title: Bone biomarkers help grading severity of coronary calcifications in non dialysis chronic kidney disease patients.
abstract: BACKGROUND
  Osteoprotegerin (OPG) and fibroblast growth factor-23 (FGF23) are recognized as strong risk factors of vascular calcifications in non dialysis chronic kidney disease (ND-CKD) patients. The aim of this study was to investigate the relationships between FGF23, OPG, and coronary artery calcifications (CAC) in this population and to attempt identification of the most powerful biomarker of CAC: FGF23? OPG?
  
  
  RESULTS
  195 ND-CKD patients (112 males/83 females, 70.8 [27.4-94.6] years) were enrolled in this cross-sectional study. All underwent chest multidetector computed tomography for CAC scoring. Vascular risk markers including FGF23 and OPG were measured. Logistic regression analyses were used to study the potential relationships between CAC and these markers. The fully adjusted-univariate analysis clearly showed high OPG (≥10.71 pmol/L) as the only variable significantly associated with moderate CAC ([100-400[) (OR = 2.73 [1.03;7.26]; p = 0.04). Such association failed to persist for CAC scoring higher than 400. Indeed, severe CAC was only associated with high phosphate fractional excretion (FEPO(4)) (≥38.71%) (OR = 5.47 [1.76;17.0]; p = 0.003) and high FGF23 (≥173.30 RU/mL) (OR = 5.40 [1.91;15.3]; p = 0.002). In addition, the risk to present severe CAC when FGF23 level was high was not significantly different when OPG was normal or high. Conversely, the risk to present moderate CAC when OPG level was high was not significantly different when FGF23 was normal or high.
  
  
  CONCLUSIONS
  Our results strongly suggest that OPG is associated to moderate CAC while FGF23 rather represents a biomarker of severe CAC in ND-CKD patients.
authors.affiliation: Laboratoire de Biochimie, CHRU de Montpellier, Montpellier, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Morena
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaussent
authors.forename: Aurore
authors.initials: A
authors.lastname: Halkovich
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Dupuy
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Bargnoux
authors.forename: Leila
authors.initials: L
authors.lastname: Chenine
authors.forename: Hélène
authors.initials: H
authors.lastname: Leray-Moragues
authors.forename: Kada
authors.initials: K
authors.lastname: Klouche
authors.forename: Hélène
authors.initials: H
authors.lastname: Vernhet
authors.forename: Bernard
authors.initials: B
authors.lastname: Canaud
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Cristol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002114:Calcinosis / Q000097:blood* / Q000209:etiology; D003324:Coronary Artery Disease / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D006435:Renal Dialysis
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D053244:Osteoprotegerin; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23