Serum osteoprotegerin as a screening tool for coronary artery calcification score in diabetic pre-dialysis patients

Hypertension Research : Official Journal of the Japanese Society of Hypertension
Satoshi MikamiMasatsugu Hori

Abstract

Although cardiovascular disease is a principal cause of death in patients with chronic kidney disease (CKD), it is often asymptomatic in diabetic patients. The coronary artery calcification score (CACS) measured by multidetector computed tomography (MDCT) is useful for screening ischemic heart disease in the general population. We investigated which clinical parameters predict high CACS in predialysis diabetic nephropathy (DN). Participants were 85 patients with DN. Nobody had any history of coronary angioplasty or coronary bypass surgery. We measured blood counts, blood chemistry, bone alkaline phosphatase, intact-PTH, interleukin-6, osteoprotegerin (OPG), hemoglobin A1c, 25-hydroxyvitamin D (25(OH)D) and fetuin-A. CACS and bone mineral density (BMD) were measured by a single 16-slice MDCT and DEXA, respectively. The median value of CACS equaled 256 Agatston units (range 0-4494 units). Stepwise increase in CACS with CKD stage progression was observed (p<0.01 for trend). Simple regression analyses showed that Log (CACS+1) was positively correlated with age, systolic blood pressure, phosphorus and OPG. In addition, it was negatively correlated with nutritional parameters, such as body mass index, albumin, total-cholesterol and 2...Continue Reading

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