title: Serum osteoprotegerin level, carotid-femoral pulse wave velocity and cardiovascular survival in haemodialysis patients.
abstract: 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.
authors.affiliation: 1st Department of Medicine, Semmelweis University Budapest, 2/a Korányi S. u., Budapest, H-1083, Hungary. speerga@bel1.sote.hu
authors.forename: Gábor
authors.initials: G
authors.lastname: Speer
authors.forename: Bertalan Cs
authors.initials: BC
authors.lastname: Fekete
authors.forename: Taha
authors.initials: T
authors.lastname: El Hadj Othmane
authors.forename: Tamás
authors.initials: T
authors.lastname: Szabó
authors.forename: József
authors.initials: J
authors.lastname: Egresits
authors.forename: Erzsébet
authors.initials: E
authors.lastname: Fodor
authors.forename: István
authors.initials: I
authors.lastname: Kiss
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Logan
authors.forename: János
authors.initials: J
authors.lastname: Nemcsik
authors.forename: András
authors.initials: A
authors.lastname: Szabó
authors.forename: Zsófia K
authors.initials: ZK
authors.lastname: Németh
authors.forename: Miklós
authors.initials: M
authors.lastname: Szathmári
authors.forename: András
authors.initials: A
authors.lastname: Tislér
mesh_terms: 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
chemical_list: D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human