Ganidagli Berivan, Nacar Huseyin, Yildiz Yusuf Selcuk, Dagli Hasan, Erken Ertugrul, Altunoren Orcun, Gungor Ozkan
Clin Nephrol. 2019 Jan;91(1):9-16. doi: 10.5414/CN109505.
Cardiovascular calcification is an important cause of morbidity and mortality in hemodialysis (HD) patients. Vascular and valvular calcification are indicators of increased tissue calcification. The relationship of osteopontin (OPN) - which is known as a vascular calcification inhibitor - and fibroblast growth factor-23 (FGF-23) - which its related to vascular calcification, as recently shown - to valvular calcification is unknown. In this cross-sectional study, we examined the relationship between heart valve calcification, serum OPN, and FGF-23 levels.
85 adults who were on HD treatment for at least 6 months were included in the study. Echocardiographic evaluation was made with the General Electric echocardiography device and the same cardiologist. FGF-23 and osteopontin levels were measured by ELISA.
54% of our patients were male, mean age was 49.8 ± 15.1 years, and mean HD duration was 52.5 ± 39.6 months. 34% of the patients were diabetic, and 17.6% had a history of coronary artery disease. 1.25 mmol/L calcium were used as dialysate calcium in 84.7% of the patients. 60% of the patients were on vitamin D replacement therapy, and 7.1% were receiving cinacalcet treatment. Valvular calcification ratio of the patients was 44%. Mean FGF-23 level was 682 ± 771.7 pg/mL, and mean OPN level was 22.2 ± 8.2 ng/mL. When the patients with and without heart valve calcification were compared, the group with heart valve calcification was older and had lower serum OPN levels. There were differences between the groups on left atrial diameters, left ventricular end-diastolic diameters, and posterior-wall thicknesses. In the logistic regression analysis, it was seen that age and serum OPN levels were predictors of valvular calcification.
CONCLUSION: Serum osteopontin level is associated with heart valve calcification in HD patients, but there was no relationship found with FGF-23. Further research is needed on the subject. .
心血管钙化是血液透析（HD）患者发病和死亡的重要原因。血管和瓣膜钙化是组织钙化增加的指标。骨桥蛋白（OPN）——一种已知的血管钙化抑制剂——和成纤维细胞生长因子23（FGF - 23）——最近研究表明其与血管钙化有关——与瓣膜钙化之间的关系尚不清楚。在这项横断面研究中，我们研究了心脏瓣膜钙化、血清OPN和FGF - 23水平之间的关系。
本研究纳入了85名接受HD治疗至少6个月的成年人。使用通用电气超声心动图设备由同一位心脏病专家进行超声心动图评估。通过酶联免疫吸附测定法（ELISA）测量FGF - 23和骨桥蛋白水平。
我们的患者中54%为男性，平均年龄为49.8±15.1岁，平均HD治疗时间为52.5±39.6个月。34%的患者患有糖尿病，17.6%有冠状动脉疾病史。84.7%的患者透析液钙浓度为1.25 mmol/L。60%的患者接受维生素D替代治疗，7.1%接受西那卡塞治疗。患者的瓣膜钙化率为44%。平均FGF - 23水平为682±771.7 pg/mL，平均OPN水平为22.2±8.2 ng/mL。比较有和没有心脏瓣膜钙化的患者时，有心脏瓣膜钙化的组年龄更大且血清OPN水平更低。两组在左心房直径、左心室舒张末期直径和后壁厚度方面存在差异。在逻辑回归分析中，发现年龄和血清OPN水平是瓣膜钙化的预测因素。
血清骨桥蛋白水平与HD患者的心脏瓣膜钙化有关，但未发现与FGF - 23有关。对此主题需要进一步研究。
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