title: Association of heart valve calcification with malnutrition-inflammation complex syndrome, beta-microglobulin, and carotid intima media thickness in patients on hemodialysis.
abstract: Heart valve calcification is an important predictor for all-cause and cardiovascular mortality in hemodialysis patients. Recently, serum beta(2)-microglobulin has been associated with cardiovascular disease in the non-hemodialysis population, but the relationship between serum beta(2)-microglobulin and valve calcification remains unknown. In this cross-sectional study, we recorded the patients' clinical parameters, including serum beta(2)-microglobulin, and related these parameters to the number of calcified valves detected by echocardiography. The patients included 80 males and 35 females (age 67 +/- 10 years; duration on hemodialysis 96 +/- 67 months). Calcification of the aortic and mitral valves was observed in 89 (77.4%) and 59 patients (51.3%), respectively. Fifty-one patients (44.3%) showed calcification of both valves. In univariate analysis, age (r = 0.301, P = 0.001), serum albumin (r = -0.219, P = 0.01), calcium (r = 0.205, P = 0.02), high sensitivity C-reactive protein (r = 0.209, P = 0.02), and beta(2)-microglobulin (r = 0.206, P = 0.02) significantly correlated with the number of calcified valves. Stepwise multiple regression analysis showed that age (beta = 0.389, P < 0.001) and calcium (beta = 0.223, P = 0.01) were independent determinants for valve calcification (r(2) = 0.195). In addition, carotid intima media thickness was significantly higher in patients with valve calcification compared with those without valve calcification. Our results suggested the impacts of calcium metabolism and malnutrition-inflammation complex syndrome on valve calcification. In addition, serum beta(2)-microglobulin may be another potential marker of cardiovascular complications in patients on hemodialysis.
authors.affiliation: Department of Nephrology and the Kidney and Dialysis Center, Shonan Kamakura General Hospital, Kamakura, Japan. ryota.ikee@tokushukai.jp
authors.forename: Ryota
authors.initials: R
authors.lastname: Ikee
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Honda
authors.forename: Machiko
authors.initials: M
authors.lastname: Oka
authors.forename: Kyoko
authors.initials: K
authors.lastname: Maesato
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Mano
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Moriya
authors.forename: Takayasu
authors.initials: T
authors.lastname: Ohtake
authors.forename: Shuzo
authors.initials: S
authors.lastname: Kobayashi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D002114:Calcinosis / Q000503:physiopathology*; D002118:Calcium / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology; D002339:Carotid Arteries / Q000473:pathology; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D008297:Male; D044342:Malnutrition / Q000503:physiopathology; D008875:Middle Aged; D012044:Regression Analysis; D006435:Renal Dialysis; D013577:Syndrome; D017539:Tunica Intima / Q000473:pathology; D001613:beta 2-Microglobulin / Q000097:blood
chemical_list: D001613:beta 2-Microglobulin; D002097:C-Reactive Protein; D002118:Calcium