ABSTRACT
AIMS: To assess the relation of high serum OPG level and carotid atherosclerosis in maintenance hemodialysis (MHD) patients using low-flux reused dialyzer. MATERIALS AND METHODS: We examined 209 MHD patients with and without carotid atherosclerosis (83 patients and 126 patients) to establish the relation between OPG and atherosclerosis. RESULTS: The proportion of carotid atherosclerosis was 39.7%. The median serum OPG level was 45.3 pmol/L. Serum OPG had a good predicting value for atherosclerosis in MHD patients using low-flux reused dialyzer (AUC = 0.934, p < 0.001, cutoff value = 43.35 pmol/L, Se = 81.3%, Sp = 90.9%). CONCLUSIONS: In this study, serum OPG had a good predicting value for atherosclerosis in MHD patients using low-flux reused dialyzer.
Subject(s)
Atherosclerosis/blood , Carotid Artery Diseases/blood , Osteoprotegerin/blood , Renal Dialysis/instrumentation , Adult , Female , Humans , Logistic Models , Male , Middle Aged , Renal Dialysis/methodsABSTRACT
BACKGROUND: Osteoprotegerin (OPG) plays protective roles against the development of vascular calcification (VC) which greatly contributes to the increased cardiovascular events in patients with chronic kidney disease (CKD). The present study aimed to find the non-traditional, kidney-related cardiovascular risk factors correlated to serum OPG and the effect of serum OPG on the arterial stiffness measured by brachial ankle pulse wave velocity (baPWV) in patients with the pre-dialysis CKD. METHODS: We cross-sectionally analyzed the data from the patients in whom baPWV and the serum OPG were measured at the time of enrollment in a prospective pre-dialysis CKD cohort study in Korea. RESULTS: Along with traditional cardiovascular risk factors such as age, diabetes mellitus, pulse pressure, and baPWV, non-traditional, kidney-related factors such as albuminuria, plasma level of hemoglobin, total CO2 content, alkaline phosphatase, and corrected calcium were independent variables for serum OPG in multivariate linear regression. Reciprocally, the serum OPG was positively associated with baPWV in multivariate linear regression. The baPWV in the 3rd and 4th quartile groups of serum OPG were higher than that in the 1st quartile group after adjustments by age, sex and other significant factors for baPWV in linear mixed model. CONCLUSION: Non-traditional, kidney-related cardiovascular risk factors in addition to traditional cardiovascular risk factors were related to serum level of OPG in CKD. Serum OPG level was significantly related to baPWV. Our study suggests that kidney-related factors involved in CKD-specific pathways for VC play a role in the increased secretion of OPG into circulation in patients with CKD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01630486.
Subject(s)
Osteoprotegerin/blood , Renal Insufficiency, Chronic/diagnosis , Vascular Stiffness/physiology , Adult , Aged , Blood Pressure , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/etiology , Creatinine/urine , Cross-Sectional Studies , Diabetes Mellitus/pathology , Female , Humans , Linear Models , Male , Middle Aged , Pulse Wave Analysis , Renal Insufficiency, Chronic/complications , Risk FactorsABSTRACT
BACKGROUND: Osteoprotegerin (OPG) plays protective roles against the development of vascular calcification (VC) which greatly contributes to the increased cardiovascular events in patients with chronic kidney disease (CKD). The present study aimed to find the non-traditional, kidney-related cardiovascular risk factors correlated to serum OPG and the effect of serum OPG on the arterial stiffness measured by brachial ankle pulse wave velocity (baPWV) in patients with the pre-dialysis CKD. METHODS: We cross-sectionally analyzed the data from the patients in whom baPWV and the serum OPG were measured at the time of enrollment in a prospective pre-dialysis CKD cohort study in Korea. RESULTS: Along with traditional cardiovascular risk factors such as age, diabetes mellitus, pulse pressure, and baPWV, non-traditional, kidney-related factors such as albuminuria, plasma level of hemoglobin, total CO2 content, alkaline phosphatase, and corrected calcium were independent variables for serum OPG in multivariate linear regression. Reciprocally, the serum OPG was positively associated with baPWV in multivariate linear regression. The baPWV in the 3rd and 4th quartile groups of serum OPG were higher than that in the 1st quartile group after adjustments by age, sex and other significant factors for baPWV in linear mixed model. CONCLUSION: Non-traditional, kidney-related cardiovascular risk factors in addition to traditional cardiovascular risk factors were related to serum level of OPG in CKD. Serum OPG level was significantly related to baPWV. Our study suggests that kidney-related factors involved in CKD-specific pathways for VC play a role in the increased secretion of OPG into circulation in patients with CKD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01630486
Subject(s)
Humans , Albuminuria , Alkaline Phosphatase , Ankle , Blood Pressure , Calcium , Cohort Studies , Diabetes Mellitus , Korea , Linear Models , Osteoprotegerin , Plasma , Prospective Studies , Pulse Wave Analysis , Renal Insufficiency, Chronic , Risk Factors , Vascular Calcification , Vascular StiffnessABSTRACT
Hyperbaric oxygen therapy (HBOT) has beneficial effects on avascular necrosis of femoral head (ANFH), but its mechanism of action is still unclear. We investigated if HBOT upregulates serum osteoprotegerin (OPG) and/or inhibits osteoclast activation. 23 patients with unilateral ANFH at stage I, II and III consented to the study: the patients received standard HBOT. Serum OPG levels were obtained at the beginning of HBOT (T0), after 15 sessions (T1), 30 sessions (T2), after a 30-day break (T3), and after 60 sessions (T4). Magnetic resonance imaging (MRI) was obtained at T0 and about one year from the end of HBO treatments. Lesion size was compared between pre- and post-HBOT. 19 patients completed the study. HBOT reduced pain symptoms in all patients. HBOT significantly reduced lesion size in all stage I and II patients and in 2 of 11 stage III patients. HBOT increased serum OPG levels but receptor activator of nuclear factor kappa-B ligand (RANKL) levels did not change.
Subject(s)
Femur Head Necrosis/blood , Femur Head Necrosis/therapy , Hyperbaric Oxygenation , Osteoprotegerin/blood , RANK Ligand/blood , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Osteoclasts/drug effects , Osteoclasts/metabolism , Osteoprotegerin/metabolismABSTRACT
OBJECTIVE: Vascular calcification is accelerated by hypertension and also contributes to hypertension; however, it is an enigma why hypertension and vascular calcification are a vicious spiral. The present study elucidates the cross-talk between renin-angiotensin II system and receptor activator of nuclear factor-κB ligand (RANKL) system in vascular calcification. APPROACH AND RESULTS: Angiotensin (Ang) II (10(-7) mol/L) significantly increased calcium deposition as assessed by Alizarin Red staining, associated with a significant increase in the expression of RANKL, RANK, and bone-related genes, such as cbfa1 and msx2, in human aortic vascular smooth muscle cells. Infusion of Ang II (100 ng/kg per minute) in ovariectomized ApoE(-/-) mice under high-fat diet significantly increased the expression of RANKL system and calcification in vivo, whereas administration of Ang II receptor blocker (olmesartan, 3 mg/kg per day) decreased the calcification and bone markers' expression. In addition, male OPG(-/-) mice showed a significant increase in vascular calcification followed by Ang II infusion as compared with wild type. Conversely, RANKL significantly increased Ang II type 1 receptor and angiotensin II-converting enzyme expression in vascular smooth muscle cells via extracellular signal-regulated protein kinase phosphorylation. CONCLUSIONS: The present study demonstrated that Ang II significantly induced vascular calcification in vitro and in vivo through RANKL activation. In addition, RANKL activated renin-angiotensin II system, especially angiotensin II-converting enzyme and Ang II type 1 receptor. Cross-talk between renin-angiotensin II system and RANKL system might work as a vicious cycle to promote vascular calcification in atherosclerosis. Further studies to inhibit renin-angiotensin II system and RANKL may provide new therapeutic options to prevent and regress vascular calcification.
Subject(s)
RANK Ligand/metabolism , Receptor Activator of Nuclear Factor-kappa B/metabolism , Receptor Cross-Talk/physiology , Renin-Angiotensin System/physiology , Vascular Calcification/metabolism , Animals , Apolipoproteins E/deficiency , Cells, Cultured , Female , Humans , Mice , Mice, Inbred Strains , Muscle, Smooth, Vascular/cytology , Muscle, Smooth, Vascular/metabolism , RANK Ligand/physiology , Receptor Activator of Nuclear Factor-kappa B/physiology , Receptor, Angiotensin, Type 1/metabolism , Sensitivity and Specificity , Signal TransductionABSTRACT
Objective To assess the clinical value of measuring the concentration of serum osteoprotegerin (OPG) in detecting the bone metastases in patients with prostate cancer. Methods The concentration of serum OPG in 40 patients was determined by ELISA. The data of ECT bone scan and Gleason score was collected simultaneously. The correlations between serum OPG and bone metastases, Gleason score were tested. Results The concentration of serum OPG in patients with bone metastases by ECT scan was( 16 237. 19 ±5144. 26) ng/L,which was significantly higher than the concentration in patients without bone metastases , which was (12 123.32 ±4136. 50)ng/L. There was no significant correlation between serum OPG and Gleason score. Conclusions The serum OPG has an important clinical value in prediction of prostate cancer with bone metastases. There is no significant correlation between serum OPG and the Gleason score.
