total indirect effects: β = 0.0188, bootstrapped 95% CI [0.0066–0.0352]). This study suggests that the association between high galectin-3 and mortality may be partially mediated by higher VC and inflammatory state in HD patients. |
| first_indexed | 2024-03-08T14:17:03Z |
| format | Article |
| id | doaj.art-477770e7784d4044bbffb93775186362 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-08T14:17:03Z |
| publishDate | 2024-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-477770e7784d4044bbffb937751863622024-01-14T12:19:06ZengNature PortfolioScientific Reports2045-23222024-01-0114111010.1038/s41598-024-51383-2Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patientsJi-Hwan Kim0Hye-Mi Noh1Hong Ji Song2Sion Lee3Sung Gyun Kim4Jwa-Kyung Kim5Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart HospitalDepartment of Family Medicine, Hallym University Sacred Heart HospitalDepartment of Family Medicine, Hallym University Sacred Heart HospitalDepartment of Statistics and Institute of Statistics, Hallym UniversityDepartment of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart HospitalDepartment of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart HospitalAbstract Galectin-3 levels have been studied as a potential biomarker for predicting cardiovascular (CV) risk and mortality in hemodialysis (HD) patients. Recently, a close relationship between galectin-3 and vascular calcification (VC) has been reported. Here, we investigated the role of VC as a mediating factor in the association between galectin-3 and mortality. Serum galectin-3 and baseline aortic arch calcification (AoAC) score were measured in 477 incident HD patients. Mortality data were obtained at a median follow-up of 40 months. Causal mediation analysis was performed to examine the effect of vascular risk factors on galectin-3-related mortality. The prevalence of AoAC in HD patients was 57% (n = 272), and elevated galectin-3 levels were associated with a significantly increased risk of AoAC. When the galectin-3 level was divided by the median level of 37 ng/mL, a higher galectin group increased the risk of all-cause mortality by 1.71-fold (95% CI 1.02–2.92, p = 0.048), even after adjustment for multiple CV risk factors. Mediation analysis showed that both the direct effect of the galectin-3 on mortality (β = 0.0368, bootstrapped 95% CI [0.0113–0.0622]) and the indirect effects were significant. AoAC score and high-sensitivity CRP levels significantly mediated the association between galectin-3 and mortality (total indirect effects: β = 0.0188, bootstrapped 95% CI [0.0066–0.0352]). This study suggests that the association between high galectin-3 and mortality may be partially mediated by higher VC and inflammatory state in HD patients.https://doi.org/10.1038/s41598-024-51383-2 |
| spellingShingle | Ji-Hwan Kim Hye-Mi Noh Hong Ji Song Sion Lee Sung Gyun Kim Jwa-Kyung Kim Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients Scientific Reports |
| title | Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients |
| title_full | Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients |
| title_fullStr | Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients |
| title_full_unstemmed | Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients |
| title_short | Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients |
| title_sort | mediating effect of vascular calcification in galectin 3 related mortality in hemodialysis patients |
| url | https://doi.org/10.1038/s41598-024-51383-2 |
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