title: Serum osteoprotegerin is associated with vascular stiffness and the onset of new cardiovascular events in hemodialysis patients.
abstract: OBJECTIVE
  Osteoprotegerin (OPG) and fetuin-A are vascular calcification regulators that may be related to high cardiovascular (CV) mortality in hemodialysis (HD) patients. We evaluated the relationship between OPG, fetuin-A, and pulse wave velocity (PWV), a marker of vascular stiffness, and determined whether OPG and fetuin-A were independent predictors of CV events in HD patients.
  
  
  METHODS
  We conducted a prospective observational study in 97 HD patients. OPG and fetuin-A were measured at baseline and arterial stiffness was evaluated by PWV. All patients were stratified into tertiles according to serum OPG levels.
  
  
  RESULTS
  A significant trend was observed across increasing serum OPG concentration tertiles for age, HD duration, systolic blood pressure, cholesterol, triglycerides, and PWV. Multiple linear regression analysis revealed that diabetes (β = 0.430, p = 0.000) and OPG levels (β = 0.308, p = 0.003) were independently associated with PWV. The frequency of new CV events was significantly higher in the upper OPG tertiles compared with those in the lower OPG tertiles. In Cox proportional hazards analysis, upper tertiles of OPG levels were significantly associated with CV events (hazard ratio = 4.536, p = 0.011).
  
  
  CONCLUSIONS
  Serum OPG, but not fetuin-A, levels were closely associated with increased vascular stiffness, and higher OPG levels may be independent predictors of new CV events in HD patients.
authors.affiliation: Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Lee
authors.forename: Hyung Jong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Sung Jin
authors.initials: SJ
authors.lastname: Moon
authors.forename: Ji Sun
authors.initials: JS
authors.lastname: Nam
authors.forename: Jwa-Kyung
authors.initials: JK
authors.lastname: Kim
authors.forename: Seung Kyu
authors.initials: SK
authors.lastname: Kim
authors.forename: Gi Young
authors.initials: GY
authors.lastname: Yun
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Ha
authors.forename: Hyeong Cheon
authors.initials: HC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D053244:Osteoprotegerin / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012307:Risk Factors; D015854:Up-Regulation; D059289:Vascular Stiffness; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis
chemical_list: C556354:AHSG protein, human; D015415:Biomarkers; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human; D060749:alpha-2-HS-Glycoprotein
keywords: Cardiovascular diseases; Osteprotegerin; Vascular stiffness