title: Association among serum fetuin-A level, coronary artery calcification, and bone mineral densitometry in maintenance hemodialysis patients.
abstract: Patients with end-stage renal disease have a very high prevalence and extent of arterial calcification. A number of studies suggest that similar pathophysiologic mechanisms are responsible for development and progression of calcification of atherosclerotic plaque and bone formation. Fetuin-A is a potent calcification inhibitor and is expressed in bone, with not-yet well-defined functions. The aim of this study was to investigate the relation between bone mineral densitometry parameters, coronary artery calcification, and serum fetuin-A levels. In a cross-sectional design, we included 72 maintenance hemodialysis (HD) patients and 30 age- and gender-matched healthy controls. Serum fetuin-A levels were studied both in maintenance HD patients and healthy controls. Maintenance HD patients had radius, hip, and lumbar spine bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry and coronary artery calcification score (CACS) measured by electron-beam computed tomography. The associations between site-specific BMD parameters, CACS, and serum fetuin-A levels were studied in maintenance HD patients. CACS, mass, and volume of plaques in coronary arteries were significantly higher in patients with a T-score below -2.5 than above in the proximal region of the radius, neck and trochanter of the femur, and the lumbar spine. Mean serum fetuin-A concentration was 0.636 +/- 0.118 g/L in maintenance HD patients and it was less than healthy controls (0.829 +/- 0.100 g/L, P < 0.0001). CACS, mass, and volume of plaques in coronary arteries correlated significantly with the serum fetuin-A levels. Moreover, significant positive correlations were shown between the serum fetuin-A levels, BMD values, and T-scores of proximal radius, neck, and trochanter of the femur, but not with the lumbar spine. The present study demonstrates an association between serum fetuin-A levels, coronary artery calcification, and bone mineral densities--except for the lumbar spine, in maintenance HD patients. However, the results should be interpreted with caution because of the cross-sectional design of the study.
authors.affiliation: Departments of Internal Medicine, Nephrology Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey. alperkirkpantur@yahoo.com
authors.forename: Alper
authors.initials: A
authors.lastname: Kirkpantur
authors.forename: Bulent
authors.initials: B
authors.lastname: Altun
authors.forename: Tuncay
authors.initials: T
authors.lastname: Hazirolan
authors.forename: Deniz
authors.initials: D
authors.lastname: Akata
authors.forename: Mustafa
authors.initials: M
authors.lastname: Arici
authors.forename: Serafettin
authors.initials: S
authors.lastname: Kirazli
authors.forename: Cetin
authors.initials: C
authors.lastname: Turgan
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000032:analysis*; D015519:Bone Density; D002114:Calcinosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011884:Radius / Q000000981:diagnostic imaging; D006435:Renal Dialysis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D060749:alpha-2-HS-Glycoprotein
chemical_list: C556354:AHSG protein, human; D015415:Biomarkers; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein