Department of Clinical Biochemistry, Jagiellonian University Medical College, Krakow, Poland.
Hypertens Res. 2012 May;35(5):531-8. doi: 10.1038/hr.2011.231. Epub 2012 Jan 26.
We conducted a cross-sectional observation study that included 500 asymptomatic subjects to investigate the relationship between bone metabolism and coronary artery calcification (CAC) in hypertensive conditions. Osteoprotegerin (OPG) and osteopontin (OPN) levels and their associations with hypertension were analyzed to predict CAC in 316 subjects. Multislice computed tomography was used to quantify CAC. Multivariate analysis of variance was used to test the non-interactive effects of hypertension, CAC severity and biomarker levels, and the logistic regression model was applied to predict the risk of CAC. OPG and OPN concentrations were significantly higher in the hypertensive than the normotensive subjects, at 3.0 (2.3-4.0) pmol l(-1) and 51 (21-136) ng ml(-1) vs. 2.4 (2.0-3.0) pmol l(-1) and 41 (13-63) ng ml(-1), respectively. The OPG level, but not OPN level, increased with age (r = 0.29; P = 0.0001). Zero or minimal CAC (<10 Agatston units (AU)) was observed in 63% of the subjects, mild (11-100 AU) in 17%, moderate (101-400 AU) in 12% and severe (401-1000 AU)-to-extensive (>1000 AU) in 8%. In hypertensive subjects, only glomerular filtration rate (GFR) (β = -0.67) and gender (β = 0.52) were significant predictors for CAC (R = 0.68). In normotensive patients, GFR (β = -0.81), gender (β = 0.48) and log-transformed OPG levels (β = 0.15) were significant predictors for CAC. OPG levels were associated with an increased risk of CAC in normotensive subjects only (odds ratio: 3.37; 95% confidence interval (1.63-6.57); P = 0.0002). OPG predicted a premature state of vascular calcification in asymptomatic normotensive individuals, and renal function significantly contributed to this process in both hypertensive and normotensive subjects.
我们进行了一项横断面观察性研究，纳入了 500 名无症状受试者，旨在探讨高血压患者骨代谢与冠状动脉钙化（CAC）之间的关系。分析了骨保护素（OPG）和骨桥蛋白（OPN）水平及其与高血压的相关性，以预测 316 例受试者的 CAC。采用多层螺旋 CT 定量 CAC。采用方差分析检验高血压、CAC 严重程度和生物标志物水平的非交互作用，应用 logistic 回归模型预测 CAC 风险。高血压组 OPG 和 OPN 浓度分别为 3.0（2.3-4.0）pmol/L 和 51（21-136）ng/ml，高于血压正常组的 2.4（2.0-3.0）pmol/L 和 41（13-63）ng/ml，差异有统计学意义。OPG 水平随年龄增加而升高（r=0.29，P=0.0001），而 OPN 水平无此变化。63%的受试者 CAC 为零或轻度（＜10 个 Agatston 单位（AU）），17%为中度（11-100 AU），12%为重度（101-400 AU）-广泛（＞1000 AU）。在高血压患者中，只有肾小球滤过率（GFR）（β=-0.67）和性别（β=0.52）是 CAC 的显著预测因素（R=0.68）。在血压正常的患者中，GFR（β=-0.81）、性别（β=0.48）和对数转换的 OPG 水平（β=0.15）是 CAC 的显著预测因素。仅在血压正常的受试者中，OPG 水平与 CAC 风险增加相关（比值比：3.37；95%置信区间：1.63-6.57；P=0.0002）。OPG 预测无症状血压正常个体血管钙化的早期状态，肾功能在高血压和血压正常患者中均显著促进这一过程。
