The ratio of osteoprotegerin to fetuin-a is independently associated with vascular stiffness in hemodialysis patients.
BACKGROUND
The aim of the present study was to compare levels of fetuin-A, osteoprotegerin (OPG), and heat shock protein (HSP)70 according to the stage of chronic kidney disease (CKD), as well as to evaluate the association between serum fetuin-A, OPG, and HSP70 concentrations with respect to vascular stiffness and calcification in hemodialysis (HD) patients.


METHODS
We measured fetuin-A, OPG, and HSP70 in 35 healthy controls, 35 patients with stage 3 CKD, 35 patients with stage 4 CKD, and 81 HD patients. Using these data, we studied the association of fetuin-A, OPG, and HSP70 with clinical, biochemical, and vascular measures in HD patients.


RESULTS
Levels of OPG and HSP70 were higher and fetuin-A was lower in HD patients than in healthy controls. The cardio-ankle vascular index (CAVI) showed a positive correlation with OPG (r = 0.248, p = 0.040) and the OPG/fetuin-A ratio (r = 0.260, p = 0.031). The ankle-brachial index (ABI) showed a negative correlation with OPG (r = -0.245, p = 0.031) and the OPG/fetuin-A ratio (r = -0.267, p = 0.018). Intima-media thickness (IMT) showed a positive correlation with OPG (r = 0.273, p = 0.014) and the OPG/fetuin-A ratio (r = 0.269, p = 0.015). On stepwise multiple linear regression analyses, only the logarithmic function of the OPG/fetuin-A ratio was independently associated with CAVI (β = 13.325, SE = 6.247, p = 0.038).


CONCLUSIONS
Our results demonstrate that OPG and the OPG/fetuin-A ratio are correlated with increased vascular stiffness and IMT in HD patients. In addition, the OPG/fetuin-A ratio was independently associated with vascular stiffness in HD patients.
Department of Laboratory Medicine, College of Medicine Chung-Ang University, Seoul, Korea.
Hye Ryoun
HR
Kim
Su-Hyun
SH
Kim
Min-Ji
MJ
Han
Yu-Sik
YS
Yoon
Dong-Jin
DJ
Oh
D000368:Aged; D059168:Carotid Intima-Media Thickness; D005260:Female; D018840:HSP70 Heat-Shock Proteins / Q000097:blood; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood*; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D006435:Renal Dialysis; D059289:Vascular Stiffness; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis*
D018840:HSP70 Heat-Shock Proteins; D053244:Osteoprotegerin; D060749:alpha-2-HS-Glycoprotein