title: Correlates of osteoprotegerin and association with aortic pulse wave velocity in patients with chronic kidney disease.
abstract: OBJECTIVE
  Osteoprotegerin (OPG), a cytokine that regulates bone resorption, has been implicated in the process of vascular calcification and stiffness.
  
  
  METHODS
  Serum OPG was measured in 351 participants with chronic kidney disease (CKD) from one site of the Chronic Renal Insufficiency Cohort Study. Cortical bone mineral content (BMC) was measured by quantitative computed tomography in the tibia. Multivariable linear regression was used to test the association between serum OPG and traditional cardiovascular risk factors, measures of abnormal bone and mineral metabolism, and pulse wave velocity.
  
  
  RESULTS
  Higher serum OPG levels were associated with older age, female gender, greater systolic BP, lower estimated GFR, and lower serum albumin. OPG was not associated with measures of abnormal bone or mineral metabolism including serum phosphorus, albumin-corrected serum calcium, intact parathyroid hormone, bone-specific alkaline phosphatase, or cortical BMC. Among 226 participants with concurrent aortic pulse wave velocity measurements, increasing tertiles of serum OPG were associated with higher aortic pulse wave velocity after adjustment for demographics, traditional vascular risk factors, and nontraditional risk factors such as estimated GFR, albuminuria, serum phosphate, corrected serum calcium, presence of secondary hyperparathyroidism, serum albumin, and C-reactive protein or after additional adjustment for cortical BMC in a subset (n = 161).
  
  
  CONCLUSIONS
  These data support a strong relationship between serum OPG and arterial stiffness independent of many potential confounders including traditional cardiovascular risk factors, abnormal bone and mineral metabolism, and inflammation.
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. jscialla@med.miami.edu
authors.forename: Julia J
authors.initials: JJ
authors.lastname: Scialla
authors.forename: Mary B
authors.initials: MB
authors.lastname: Leonard
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Townsend
authors.forename: Lawrence
authors.initials: L
authors.lastname: Appel
authors.forename: Myles
authors.initials: M
authors.lastname: Wolf
authors.forename: Matt J
authors.initials: MJ
authors.lastname: Budoff
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Eva
authors.initials: E
authors.lastname: Lustigova
authors.forename: Crystal A
authors.initials: CA
authors.lastname: Gadegbeku
authors.forename: Melanie
authors.initials: M
authors.lastname: Glenn
authors.forename: Asaf
authors.initials: A
authors.lastname: Hanish
authors.forename: Dominic
authors.initials: D
authors.lastname: Raj
authors.forename: Sylvia E
authors.initials: SE
authors.lastname: Rosas
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Seliger
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Weir
authors.forename: Rulan S
authors.initials: RS
authors.lastname: Parekh
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001011:Aorta / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D002318:Cardiovascular Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016009:Chi-Square Distribution; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D018570:Risk Assessment; D012307:Risk Factors; D013977:Tibia / Q000000981:diagnostic imaging / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D014481:United States; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human