title: Relationship between bone mineral density and serum osteoprotegerin in patients with chronic heart failure.
abstract: OBJECTIVE
  Heart failure (HF) had been reported with increased risk of hip fractures. However, the relationship between circulating biomarkers and bone mineral density (BMD) in chronic HF remained unclear.
  
  
  METHODS
  This is a cross-sectional study which recruited stable chronic HF from registry of the Heart Failure Center of National Taiwan University Hospital. Patients underwent dual-energy x-ray absorptiometry (DEXA) measurements at hip and lumbar spines and biochemical assessments including B-type natriuretic peptide (BNP-32), myostatin, follistatin and osteoprotegerin (OPG).
  
  
  RESULTS
  A total of 115 stable chronic HF individuals with left ventricular ejection fraction (EF) <45% (74% of male, mean age at 59) were recruited with 24 patients in NYHA class I, 73 patients in NYHA class II and 18 patients in NYHA class III. Results of BMD showed that Z scores of hip in NYHA III group (-0.12 ± 1.15) was significantly lower than who were NYHA II (0.58 ± 1.04). Serum OPG was significantly higher in subjects of NYHA III (9.3 ± 4.6 pmol/l) than NYHA II (7.4 ± 2.8 pmol/l) or NYHA I (6.8 ± 3.6 pmol/l) groups. There's a significant negative association between log transformed serum OPG and trochanteric BMD (R = -0.299, P = 0.001), which remained significant after multivariate analysis.
  
  
  CONCLUSIONS
  Our study demonstrated an inverse association between serum OPG and trochanteric BMD in patients with HF. OPG may be a predictor of BMD and an alternative to DEXA for identifying at risk HF patients for osteoporosis.
authors.affiliation: National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Ying-Hsien
authors.initials: YH
authors.lastname: Chen
authors.forename: Yen-Wen
authors.initials: YW
authors.lastname: Wu
authors.forename: Wei-Shiung
authors.initials: WS
authors.lastname: Yang
authors.forename: Shoei-Shen
authors.initials: SS
authors.lastname: Wang
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Lee
authors.forename: Nai-Kuan
authors.initials: NK
authors.lastname: Chou
authors.forename: Ron-Bin
authors.initials: RB
authors.lastname: Hsu
authors.forename: Yen-Hung
authors.initials: YH
authors.lastname: Lin
authors.forename: Mao-Shin
authors.initials: MS
authors.lastname: Lin
authors.forename: Yi-Lwun
authors.initials: YL
authors.lastname: Ho
authors.forename: Ming-Fong
authors.initials: MF
authors.lastname: Chen
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000503:physiopathology; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D053244:Osteoprotegerin / Q000097:blood*
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human