Abstract
ObjectivesTo investigate the serum level of osteocalcin (OC), also known as bone Gla protein, in maintenance hemodialysis (MHD) patients and its correlation with abdominal aortic calcification (AAC).MethodsFrom July 2017 to February 2020, we enrolled 108 adult MHD patients. Routine fasting blood laboratory tests were performed before the start of the second hemodialysis in a week. Abdominal aortic calcification score (AACs) was assessed within 1 month. Pearson correlation and Logistic regression were used to analyze the data.ResultsThe OC level was 231.56 (25.92,361.33) ng/ml, elevating significantly in this group of MHD patients. It had a positive correlation with serum phosphorus (r = 0.511, P = 0.001), intact parathyroid hormone(iPTH) (r = 0.594, P = 0.0001), fibroblast growth factor 23(FGF23) (r = 0.485, P = 0.003) and a negative correlation with age(r = -0.356, P = 0.039). Based on the AACs, patients were divided into two groups. Serum OC level were higher in patients with AACs≥5 (p=0.032). A multiple logistics regression analysis revealed that age (odds ratio [OR]1.14, P=0.005) and OC(OR=1.10, P=0.008)were risk factors for high AACs(≥5).ConclusionThe study implicated that OC elevated significantly in this group of MHD patients.OC is positively correlated with phosphorus, iPTH, FGF23, and a negative correlation with age. OC was a risk factor for vascular calcification in this study, but this study did not classify osteocalcin as c-OC and unOC. Whether unOC is associated more directly with vascular calcification requires further study.
Highlights
Chronic kidney disease–mineral and bone disorder (CKD– MBD) is a common complication in end-stage renal disease (ESRD)
Kidney Disease Improving Global Outcomes (KDIGO) in their international clinical guideline for the management of CKD-MBD suggested that lateral lumbar radiography should be used as an alternative to computerized tomography to assess vascular calcification (VC) [1]
This study aimed to explore the relationship between the serum OC level and other indices of VC and to determine whether serum OC level is the risk factor affecting VC in MHD patients with CKD–MBD
Summary
Chronic kidney disease–mineral and bone disorder (CKD– MBD) is a common complication in end-stage renal disease (ESRD). VC is the major cause of cardiovascular disease (CVD) in ESRD, including ischemic cardiac events and subsequent vascular damage. Cardiovascular calcification contributes to approximately 50% of all deaths in hemodialysis patients [2]. Kauppila et al described an AAC grading quantification method by using lateral lumbar radiography in a Framingham study subgroup [5]. They showed that this method was predictive of cardiovascular events and mortality [6]. Kidney Disease Improving Global Outcomes (KDIGO) in their international clinical guideline for the management of CKD-MBD suggested that lateral lumbar radiography should be used as an alternative to computerized tomography to assess VC [1]
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