Serum osteoprotegerin in prevalent hemodialysis patients: associations with mortality, atherosclerosis and cardiac function
Abstract Background To assess whether serum osteoprotegerin (OPG) and/or fetuin-A predict mortality and cardiovascular (CV) morbidity and mortality in hemodialysis patients. Methods Multicenter, observational, prospective study that included 220 hemodialysis patients followed up for up to 6 years. S...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-09-01
|
| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12882-017-0701-8 |
| _version_ | 1811280672775471104 |
|---|---|
| author | Sílvia Collado Elisabeth Coll Carlos Nicolau Manel Azqueta Mercedes Pons Josep M Cruzado Bernat de la Torre Ramón Deulofeu Sergi Mojal Julio Pascual Aleix Cases |
| author_facet | Sílvia Collado Elisabeth Coll Carlos Nicolau Manel Azqueta Mercedes Pons Josep M Cruzado Bernat de la Torre Ramón Deulofeu Sergi Mojal Julio Pascual Aleix Cases |
| author_sort | Sílvia Collado |
| collection | DOAJ |
| description | Abstract Background To assess whether serum osteoprotegerin (OPG) and/or fetuin-A predict mortality and cardiovascular (CV) morbidity and mortality in hemodialysis patients. Methods 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. Results 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). Conclusions 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. |
| first_indexed | 2024-04-13T01:18:58Z |
| format | Article |
| id | doaj.art-b19661e9eb094f4c9c10860c28a52647 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-13T01:18:58Z |
| publishDate | 2017-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-b19661e9eb094f4c9c10860c28a526472022-12-22T03:08:50ZengBMCBMC Nephrology1471-23692017-09-0118111010.1186/s12882-017-0701-8Serum osteoprotegerin in prevalent hemodialysis patients: associations with mortality, atherosclerosis and cardiac functionSílvia Collado0Elisabeth Coll1Carlos Nicolau2Manel Azqueta3Mercedes Pons4Josep M Cruzado5Bernat de la Torre6Ramón Deulofeu7Sergi Mojal8Julio Pascual9Aleix Cases10Nephrology Department Hospital del Mar, Institut Hospital del Mar d’Investigacions MèdiquesNephrology Department, Fundació PuigvertCDI, Hospital ClínicCardiology Department, Hospital ClínicCETIRSA Barcelona, Fresenius Medical CareInstitut Hemodiàlisi Barcelona, DiaverumCD Palau, DiaverumCDB, Hospital ClínicDepartment of Statistics, Institut Mar D’Investigacions MèdiquesNephrology Department Hospital del Mar, Institut Hospital del Mar d’Investigacions MèdiquesNephrology Department, Hospital Clínic, Universitat de Barcelona, IDIBAPSAbstract Background To assess whether serum osteoprotegerin (OPG) and/or fetuin-A predict mortality and cardiovascular (CV) morbidity and mortality in hemodialysis patients. Methods 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. Results 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). Conclusions 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.http://link.springer.com/article/10.1186/s12882-017-0701-8Cardiovascular diseaseCardiac dysfunctionFetuin-aHemodialysisMortalityOsteoprotegerin |
| spellingShingle | Sílvia Collado Elisabeth Coll Carlos Nicolau Manel Azqueta Mercedes Pons Josep M Cruzado Bernat de la Torre Ramón Deulofeu Sergi Mojal Julio Pascual Aleix Cases Serum osteoprotegerin in prevalent hemodialysis patients: associations with mortality, atherosclerosis and cardiac function BMC Nephrology Cardiovascular disease Cardiac dysfunction Fetuin-a Hemodialysis Mortality Osteoprotegerin |
| title | Serum osteoprotegerin in prevalent hemodialysis patients: associations with mortality, atherosclerosis and cardiac function |
| title_full | Serum osteoprotegerin in prevalent hemodialysis patients: associations with mortality, atherosclerosis and cardiac function |
| title_fullStr | Serum osteoprotegerin in prevalent hemodialysis patients: associations with mortality, atherosclerosis and cardiac function |
| title_full_unstemmed | Serum osteoprotegerin in prevalent hemodialysis patients: associations with mortality, atherosclerosis and cardiac function |
| title_short | Serum osteoprotegerin in prevalent hemodialysis patients: associations with mortality, atherosclerosis and cardiac function |
| title_sort | serum osteoprotegerin in prevalent hemodialysis patients associations with mortality atherosclerosis and cardiac function |
| topic | Cardiovascular disease Cardiac dysfunction Fetuin-a Hemodialysis Mortality Osteoprotegerin |
| url | http://link.springer.com/article/10.1186/s12882-017-0701-8 |
| work_keys_str_mv | AT silviacollado serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction AT elisabethcoll serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction AT carlosnicolau serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction AT manelazqueta serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction AT mercedespons serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction AT josepmcruzado serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction AT bernatdelatorre serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction AT ramondeulofeu serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction AT sergimojal serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction AT juliopascual serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction AT aleixcases serumosteoprotegerininprevalenthemodialysispatientsassociationswithmortalityatherosclerosisandcardiacfunction |