Aortic pulse wave velocity is greater in peritoneal dialysis patients with lower dual energy X-ray absorptiometry (DXA) femoral neck bone mineral density

Correlation analysis of estimated pulse wave velocity and severe abdominal aortic calcification: based on the National Health and Nutrition Examination Survey database

Objective.To investigate how severe abdominal aortic calcification (SAAC) and estimated pulse wave velocity (ePWV) relate to each other and to all-cause and cardiovascular disease (CVD) mortalities.Approach.National Health and Nutrition Examination Survey 2013-2014 data were analyzed. ePWV, computed using age and mean blood pressure, served as an independent variable. Dependent variable SAAC (AAC score >6) was quantified using dual-energy x-ray absorptiometry and Kauppila grading. A weighted logistic regression model, interaction terms, and restricted cubic spline analysis examined relationship between ePWV and SAAC. Kaplan-Meier curves were drawn among SAAC people. A weighted Cox regression model was built to examine associations of ePWV with all-cause and CVD mortalities.Main results.2849 individuals were included. A strong positive connection (odds ratio (OR) > 1,P< 0.05) was seen between ePWV and SAAC risk. Interaction termP-value indicated that only ethnicity (P< 0.05) had an impact on this link but smoking, alcohol use, age, sex, body mass index, or hypertension did not. SAAC patients showed greater ePWV, all-cause and CVD mortalities (P< 0.05) than non-SAAC subjects. Greater ePWV (>12.00 m s-1) was associated with higher risks of all-cause and CVD mortalities in SAAC participants (hazard ratio (HR) > 1,P< 0.05). Significance.This study, for the first time based on the NHANES database, reveals a positive correlation between ePWV and SAAC, and identifies ePWV as an independent predictor of all-cause and cardiovascular mortality risk in patients with SAAC, providing a new biomarker for the prevention and early intervention of cardiovascular diseases.

Different type and dosage of heparin were not associated with the progression of coronary artery calcification in haemodialysis patients

AIM

Several studies have verified that unfractionated heparin (UFH) and low molecular heparin (LWMH) can induce bone loss, and bone mineral density has been inversely associated with vascular calcification in some clinical researches. But few have focused on the relationship between types and dosages of heparin and the progression of vascular calcification. We observed the progression of coronary artery calcification (CAC) in maintenance haemodialysis (MHD) patients who were treated with UFH and LMWH.

METHODS

This was a prospective prevalent cohort study of MHD patients. Computed tomography was performed at enrolment and 2 years after enrolment, and CAC score was obtained. Demographic and clinical data, baseline and time-average laboratory indices were collected. Multiple linear regression and logistic regression were used to estimate the influencing factors of progression of CAC.

RESULTS

In this study, (i) we initially enrolled 69 HD patients, and then 56 patients finished the follow-up. (ii) Among the total 56 patients, 27 patients (48.2%) were treated with UFH, 14 (25.0%) with LMWH and 15 (26.8%) with both. The median baseline CAC scores of three groups (UFH, LMWH and both users) were 91.0 (1.0, 1052.0), 134.0 (0, 1292.0) and 250.5 (27.0, 1139.0), respectively, with no significant difference (P = 0.663); the median CAC progression scores were 42.0 (0, 364.0), 172.0 (7.0, 653.0) and 118.5 (0, 434.0), respectively, with no significant difference (P = 0.660). (iii) Pearson and spearman correlation analysis shown that the progression of CAC was not associated with cumulative dosage of heparin used. (iv) After adjusted for diabetes mellitus, time-averaged intact parathyroid hormone, phosphate and alkaline phosphatase, logistic regression analysis showed using different types of heparin was not an independent risk factor for CAC progression; and multiple linear regression analysis showed that the type of heparin used was not associated with CAC progression.

CONCLUSION

There were no significant differences in the effects of the types and dosages of heparin on CAC progression in patients on haemodialysis.