National Taiwan University College of Medicine, Taipei, Taiwan.
PLoS One. 2012;7(8):e44242. doi: 10.1371/journal.pone.0044242. Epub 2012 Aug 30.
Heart failure (HF) had been reported with increased risk of hip fractures. However, the relationship between circulating biomarkers and bone mineral density (BMD) in chronic HF remained unclear.
This is a cross-sectional study which recruited stable chronic HF from registry of the Heart Failure Center of National Taiwan University Hospital. Patients underwent dual-energy x-ray absorptiometry (DEXA) measurements at hip and lumbar spines and biochemical assessments including B-type natriuretic peptide (BNP-32), myostatin, follistatin and osteoprotegerin (OPG).
A total of 115 stable chronic HF individuals with left ventricular ejection fraction (EF) <45% (74% of male, mean age at 59) were recruited with 24 patients in NYHA class I, 73 patients in NYHA class II and 18 patients in NYHA class III. Results of BMD showed that Z scores of hip in NYHA III group (-0.12 ± 1.15) was significantly lower than who were NYHA II (0.58 ± 1.04). Serum OPG was significantly higher in subjects of NYHA III (9.3 ± 4.6 pmol/l) than NYHA II (7.4 ± 2.8 pmol/l) or NYHA I (6.8 ± 3.6 pmol/l) groups. There's a significant negative association between log transformed serum OPG and trochanteric BMD (R = -0.299, P = 0.001), which remained significant after multivariate analysis.
Our study demonstrated an inverse association between serum OPG and trochanteric BMD in patients with HF. OPG may be a predictor of BMD and an alternative to DEXA for identifying at risk HF patients for osteoporosis.
心力衰竭（HF）与髋部骨折风险增加有关。然而，慢性 HF 患者循环生物标志物与骨密度（BMD）之间的关系尚不清楚。
这是一项横断面研究，招募了来自台湾大学医院心力衰竭中心登记处的稳定慢性 HF 患者。患者接受了髋部和腰椎的双能 X 射线吸收法（DEXA）测量以及包括 B 型利钠肽（BNP-32）、肌肉生长抑制素、卵泡抑素和骨保护素（OPG）在内的生化评估。
共招募了 115 名左心室射血分数（EF）<45%的稳定慢性 HF 患者（74%为男性，平均年龄为 59 岁），其中 24 名患者为 NYHA Ⅰ级，73 名患者为 NYHA Ⅱ级，18 名患者为 NYHA Ⅲ级。BMD 结果显示，NYHA Ⅲ级患者的髋部 Z 评分（-0.12±1.15）明显低于 NYHA Ⅱ级患者（0.58±1.04）。NYHA Ⅲ级患者的血清 OPG 水平（9.3±4.6 pmol/l）明显高于 NYHA Ⅱ级（7.4±2.8 pmol/l）或 NYHA Ⅰ级（6.8±3.6 pmol/l）患者。血清 OPG 与转子 BMD 呈显著负相关（R=-0.299，P=0.001），多变量分析后仍有显著相关性。
我们的研究表明，HF 患者的血清 OPG 与转子 BMD 呈负相关。OPG 可能是 BMD 的预测指标，可替代 DEXA 用于识别 HF 患者骨质疏松的风险。
