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rdf:type |
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lifeskim:mentions |
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pubmed:issue |
1
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pubmed:dateCreated |
2005-12-28
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pubmed:abstractText |
Expression of bone proteins resulting from transdifferentiation of vascular smooth muscle cells into osteoblasts suggests that vascular calcifications are a bioactive process. Regulating molecules such as osteoprotegerin (OPG) and receptor activator of NF-kappaB ligand (RANKL) could play a key role in bone-vascular calcification imbalance. This study investigated the contribution of these proteins as well as mineral metabolism disorders in hemodialysis (HD) patient outcome. A total of 185 HD patients were followed up prospectively for 2 yr. In addition to clinical characteristics, mineral metabolism markers as well as OPG and soluble RANKL (sRANKL) were measured at baseline. After 2 yr, survival rates were described with Kaplan-Meier and compared with Cox regression analyses; 50 patients died (27 from cardiovascular diseases). Calcium, phosphate, and calcium x phosphate product were not associated with mortality. Both hyperparathyroidism (parathyroid hormone > or =300 pg/ml) and hypoparathyroidism (parathyroid hormone <150 pg/ml) were poorly associated with all-cause and cardiovascular mortality. By contrast, elevated OPG levels predicted all-cause (relative risk [RR] 2.67; 95% confidence interval [CI] 1.32 to 5.41; P = 0.006) and cardiovascular mortality (RR 3.15; 95% CI 1.14 to 8.69; P = 0.03). Low levels of sRANKL were associated with a protective effect for all-cause mortality (RR 0.45; 95% CI 0.21 to 0.94; P = 0.03). The association of OPG with all-cause mortality was stronger in patients with C-reactive protein > or =12.52 mg/L. In this condition, both highest (RR 5.68; 95% CI 1.48 to 22.73; P = 0.01) and lowest tertiles (RR 5.37; 95% CI 147 to 1968; P = 0.01) significantly predicted poor outcome. These results show that regulating-bone molecules, especially OPG, are strong predictors of mortality in HD patients, suggesting that OPG is a vascular risk factor, in particular in patients who have high C-reactive protein levels. OPG determination therefore should be added to the biologic follow-up of these patients.
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pubmed:language |
eng
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pubmed:journal |
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pubmed:citationSubset |
IM
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pubmed:chemical |
http://linkedlifedata.com/resource/pubmed/chemical/C-Reactive Protein,
http://linkedlifedata.com/resource/pubmed/chemical/Carrier Proteins,
http://linkedlifedata.com/resource/pubmed/chemical/Glycoproteins,
http://linkedlifedata.com/resource/pubmed/chemical/Membrane Glycoproteins,
http://linkedlifedata.com/resource/pubmed/chemical/Osteoprotegerin,
http://linkedlifedata.com/resource/pubmed/chemical/Parathyroid Hormone,
http://linkedlifedata.com/resource/pubmed/chemical/RANK Ligand,
http://linkedlifedata.com/resource/pubmed/chemical/Receptor Activator of Nuclear...,
http://linkedlifedata.com/resource/pubmed/chemical/Receptors, Cytoplasmic and Nuclear,
http://linkedlifedata.com/resource/pubmed/chemical/Receptors, Tumor Necrosis Factor,
http://linkedlifedata.com/resource/pubmed/chemical/TNFRSF11A protein, human,
http://linkedlifedata.com/resource/pubmed/chemical/TNFRSF11B protein, human,
http://linkedlifedata.com/resource/pubmed/chemical/TNFSF11 protein, human
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pubmed:status |
MEDLINE
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pubmed:month |
Jan
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pubmed:issn |
1046-6673
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pubmed:author |
pubmed-author:CanaudBernardB,
pubmed-author:ChalabiLotfiL,
pubmed-author:CristolJean-PaulJP,
pubmed-author:DelcourtCécileC,
pubmed-author:DupuyAnne-MarieAM,
pubmed-author:JaussentIsabelleI,
pubmed-author:Leray-MoraguesHélèneH,
pubmed-author:MauriceFrançoisF,
pubmed-author:MorenaMarionM,
pubmed-author:RivoryJean-PierreJP,
pubmed-author:TerrierNathalieN
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pubmed:issnType |
Print
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pubmed:volume |
17
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
262-70
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pubmed:dateRevised |
2006-11-15
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pubmed:meshHeading |
pubmed-meshheading:16280472-Adult,
pubmed-meshheading:16280472-Aged,
pubmed-meshheading:16280472-Aged, 80 and over,
pubmed-meshheading:16280472-C-Reactive Protein,
pubmed-meshheading:16280472-Carrier Proteins,
pubmed-meshheading:16280472-Female,
pubmed-meshheading:16280472-Glycoproteins,
pubmed-meshheading:16280472-Humans,
pubmed-meshheading:16280472-Male,
pubmed-meshheading:16280472-Membrane Glycoproteins,
pubmed-meshheading:16280472-Middle Aged,
pubmed-meshheading:16280472-Multivariate Analysis,
pubmed-meshheading:16280472-Osteoprotegerin,
pubmed-meshheading:16280472-Parathyroid Hormone,
pubmed-meshheading:16280472-Prospective Studies,
pubmed-meshheading:16280472-RANK Ligand,
pubmed-meshheading:16280472-Receptor Activator of Nuclear Factor-kappa B,
pubmed-meshheading:16280472-Receptors, Cytoplasmic and Nuclear,
pubmed-meshheading:16280472-Receptors, Tumor Necrosis Factor,
pubmed-meshheading:16280472-Renal Dialysis,
pubmed-meshheading:16280472-Risk Factors
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pubmed:year |
2006
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pubmed:articleTitle |
Plasma osteoprotegerin is associated with mortality in hemodialysis patients.
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pubmed:affiliation |
Biochemistry Laboratory, Lapeyronie University Hospital, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier cedex 5, France.
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pubmed:publicationType |
Journal Article
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