Serum osteoprotegerin level, carotid-femoral pulse wave velocity and cardiovascular survival in haemodialysis patients.
BACKGROUND
Osteoprotegerin (OPG) is a marker and regulator of arterial calcification, and it is related to cardiovascular survival in haemodialysis patients. The link between OPG and aortic stiffening--a consequence of arterial calcification--has not been previously evaluated in this population, and it is not known whether OPG-related mortality risk is mediated by arterial stiffening.


METHODS
At baseline, OPG and aortic pulse wave velocity (PWV) were measured in 98 chronic haemodialysis patients who were followed for a median of 24 months. The relationship between OPG and PWV was assessed by multivariate linear regression. The role of PWV in mediating OPG related cardiovascular mortality was evaluated by including both OPG and PWV in the same survival model.


RESULTS
At baseline mean (standard deviation) PWV was 11.2 (3.3) m/s and median OPG (interquartile range) was 11.1 (7.5-15.9) pmol/L. There was a strong, positive, linear relationship between PWV and lnOPG (P = 0.009, model R(2) = 0.540) independent of covariates. During follow-up 23 patients died of cardiovascular causes. In separate univariate survival models both PWV and lnOPG were related to cardiovascular mortality [hazard ratios 1.31 (1.14-1.50) and 8.96 (3.07-26.16), respectively]. When both PWV and lnOPG were entered into the same model, only lnOPG remained significantly associated with cardiovascular mortality [hazard ratio 1.11 (0.93-1.33) and 7.18 (1.89-27.25), respectively).


CONCLUSIONS
In haemodialysis patients OPG is strongly related to PWV and OPG related cardiovascular mortality risk is, in part, mediated by increased PWV.
Speer
Gábor
G
1st Department of Medicine, Semmelweis University Budapest, 2/a Korányi S. u., Budapest, H-1083, Hungary. speerga@bel1.sote.hu
Fekete
Bertalan Cs
BC
El Hadj Othmane
Taha
T
Szabó
Tamás
T
Egresits
József
J
Fodor
Erzsébet
E
Kiss
István
I
Logan
Alexander G
AG
Nemcsik
János
J
Szabó
András
A
Németh
Zsófia K
ZK
Szathmári
Miklós
M
Tislér
András
A
D000368:Aged; D001783:Blood Flow Velocity; D002114:Calcinosis / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D002339:Carotid Arteries / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D015999:Multivariate Analysis; D053244:Osteoprotegerin / Q000097:blood*; D011446:Prospective Studies; D012039:Regional Blood Flow; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors
D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human