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Lin RA, Hsieh JT, Huang CC, Yang CY, Lin YP, Tarng DC. Circulating Osteocalcin Fractions are Associated with Vascular Calcification and Mortality in Chronic Hemodialysis Patients. Calcif Tissue Int 2023; 113:416-425. [PMID: 37665403 DOI: 10.1007/s00223-023-01122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Vascular calcification, a component of chronic kidney disease-mineral and bone disorder (CKD-MBD), is prevalent in patients with end-stage kidney disease (ESKD) and contributes to high mortality. However, the association between the blood level of total osteocalcin (OC) and vascular calcification and mortality remains inconclusive. We, therefore, investigated whether different OC fractions can serve as biomarkers of vascular calcification and mortality in the ESKD population. METHODS This observational cohort study enrolled patients on maintenance hemodialysis. Plasma carboxylated OC (cOC), uncarboxylated OC (ucOC), and intact parathyroid hormone (PTH) were measured. The percentage of carboxylated OC (%cOC) was calculated as dividing cOC by total OC. The vascular calcification severity was defined by an aortic calcification grade. The patients were followed for three years and one month. RESULTS A total of 184 patients were enrolled. In the multivariable logistic regression, plasma %cOC, but not cOC or ucOC, was independently associated with the severity of vascular calcification (OR 1.019, p = 0.036). A significant U-shaped correlation was found between plasma %cOC and PTH (p = 0.002). In the multivariable Cox regression, patients with higher plasma %cOC had a higher risk of mortality (quartiles Q4 versus Q1-Q3, HR 1.991 [95% CI: 1.036-3.824], p = 0.039). CONCLUSIONS In patients undergoing chronic hemodialysis, plasma %cOC positively correlated with vascular calcification and exhibited a U-shaped correlation with PTH. Furthermore, a higher plasma %cOC was associated with increased mortality. These findings suggest that plasma %cOC may serve as a biomarker for CKD-MBD and a predictor of clinical outcomes in chronic hemodialysis patients.
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Affiliation(s)
- Ruei-An Lin
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Jyh-Tong Hsieh
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital and Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, 201, Sec. 2, Shih-Pai Rd., Beitou Dist, Taipei, 11217, Taiwan
| | - Chin-Chou Huang
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Yu Yang
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
- National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
- Stem Cell Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Yao-Ping Lin
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Der-Cherng Tarng
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang Ming Chiao Tung University, Hsinchu, Taiwan
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2
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Maddaloni E, Coraggio L, Amendolara R, Baroni MG, Cavallo MG, Copetti M, Cossu E, D'Angelo P, D'Onofrio L, Cosmo SD, Leonetti F, Morano S, Morviducci L, Napoli N, Prudente S, Pugliese G, Park K, Holman RR, Trischitta V, Buzzetti R. Association of osteocalcin, osteoprotegerin, and osteopontin with cardiovascular disease and retinopathy in type 2 diabetes. Diabetes Metab Res Rev 2023:e3632. [PMID: 36880127 DOI: 10.1002/dmrr.3632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/02/2022] [Accepted: 02/26/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Novel biomarkers of vascular disease in diabetes could help identify new mechanistic pathways. Osteocalcin, osteoprotegerin, and osteopontin are key molecules involved in bone and vascular calcification processes, both of which are compromised in diabetes. We aimed to evaluate possible associations of osteocalcin, osteoprotegerin, and osteopontin with cardiovascular disease (CVD) and diabetic retinopathy (DR) among people with type 2 diabetes (T2D). MATERIALS AND METHODS Osteocalcin, osteoprotegerin, and osteopontin concentrations were measured at enrolment in 848 participants with T2D from the Sapienza University Mortality and Morbidity Event Rate (SUMMER) Study (ClinicalTrials.gov: NCT02311244). Logistic regression models and propensity score matching were used to assess possible associations of osteocalcin, osteoprotegerin, and osteopontin with a history of CVD and with evidence of any grade of DR adjusting for confounders. RESULTS Previous CVD was reported in 139 (16.4%) participants, while 144 (17.0%) had DR. After adjusting for possible confounders, osteocalcin but not osteoprotegerin or osteopontin concentrations were associated with a history of CVD (Odds Ratio [OR] and 95% CI for one standard deviation (SD) increase in osteocalcin concentrations (natural log): 1.35 (1.06-1.72), p = 0.014). Associations with prevalent DR were seen for osteoprotegerin (OR for one SD increase in osteoprotegerin concentrations (natural log): 1.25 (1.01-1.55), p = 0.047) and osteopontin (OR for one SD increase in osteopontin concentrations (natural log): 1.25 (1.02-1.53), p = 0.022), but not osteocalcin. CONCLUSIONS In T2D, higher serum osteocalcin concentrations are associated with macrovascular complications and higher osteoprotegerin and osteopontin concentrations with microvascular complications, suggesting that these osteokines might be involved in pathways directly related to vascular disease.
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Affiliation(s)
- Ernesto Maddaloni
- Sapienza University of Rome, Rome, Italy
- Diabetes Trials Unit, OCDEM, University of Oxford, Oxford, UK
| | | | | | | | | | - Massimiliano Copetti
- Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Rome, Italy
| | | | | | | | - Salvatore De Cosmo
- Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Rome, Italy
| | | | | | | | | | - Sabrina Prudente
- Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Rome, Italy
| | | | - Kyoungmin Park
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Rury R Holman
- Diabetes Trials Unit, OCDEM, University of Oxford, Oxford, UK
| | - Vincenzo Trischitta
- Sapienza University of Rome, Rome, Italy
- Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Rome, Italy
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Robertson CL, Ghosh G, Fitzgerald P, Hankey GJ, Levinger I, Golledge J, Almeida OP, Flicker L, Ebeling PR, Yeap BB. Bone Turnover Markers Including Undercarboxylated Osteocalcin Are Associated With Mortality Risk in Older Men. J Bone Miner Res 2022; 37:1464-1472. [PMID: 35689459 PMCID: PMC9540459 DOI: 10.1002/jbmr.4631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/05/2022] [Accepted: 06/09/2022] [Indexed: 11/25/2022]
Abstract
Osteocalcin in its undercarboxylated form (ucOC) may influence diabetes risk; however, its relationship with all-cause and cause-specific mortality is unclear. Whether other bone turnover markers (BTMs) are associated with mortality risk differently from ucOC also remains uncertain. Our aim was to determine associations of serum ucOC with all-cause and cause-specific mortality and compare these with the corresponding associations of serum total osteocalcin (TOC), procollagen type I N-propeptide (PINP), and collagen type 1 C-terminal cross-linked telopeptide (CTX) in older men. We conducted a prospective cohort study of 3871 community-dwelling men, aged 77.0 ± 3.6 years at baseline, followed for a median of 12.3 years. Exposure variables were ucOC, TOC, PINP, and CTX concentrations assayed in serum. Outcomes were incidence of all deaths and deaths due to cardiovascular disease (CVD) or cancer, ascertained using death registry data. Cox regression analyses adjusted for cardiovascular risk factors and prevalent CVD and for prevalent cancer in analyses of cancer-related mortality. Higher concentrations of ucOC, PINP, and CTX were associated with all-cause mortality (hazard ratio [HR] per 1 standard deviation increase: ucOC 1.12, 95% confidence interval [CI] 1.06-1.18, p < 0.001; PINP HR = 1.06, 95% CI 1.01-1.11, p = 0.009; CTX HR = 1.13, 95% CI 1.08-1.19, p < 0.001), but TOC was not associated. Similar results were found after excluding men with an incident fracture during follow-up. Higher ucOC and CTX were associated with CVD mortality (ucOC HR per 1 SD increase 1.13, 95% CI 1.05-1.22, p = 0.001; CTX HR = 1.12, 95% CI 1.04-1.20, p = 0.003), but this result was not significant in competing risks analysis. Higher CTX was also associated with cancer mortality (HR = 1.12, 95% CI 1.01-1.23, p = 0.024). In conclusion, in older men, higher bone turnover, assessed by BTMs including ucOC, is a biomarker for all-cause mortality risk. Undercarboxylated osteocalcin was a more informative biomarker for this outcome than TOC. Higher CTX was associated with all-cause and cancer-related mortality. Further evaluation of causality and potential underlying mechanisms is warranted. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
| | - Gaurav Ghosh
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
| | - Patrick Fitzgerald
- Western Australian Centre for Healthy Ageing, University of Western Australia, Perth, Australia
| | - Graeme J Hankey
- Medical School, University of Western Australia, Perth, Australia
| | - Itamar Levinger
- Institute for Health and Sport, Victoria University, Melbourne, Australia.,Australian Institute for Musculoskeletal Science, University of Melbourne and Western Health, St Albans, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, Australia.,Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Australia
| | - Osvaldo P Almeida
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Healthy Ageing, University of Western Australia, Perth, Australia
| | - Leon Flicker
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Healthy Ageing, University of Western Australia, Perth, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Bu B Yeap
- Medical School, University of Western Australia, Perth, Australia.,Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
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Hsiao YT, Shimizu I, Yoshida Y, Minamino T. Role of circulating molecules in age-related cardiovascular and metabolic disorders. Inflamm Regen 2022; 42:2. [PMID: 35012677 PMCID: PMC8744343 DOI: 10.1186/s41232-021-00187-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/30/2021] [Indexed: 12/12/2022] Open
Abstract
Studies analyzing heterochronic parabiosis mice models showed that molecules in the blood of young mice rejuvenate aged mice. Therefore, blood-based therapies have become one of the therapeutic approaches to be considered for age-related diseases. Blood includes numerous biologically active molecules such as proteins, metabolites, hormones, miRNAs, etc. and accumulating evidence indicates some of these change their concentration with chronological aging or age-related disorders. The level of some circulating molecules showed a negative or positive correlation with all-cause mortality, cardiovascular events, or metabolic disorders. Through analyses of clinical/translation/basic research, some molecules were focused on as therapeutic targets. One approach is the supplementation of circulating anti-aging molecules. Favorable results in preclinical studies let some molecules to be tested in humans. These showed beneficial or neutral results, and some were inconsistent. Studies with rodents and humans indicate circulating molecules can be recognized as biomarkers or therapeutic targets mediating their pro-aging or anti-aging effects. Characterization of these molecules with aging, testing their biological effects, and finding mimetics of young systemic milieu continue to be an interesting and important research topic to be explored.
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Affiliation(s)
- Yung Ting Hsiao
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
- Institute for Diseases of Old Age, Juntendo University Graduate School of Medicine, Tokyo, 113-8431, Japan
| | - Ippei Shimizu
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
| | - Yohko Yoshida
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
- Department of Advanced Senotherapeutics, Juntendo University Graduate School of Medicine, Tokyo, 113-8431, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
- Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, 100-0004, Japan.
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Bargieł W, Cierpiszewska K, Maruszczak K, Pakuła A, Szwankowska D, Wrzesińska A, Gutowski Ł, Formanowicz D. Recognized and Potentially New Biomarkers-Their Role in Diagnosis and Prognosis of Cardiovascular Disease. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57070701. [PMID: 34356982 PMCID: PMC8305174 DOI: 10.3390/medicina57070701] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/03/2021] [Accepted: 07/04/2021] [Indexed: 01/08/2023]
Abstract
Atherosclerosis and its consequences are the leading cause of mortality in the world. For this reason, we have reviewed atherosclerosis biomarkers and selected the most promising ones for review. We focused mainly on biomarkers related to inflammation and oxidative stress, such as the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), and lipoprotein-associated phospholipase A2 (Lp-PLA2). The microRNA (miRNA) and the usefulness of the bone mineralization, glucose, and lipid metabolism marker osteocalcin (OC) were also reviewed. The last biomarker we considered was angiogenin (ANG). Our review shows that due to the multifactorial nature of atherosclerosis, no single marker is known so far, the determination of which would unambiguously assess the severity of atherosclerosis and help without any doubt in the prognosis of cardiovascular risk.
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Affiliation(s)
- Weronika Bargieł
- Faculty of Medicine, Poznan University of Medical Sciences, 60-812 Poznan, Poland; (W.B.); (K.C.); (K.M.); (A.P.); (D.S.); (A.W.)
| | - Katarzyna Cierpiszewska
- Faculty of Medicine, Poznan University of Medical Sciences, 60-812 Poznan, Poland; (W.B.); (K.C.); (K.M.); (A.P.); (D.S.); (A.W.)
| | - Klara Maruszczak
- Faculty of Medicine, Poznan University of Medical Sciences, 60-812 Poznan, Poland; (W.B.); (K.C.); (K.M.); (A.P.); (D.S.); (A.W.)
| | - Anna Pakuła
- Faculty of Medicine, Poznan University of Medical Sciences, 60-812 Poznan, Poland; (W.B.); (K.C.); (K.M.); (A.P.); (D.S.); (A.W.)
| | - Dominika Szwankowska
- Faculty of Medicine, Poznan University of Medical Sciences, 60-812 Poznan, Poland; (W.B.); (K.C.); (K.M.); (A.P.); (D.S.); (A.W.)
| | - Aleksandra Wrzesińska
- Faculty of Medicine, Poznan University of Medical Sciences, 60-812 Poznan, Poland; (W.B.); (K.C.); (K.M.); (A.P.); (D.S.); (A.W.)
| | - Łukasz Gutowski
- Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland;
| | - Dorota Formanowicz
- Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland;
- Correspondence:
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Zhelyazkova-Savova MD, Yotov YT, Nikolova MN, Nazifova-Tasinova NF, Vankova DG, Atanasov AA, Galunska BT. Statins, vascular calcification, and vitamin K-dependent proteins: Is there a relation? Kaohsiung J Med Sci 2021; 37:624-631. [PMID: 33634559 DOI: 10.1002/kjm2.12373] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/30/2020] [Accepted: 01/24/2021] [Indexed: 12/16/2022] Open
Abstract
The present cross-sectional clinical study aimed to examine the connection between statin exposure, coronary artery calcification (CAC), and vitamin K-dependent proteins (VKDPs) in patients with cardiovascular (CV) conditions. Two groups of patients were studied: patients with established CV disease (CVD) and healthy patients at moderate risk for CVD (a control group). The groups were also split into statin users and non-users. The following VKDPs were measured in plasma: uncarboxylated Matrix Gla-protein (ucMGP), undercarboxylated (ucOC), and carboxylated osteocalcin (cOC), Gla-rich protein (GRP). CAC score (CACS) was determined by multislice computed tomography. Among all the participants in the study, CACS was more pronounced in statin users compared to non-users; the same was found also among the CVD patients and among the controls. While the levels of ucMGP and GRP did not differ between statin users and non-users, ucOC and ucOC/cOC were significantly elevated in statin users, indicating vitamin K deficiency. There was a positive correlation between the levels of ucOC and CACS in the entire population and in the group of statin users, but not in statin non-users. No association was found between ucMGP or GRP and CACS. Statins had also an impact on the international normalized ratio and interacted with vitamin K antagonists (VKAs). Our results are in agreement with the existing evidence about positive association between statins and vascular calcification. They enlighten to a certain extent the possible mechanisms through which statins may enhance calcium accumulation in arterial wall, namely, by inhibition of vitamin K dependent proteins and functions involved in vascular protection.
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Affiliation(s)
- Maria D Zhelyazkova-Savova
- Department of Pharmacology, Clinical Pharmacology and Therapy, Varna Medical University, Varna, Bulgaria
| | - Yoto T Yotov
- First Department of Internal Diseases, Faculty of Medicine, Medical University of Varna, Varna, Bulgaria
| | - Miglena N Nikolova
- Department of Biochemistry, Molecular medicine and Nutrigenomics, Faculty of Pharmacy, Medical University of Varna, Varna, Bulgaria
| | - Neshe F Nazifova-Tasinova
- Department of Biochemistry, Molecular medicine and Nutrigenomics, Faculty of Pharmacy, Medical University of Varna, Varna, Bulgaria
| | - Deyana G Vankova
- Department of Biochemistry, Molecular medicine and Nutrigenomics, Faculty of Pharmacy, Medical University of Varna, Varna, Bulgaria
| | - Atanas A Atanasov
- First Department of Internal Diseases, Faculty of Medicine, Medical University of Varna, Varna, Bulgaria
| | - Bistra Tz Galunska
- Department of Biochemistry, Molecular medicine and Nutrigenomics, Faculty of Pharmacy, Medical University of Varna, Varna, Bulgaria
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Cahalane RM, Barrett HE, Ross AM, Mulvihill JJE, Purtill H, Selvarajah L, O'Brien J, Kavanagh EG, Moloneye MA, Egan SM, Leahy FC, Griffin TP, Islam MN, O'Shea PM, Walsh MT, O'Connor EM. On the association between circulating biomarkers and atherosclerotic calcification in a cohort of arterial disease participants. Nutr Metab Cardiovasc Dis 2021; 31:1533-1541. [PMID: 33810961 DOI: 10.1016/j.numecd.2021.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 01/18/2021] [Accepted: 02/03/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS Atherosclerotic calcification is a powerful predictor of cardiovascular disease. This study aims to determine whether circulating levels of a local/systemic calcification inhibitor or a marker of bone formation correlate with measures of coronary or extracoronary calcification. METHODS AND RESULTS Clinical computed tomography (CT) was performed on 64 arterial disease participants undergoing carotid and lower extremity endarterectomy. Coronary artery calcium (CAC) scores and volumes were acquired from the CT scans (n = 42). CAC scores and volumes were used to derive CAC density scores. Micro-CT was performed on excised carotid (n = 36) and lower extremity (n = 31) plaques to quantify the volume and volume fraction of extracoronary calcification. Circulating levels of dephospho-uncarboxylated Matrix Gla Protein (dp-ucMGP), fetuin-A, carboxylated and uncarboxylated osteocalcin (ucOC) were quantified using commercial immunoassays. Carotid participant CAC density scores were moderately negatively correlated with plasma dp-ucMGP (rs = -0.592, P = 0.008). A weak negative association was found between CAC scores and %ucOC for all participants (rs = -0.335, P = 0.040). Another weak negative correlation was observed between fetuin-A and the volume of calcification within excised carotid specimens (rs = -0.366, P = 0.031). Despite substantial differences in coronary and extracoronary calcium measurements, the levels of circulating biomarkers did not vary significantly between carotid and lower extremity subgroups. CONCLUSION Correlations identified between circulating biomarkers and measures of coronary and extracoronary calcium were not consistent among participant subgroups. Further research is required to determine the association between circulating biomarkers, coronary and extracoronary calcium.
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Affiliation(s)
- Rachel M Cahalane
- BioScience and BioEngineering Research, Biomaterials Cluster, Bernal Institute, School of Engineering, University of Limerick, Ireland.
| | - Hilary E Barrett
- BioScience and BioEngineering Research, Biomaterials Cluster, Bernal Institute, School of Engineering, University of Limerick, Ireland.
| | - Aisling M Ross
- BioScience and BioEngineering Research, Biomaterials Cluster, Bernal Institute, School of Engineering, University of Limerick, Ireland.
| | - John J E Mulvihill
- BioScience and BioEngineering Research, Biomaterials Cluster, Bernal Institute, School of Engineering, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland.
| | - Helen Purtill
- Health Research Institute, University of Limerick, Ireland; Department of Mathematics and Statistics, Aging Research Centre, University of Limerick, Ireland.
| | | | - Julie O'Brien
- Department of Radiology, University Hospital Limerick, Ireland.
| | - Eamon G Kavanagh
- Department of Vascular Surgery, University Hospital Limerick, Ireland.
| | | | - Siobhan M Egan
- Clinical Research Support Unit, University Hospital Limerick, Ireland.
| | - Fiona C Leahy
- Clinical Research Support Unit, University Hospital Limerick, Ireland.
| | - Tomás P Griffin
- Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals, Galway, Ireland; Regenerative Medicine Institute (REMEDI) at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland.
| | - M N Islam
- Regenerative Medicine Institute (REMEDI) at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland; Department of Clinical Biochemistry, University Hospital Galway, Ireland.
| | - Paul M O'Shea
- Department of Clinical Biochemistry, University Hospital Galway, Ireland.
| | - Michael T Walsh
- BioScience and BioEngineering Research, Biomaterials Cluster, Bernal Institute, School of Engineering, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland.
| | - Eibhlís M O'Connor
- Health Research Institute, University of Limerick, Ireland; Department of Biological Sciences, School of Natural Sciences, University of Limerick, Ireland; Alimentary Pharmabiotic Centre, Microbiome Institute, University College Cork, Ireland.
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8
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Keryakos HKH, Okaily NI, Boulis MAY, Salama AMS. Osteocalcin and vascular calcification in hemodialysis patients: an observational cohort study. Int Urol Nephrol 2021; 53:1015-1023. [PMID: 33433789 DOI: 10.1007/s11255-020-02753-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/15/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Vascular calcification contributes to morbidity and mortality in patients with ESRD on maintenance hemodialysis. AIMS To study the relationship between osteocalcin and vascular calcification. METHODS 160 patients with ESRD on maintenance hemodialysis and 60 age-and sex-matched healthy controls were recruited. Serum vitamin K2 and osteocalcin both intact and undercarboxylated were measured. Transthoracic echocardiography was done for valvular calcification and thickening, and carotid duplex was done for carotid intimal medial calcification and thickening. RESULTS Hemodialysis patients have higher median serum vitamin K2 (p < 0.001), higher undercarboxylated osteocalcin (p < 0.001). Only older age, duration of hypertension, and duration of established cardiovascular disease are associated with carotid media-intimal calcification. Old age is a strong predictor of carotid media intimal thickening. Female sex is associated with a valvular thickening. CONCLUSIONS Functional vitamin K deficiency is present in maintenance hemodialysis patients and serum osteocalcin is not associated with cardiovascular calcification.
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Affiliation(s)
- Hesham Kamal Habeeb Keryakos
- Internal Medicine Department, Faculty of Medicine, Minia University, Aswan-Cairo Agricultural Road, El-Minia, 61111, Egypt.
| | - Nagwa Ismail Okaily
- Clinical Pathology Department, Faculty of Medicine, Minia University, El-Minia, Egypt
| | - Mariam Asaad Yacoub Boulis
- Internal Medicine Department, Faculty of Medicine, Minia University, Aswan-Cairo Agricultural Road, El-Minia, 61111, Egypt
| | - Ahmed Mohamed Saadeldin Salama
- Internal Medicine Department, Faculty of Medicine, Minia University, Aswan-Cairo Agricultural Road, El-Minia, 61111, Egypt
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9
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Abstract
Over the last decades, the association between vascular calcification (VC) and all-cause/cardiovascular mortality, especially in patients with high atherogenic status, such as those with diabetes and/or chronic kidney disease, has been repeatedly highlighted. For over a century, VC has been noted as a passive, degenerative, aging process without any treatment options. However, during the past decades, studies confirmed that mineralization of the arteries is an active, complex process, similar to bone genesis and formation. The main purpose of this review is to provide an update of the existing biomarkers of VC in serum and develop the various pathogenetic mechanisms underlying the calcification process, including the pivotal roles of matrix Gla protein, osteoprotegerin, bone morphogenetic proteins, fetuin-a, fibroblast growth-factor-23, osteocalcin, osteopontin, osteonectin, sclerostin, pyrophosphate, Smads, fibrillin-1 and carbonic anhydrase II.
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