Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
J Nephrol. 2009 Nov-Dec;22(6):774-82.
The production and expression of osteoprotegerin (OPG), a bone regulating protein, is regulated by inflammatory cytokines.
As clinical and experimental studies have implicated OPG in atherogenesis, we investigated serum OPG in relation to inflammation, endothelial dysfunction and oxidative stress markers in 265 chronic kidney disease (CKD) stage 5 patients. Cardiovascular disease (CVD), carotid plaques (n=69) and mortality (5 years) in relation to OPG were also analyzed, and the impact of inflammation on the association of OPG with mortality was evaluated.
OPG correlated positively with circulating surrogate markers of inflammatory, endothelial dysfunction and oxidative stress. Patients with clinical CVD or carotid plaques had higher concentrations of OPG than their respective counterparts. Increased OPG levels per se were related to higher cardiovascular and all-cause mortality even after adjustment for age, sex, C-reactive protein, diabetes mellitus and baseline CVD. Moreover, the presence of inflammation further and independently aggravated the hazard ratios (HR) for both cardiovascular (HR=2.8; 95% confidence interval [95% CI], 1.3-6.4; p=0.01) and all-cause (HR=2.5; 95% CI, 1.4-4.5; p<0.01) mortality.
Elevated OPG levels are associated with surrogate markers of inflammation, endothelial dysfunction, oxidative stress and CVD in CKD patients. Moreover, inflammation and OPG levels seem to have additive effects on survival.
骨保护素（OPG）是一种调节骨代谢的蛋白，其产生和表达受炎症细胞因子调节。
由于临床和实验研究表明 OPG 参与动脉粥样硬化的形成，我们研究了 265 名慢性肾脏病（CKD）5 期患者的血清 OPG 与炎症、内皮功能障碍和氧化应激标志物的关系。还分析了 OPG 与心血管疾病（CVD）、颈动脉斑块（n=69）和死亡率（5 年）的关系，并评估了炎症对 OPG 与死亡率之间关联的影响。
OPG 与循环中炎症、内皮功能障碍和氧化应激的替代标志物呈正相关。有临床 CVD 或颈动脉斑块的患者的 OPG 浓度高于各自的对照组。OPG 水平的升高本身与更高的心血管和全因死亡率相关，即使在调整年龄、性别、C 反应蛋白、糖尿病和基线 CVD 后也是如此。此外，炎症的存在进一步独立地加重了心血管（HR=2.8；95%置信区间[95%CI]，1.3-6.4；p=0.01）和全因（HR=2.5；95%CI，1.4-4.5；p<0.01）死亡率的危险比（HR）。
在 CKD 患者中，升高的 OPG 水平与炎症、内皮功能障碍、氧化应激和 CVD 的替代标志物相关。此外，炎症和 OPG 水平似乎对生存有累加效应。
