Serum Osteoprotegerin Is an Independent Marker of Metabolic Complications in Non-DialysisDependent Chronic Kidney Disease Patients.

Aleksandra Rymarz,Anna Matyjek,Zbigniew Bartoszewicz,Stanisław Niemczyk,Katarzyna Romejko

doi:10.3390/nu13103609

Aleksandra Rymarz, Anna Matyjek + Show 3 more

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https://doi.org/10.3390/nu13103609

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Abstract

Background: Osteoprotegerin (OPG) belongs to the tumour necrosis factor superfamily and is known to accelerate endothelial dysfunction and vascular calcification. OPG concentrations are elevated in patients with chronic kidney disease. The aim of this study was to investigate the association between OPG levels and frequent complications of chronic kidney disease (CKD) such as anaemia, protein energy wasting (PEW), inflammation, overhydration, hyperglycaemia and hypertension. Methods: One hundred non-dialysis-dependent men with CKD stage 3–5 were included in the study. Bioimpedance spectroscopy (BIS) was used to measure overhydration, fat amount and lean body mass. We also measured the serum concentrations of haemoglobin, albumin, total cholesterol, C-reactive protein (CRP), fibrinogen and glycated haemoglobin (HgbA1c), as well as blood pressure. Results: We observed a significant, positive correlation between OPG and age, serum creatinine, CRP, fibrinogen, HgbA1c concentrations, systolic blood pressure and overhydration. Negative correlations were observed between OPG and glomerular filtration rate (eGFR), serum albumin concentrations and serum haemoglobin level. Logistic regression models revealed that OPG is an independent marker of metabolic complications such as anaemia, PEW, inflammation and poor renal prognosis (including overhydration, uncontrolled diabetes and hypertension) in the studied population. Conclusion: Our results suggest that OPG can be an independent marker of PEW, inflammation and vascular metabolic disturbances in patients with chronic kidney disease.

Highlights

Introduction published maps and institutional affilOsteoprotegerin (OPG) is a molecule belonging to the tumour necrosis factor (TNF)superfamily
The purpose of our study was to investigate the association between OPG levels and the main complications of chronic kidney disease, including anaemia, protein energy wasting, inflammation and poor prognosis factors of CKD progression such as overhydration, hyperglycaemia and hypertension
The study population consisted of 100 male patients with chronic kidney disease and eGFR lower than 60 mL/min/1.73 m2, non-treated with dialysis

Summary

Introduction

Osteoprotegerin (OPG) is a molecule belonging to the tumour necrosis factor (TNF). It is a decoy receptor for TNF-related apoptosis-inducing ligand (TRAIL). The. TNF superfamily regulates immune responses, homeostasis as well as haematopoiesis [1]. OPG was identified as a bone resorption inhibitor that blocks the binding of RANK (receptor activator of nuclear factor kappa-β) to its ligand RANKL [2]. The OPG/RANKL/RANK system is involved in pathological angiogenesis, inflammatory states and cell survival. OPG is a glycoprotein released by vascular smooth muscle cells, endothelial cells, osteoblasts and immune cells. There is a signalling pathway between endothelial cells and osteoblasts during osteogenesis creating a connection between angiogenesis and osteogenesis [4]. The OPG/RANKL/RANK/TRAIL system, via receptors located on the cell surface, sends intracellular signals and modifies gene expression.

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