title: The balance of fetuin-A and osteoprotegerin is independently associated with diastolic dysfunction in hemodialysis patients.
abstract: Fetuin-A and osteoprotegerin (OPG) are arterial calcification regulators, which are related to cardiovascular survival in hemodialysis patients. We hypothesized that a balance of these calcification regulators might mediate the progression of left ventricular (LV) diastolic dysfunction in hemodialysis patients. We recruited 63 hemodialysis patients and measured their serum fetuin-A, OPG, arterial stiffness, aortic calcification and echocardiographic parameters, including the transmitral early diastolic velocity/tissue Doppler mitral annular early diastolic velocity ratio (E/E'), and analyzed the relationships between these variables. Fetuin-A levels were significantly and negatively correlated with the ankle-brachial pulse wave velocity (baPWV), aortic calcification score (AOCS), left atrial volume index (LAVI), LV mass index (LVMI) and E/E'. OPG levels and the ratio of OPG to fetuin-A levels were significantly and positively correlated with the baPWV, AOCS, LAVI and E/E'. A stepwise multiple regression analysis revealed that E/E' was independently correlated with fetuin-A levels (β=-0.334, P=0.02), OPG levels (β=0.367, P=0.01) and the ratio of OPG to fetuin-A (β=0.295, P=0.04). Categorizing the patients according to their serum fetuin-A and OPG levels revealed that patients with low fetuin-A and high OPG levels had the highest LAVI, LVMI and E/E' values after adjusting for potential confounders. Serum fetuin-A levels negatively reflected, whereas OPG levels and the ratio of OPG to fetuin-A positively reflected an increase in vascular and ventricular stiffness, leading to the aggravation of diastolic dysfunction. Therefore, based on our results, the balance of the tissue calcification regulators fetuin-A and OPG could mediate the progression of LV diastolic dysfunction in hemodialysis patients.
authors: Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.
authors: Ali
authors: A
authors: Talib
authors: Naoki
authors: N
authors: Nakagawa
authors: Erika
authors: E
authors: Saito
authors: Motoki
authors: M
authors: Matsuki
authors: Motoi
authors: M
authors: Kobayashi
authors: Kazumi
authors: K
authors: Akasaka
authors: Tomoya
authors: T
authors: Hirayama
authors: Hironori
authors: H
authors: Ishida
authors: Nobuyuki
authors: N
authors: Sato
authors: Naoyuki
authors: N
authors: Hasebe
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001783:Blood Flow Velocity / Q000502:physiology; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000097:blood* / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
chemical_list: D053244:Osteoprotegerin; D060749:alpha-2-HS-Glycoprotein