Bone mineral density of extremities is associated with coronary calcification and biopsy-verified vascular calcification in living-donor renal transplant recipients

被引:11
作者
Chen, Zhimin [1 ,2 ,3 ]
Sun, Jia [1 ,2 ]
Haarhaus, Mathias [1 ,2 ]
Barany, Peter [1 ,2 ]
Wennberg, Lars [4 ]
Ripsweden, Jonaz [5 ]
Brismar, Torkel B. [5 ]
Lindholm, Bengt [1 ,2 ]
Wernerson, Annika [1 ,2 ]
Soderberg, Magnus [6 ]
Stenvinkel, Peter [1 ,2 ]
Qureshi, Abdul Rashid [1 ,2 ]
机构
[1] M99 Karolinska Univ Hosp, Div Renal Med, Karolinska Inst, Huddinge,CLINTEC, SE-14186 Stockholm, Sweden
[2] M 99 Karolinska Univ Hosp, Div Baxter Novum, Karolinska Inst, Huddinge CLINTEC, SE-14186 Stockholm, Sweden
[3] Zhejiang Univ, Kidney Dis Ctr, Affiliated Hosp 1, Coll Med, Hangzhou, Zhejiang, Peoples R China
[4] Karolinska Inst, Transplantat Surg, CLINTEC, Stockholm, Sweden
[5] Karolinska Inst, Radiol, CLINTEC, Stockholm, Sweden
[6] AstraZeneca, Pathol Drug Safety & Metab, Molndal, Sweden
基金
英国医学研究理事会;
关键词
Bone mineral density; Coronary artery calcium; Vascular calcification; Living-donor renal transplant recipients; End-stage renal disease; CHRONIC KIDNEY-DISEASE; MAINTENANCE HEMODIALYSIS-PATIENTS; BEAM COMPUTED-TOMOGRAPHY; ARTERY CALCIFICATION; POSTMENOPAUSAL WOMEN; CARDIOVASCULAR-DISEASE; AORTIC CALCIFICATION; PREDICTS MORTALITY; OSTEOPOROSIS; DIALYSIS;
D O I
10.1007/s00774-016-0788-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Chronic kidney disease (CKD) mineral and bone disorders (CKD-MBD) may lead to low bone mineral density (BMD) and vascular calcification (VC), but links to the latter are unclear. Here we investigated associations between BMD, coronary artery calcium (CAC) scores, and histological signs of VC in end-stage renal disease (ESRD) patients undergoing living-donor kidney transplantation (LD-Rtx). In 66 ESRD patients (median age 45 years, 68% males), BMD (by dual-energy X-ray absorptiometry, DXA), CAC score (by computed tomography, CT; n = 54), and degree of VC score (graded by histological examination of epigastric artery specimens collected at LD-Rtx; n = 55) were assessed at the time of LD-Rtx. Of the patients, 26% had osteopenia and 7% had osteoporosis. Of those undergoing artery biopsy, 16% had extensive VC, and of those undergoing CT 28% had high CAC score (> 100 Agatston units). CAC scores correlated with BMD of legs and pelvis. BMDs of leg and pelvic sub-regions were significantly lower in patients with extensive VC. In multivariate regression analysis adjusted for age and gender, lower BMD of leg sub-region was associated with CAC score > 100 AUs and extensive VC, and patients with extensive VC had significantly higher CAC score. Both high CAC and extensive VC were independently predicted by low BMD of legs. Low BMD has the potential to identify ESRD patients at risk of vascular calcification.
引用
收藏
页码:536 / 543
页数:8
相关论文
共 38 条
[1]   QUANTIFICATION OF CORONARY-ARTERY CALCIUM USING ULTRAFAST COMPUTED-TOMOGRAPHY [J].
AGATSTON, AS ;
JANOWITZ, WR ;
HILDNER, FJ ;
ZUSMER, NR ;
VIAMONTE, M ;
DETRANO, R .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1990, 15 (04) :827-832
[2]   Determinants of progression of coronary artery calcification in type 2 diabetes [J].
Anand, Dhakshinamurthy Vijay ;
Lim, Eric ;
Darko, Daniel ;
Bassett, Paul ;
Hopkins, David ;
Lipkin, David ;
Corder, Roger ;
Lahiri, Avijit .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 50 (23) :2218-2225
[3]   EFFECT OF DEGENERATIVE SPINAL AND AORTIC CALCIFICATION ON BONE-DENSITY MEASUREMENTS IN POSTMENOPAUSAL WOMEN - LINKS BETWEEN OSTEOPOROSIS AND CARDIOVASCULAR-DISEASE [J].
BANKS, LM ;
LEES, B ;
MACSWEENEY, JE ;
STEVENSON, JC .
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 1994, 24 (12) :813-817
[4]   Osteoporosis and coronary atherosclerosis in asymptomatic postmenopausal women [J].
Barengolts, EI ;
Berman, M ;
Kukreja, SC ;
Kouznetsova, T ;
Lin, C ;
Chomka, EV .
CALCIFIED TISSUE INTERNATIONAL, 1998, 62 (03) :209-213
[5]   Association of Changes in Bone Remodeling and Coronary Calcification in Hemodialysis Patients: A Prospective Study [J].
Barreto, Daniela Veit ;
Barreto, Fellype de Carvalho ;
de Carvalho, Aluizio Barbosa ;
Cuppari, Lilian ;
Draibe, Sergio Antonio ;
Dalboni, Maria Aparecida ;
Affonso Moyses, Rosa Maria ;
Neves, Katia Rodrigues ;
Jorgetti, Vanda ;
Miname, Marcio ;
Santos, Raul D. ;
Canziani, Maria Eugenia F. .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2008, 52 (06) :1139-1150
[6]   Coronary calcification in hemodialysis patients: The contribution of traditional and uremia-related risk factors [J].
Barreto, DV ;
Barreto, FC ;
Carvalho, AB ;
Cuppari, L ;
Cendoroglo, M ;
Draibe, SA ;
Moyses, RMA ;
Neves, KR ;
Jorgetti, V ;
Blair, A ;
Guiberteau, R ;
Canziani, MEF .
KIDNEY INTERNATIONAL, 2005, 67 (04) :1576-1582
[7]   Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease [J].
Blacher, J ;
Guerin, AP ;
Pannier, B ;
Marchais, SJ ;
London, GM .
HYPERTENSION, 2001, 38 (04) :938-942
[8]   Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients [J].
Block, G. A. ;
Raggi, P. ;
Bellasi, A. ;
Kooienga, L. ;
Spiegel, D. M. .
KIDNEY INTERNATIONAL, 2007, 71 (05) :438-441
[9]   Electron beam computed tomography in the evaluation of cardiac calcifications in chronic dialysis patients [J].
Braun, J ;
Oldendorf, M ;
Moshage, W ;
Heidler, R ;
Zeitler, E ;
Luft, FC .
AMERICAN JOURNAL OF KIDNEY DISEASES, 1996, 27 (03) :394-401
[10]   Bone health and coronary artery calcification: The Rotterdam Study [J].
Campos-Obando, Natalia ;
Kavousi, Maryam ;
van Lennep, Jeanine E. Roeters ;
Rivadeneira, Fernando ;
Hofman, Albert ;
Uitterlinden, Andre G. ;
Franco, Oscar H. ;
Zillikens, M. Carola .
ATHEROSCLEROSIS, 2015, 241 (01) :278-283