title: Malnutrition, a new inducer for arterial calcification in hemodialysis patients?
abstract: BACKGROUND
  Arterial calcification is a significant cardiovascular risk factor in hemodialysis patients. A series of factors are involved in the process of arterial calcification; however, the relationship between malnutrition and arterial calcification is still unclear.
  
  
  METHODS
  68 hemodialysis patients were enrolled in this study. Nutrition status was evaluated using modified quantitative subjective global assessment (MQSGA). Related serum biochemical parameters were measured. And the radial artery samples were collected during the arteriovenous fistula surgeries. Hematoxylin/eosin stain was used to observe the arterial structures while Alizarin red stain to observe calcified depositions and classify calcified degree. The expressions of bone morphogenetic protein 2 (BMP2) and matrix Gla protein (MGP) were detected by immunohistochemistry and western blot methods.
  
  
  RESULTS
  66.18% hemodialysis patients were malnutrition. In hemodialysis patients, the calcified depositions were mainly located in the medial layer of the radial arteries and the expressions of BMP2 and MGP were both increased in the calcified areas. The levels of serum albumin were negatively associated with calcification score and the expressions of BMP2 and MGP. While MQSGA score, serum phosphorus and calcium × phosphorus product showed positive relationships with calcification score and the expressions of BMP2 and MGP.
  
  
  CONCLUSIONS
  Malnutrition is prevalent in hemodialysis patients and is associated with arterial calcification and the expressions of BMP2 and MGP in calcified radial arteries. Malnutrition may be a new inducer candidate for arterial calcification in hemodialysis patients.
authors.affiliation: Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou 510120, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
authors.forename: Gang
authors.initials: G
authors.lastname: Cheng
authors.forename: Xue
authors.initials: X
authors.lastname: Cai
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Ying
authors.initials: Y
authors.lastname: Jiang
authors.forename: Tong
authors.initials: T
authors.lastname: Wang
authors.forename: Jingfeng
authors.initials: J
authors.lastname: Wang
authors.forename: Hui
authors.initials: H
authors.lastname: Huang
mesh_terms: D001158:Arteries / Q000378:metabolism / Q000473:pathology*; D015153:Blotting, Western; D055396:Bone Morphogenetic Protein 2 / Q000378:metabolism; D002114:Calcinosis; D002118:Calcium / Q000097:blood; D002135:Calcium-Binding Proteins / Q000378:metabolism; D016326:Extracellular Matrix Proteins / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D044342:Malnutrition / Q000473:pathology*; D010758:Phosphorus / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*; D012709:Serum Albumin / Q000378:metabolism; D000097568:Matrix Gla Protein
chemical_list: D055396:Bone Morphogenetic Protein 2; D002118:Calcium; D002135:Calcium-Binding Proteins; D016326:Extracellular Matrix Proteins; D010758:Phosphorus; D012709:Serum Albumin; D000097568:Matrix Gla Protein