Abstract
Background and Objectives: Osteocalcin is the most abundant noncollagenous protein in bone matrix, which is considered a marker of bone formation. Previous studies indicate that circulating osteocalcin can be expressed by osteoblasts and even by osteoblast-like cells in vessel walls, and it is often associated with arterial stiffness. Our study aims to examine the potential association between osteocalcin levels and endothelial function among kidney transplant (KT) recipients. Materials and Methods: Fasting blood samples were obtained from 68 KT recipients. To measure the endothelial function and vascular reactivity index (VRI), a digital thermal monitoring test (VENDYS) was used. A commercial enzyme-linked immunosorbent assay kit was also utilized to measure serum total osteocalcin levels. In this study, a VRI of less than 1.0 indicated poor vascular reactivity; a VRI of 1.0–2.0 indicated intermediate vascular reactivity; and a VRI of 2.0 or higher indicated good vascular reactivity. Results: Our findings show that 8 KT recipients (11.8%) had poor vascular reactivity (VRI < 1.0), 26 (38.2%) had intermediate vascular reactivity (1.0 ≤ VRI < 2.0), and 34 (50%) had good vascular reactivity. Increased serum osteocalcin levels (p < 0.001) were found to be associated with poor vascular reactivity. Advanced age (r = −0.361, p = 0.002), serum alkaline phosphate level (r = −0.254, p = 0.037), and log-transformed osteocalcin levels (r = − 0.432, p < 0.001) were identified to be negatively correlated with VRI in KT recipients. Multivariable forward stepwise linear regression analysis revealed that the serum level of osteocalcin (β = −0.391, adjusted R2 change = 0.174; p < 0.001) and advanced age (β = −0.308, adjusted R2 change = 0.084; p = 0.005) were significantly and independently associated with VRI in KT recipients. Conclusions: Higher serum osteocalcin level was associated with lower VRI and poorer endothelial dysfunction among KT recipients.
Highlights
Cardiovascular disease is one of the major causes of morbidity and mortality in kidney transplant (KT) recipients
We aimed to investigate the association between osteocalcin levels and endothelial function among KT recipients
Our findings showed that increased serum osteocalcin level was associated with poor vascular reactivity index (VRI), which was suggestive of endothelial dysfunction, and that this association was not dependent on the age of
Summary
Cardiovascular disease is one of the major causes of morbidity and mortality in kidney transplant (KT) recipients. Nontraditional factors were found to significantly contribute to cardiovascular events These include time on dialysis before transplantation, drugs used for immunosuppression, allograft dysfunction, anemia, and elevated homocysteine levels [2,3]. Endothelial dysfunction is a key initial event in the pathogenesis of atherosclerosis, and it contributes to the formation and progression of plaque [4]. It has often been associated with a wide range of cardiovascular diseases, including coronary artery disease and chronic heart failure, as well as chronic renal failure [4]. Our study aims to examine the potential association between osteocalcin levels and endothelial function among kidney transplant (KT). Results: Our findings show that 8 KT recipients (11.8%) had poor vascular reactivity (VRI < 1.0), 26 (38.2%) had intermediate vascular reactivity
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