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Elevated osteoprotegerin is associated with inflammation, malnutrition and new onset cardiovascular events in peritoneal dialysis patients.

 Hyang Mo Koo  ;  Hwa Mi Do  ;  Eun Jin Kim  ;  Mi Jung Lee  ;  Dong Ho Shin  ;  Seung Jun Kim  ;  Hyung Jung Oh  ;  Dong Eun Yoo  ;  Jwa-Kyung Kim  ;  Jung Tak Park  ;  Seung Hyeok Han  ;  Shin-Wook Kang  ;  Kyu Hun Choi  ;  Tae-Hyun Yoo 
 ATHEROSCLEROSIS, Vol.219(2) : 925-930, 2011 
Journal Title
Issue Date
Adult ; Biomarkers/blood ; Body Composition ; C-Reactive Protein/metabolism ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/etiology* ; Cardiovascular Diseases/mortality ; Comorbidity ; Creatinine/blood ; Female ; Humans ; Inflammation/blood ; Inflammation/etiology* ; Inflammation/mortality ; Inflammation Mediators/blood ; Kaplan-Meier Estimate ; Male ; Malnutrition/blood ; Malnutrition/etiology* ; Malnutrition/mortality ; Middle Aged ; Osteoprotegerin/blood* ; Peritoneal Dialysis/adverse effects* ; Peritoneal Dialysis/mortality ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Republic of Korea/epidemiology ; Risk Assessment ; Risk Factors ; Serum Albumin/metabolism ; Time Factors ; Up-Regulation
Osteoprotegerin ; Inflammation ; Cardiovascular events ; Peritoneal dialysis
BACKGROUNDS: Osteoprotegerin (OPG) is known to regulate bone mineral metabolism and to be also associated with inflammation, cardiovascular disease (CVD) and mortality. Malnutrition-inflammation-atherosclerosis (MIA) syndrome is commonly found and closely linked to mortality in dialysis patients. The aim of this study was to investigate the associations between OPG and MIA syndrome in prevalent peritoneal dialysis (PD) patients. METHODS: Prevalent PD patients for more than 6 months were prospectively followed up from March 2005 to May 2010. At baseline, OPG, hs-CRP, albumin, and %lean body mass (LBM) by creatinine kinetics were checked, and subjective global assessment (SGA) was performed. New-onset cardiovascular events were evaluated during the study period. Based on the median level of OPG, patients were classified as lower OPG (LO) group (n = 88) and higher OPG (HO) group (n = 88). RESULTS: A total of 176 patients (age 52.0 ± 11.8 years, male 50.6%, duration of PD 105.3 ± 67.2 months) were recruited and followed. In HO group, age, hs-CRP level and Charlson's comorbidity indices were higher, whereas serum albumin level, %LBM and SGA score were significantly lower than LO group. OPG levels were positively correlated with inflammatory markers, whereas negatively correlated with nutritional status. Cardiovascular events occurred in 51 patients during the study period. Newly developed cardiovascular events were significantly common in HO group (n = 36, 40.9%) than LO group (n = 15, 17%, p = 0.002). Cox regression analysis revealed that higher OPG level (per 1-SD increase in OPG, HR: 1.44; 95% CI: 1.03-2.00; p = 0.034) was a significant risk factor for cardiovascular events even after adjustments for demographic and biochemical parameters. CONCLUSION: OPG was significantly correlated with markers of systemic inflammation and malnutrition and was a significant predictor of CVD in PD patients. These findings suggest OPG might be a prognostic indicator of MIA syndrome in prevalent PD patients
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Koo, Hyang Mo(구향모)
Kim, Seung Jun(김승준)
Kim, Eun Jin(김은진)
Kim, Jwa Kyung(김좌경)
Doh, Fa Mee(도화미) ORCID logo https://orcid.org/0000-0002-4780-6728
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Oh, Hyung Jung(오형중)
Yoo, Dong Eun(유동은)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Mi Jung(이미정)
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
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