School of Medicine, Nankai University, Tianjin, China.
Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, China.
J Clin Hypertens (Greenwich). 2022 Jul;24(7):928-936. doi: 10.1111/jch.14523. Epub 2022 Jun 10.
Osteocalcin (OCN) is a bone-derived and vitamin K dependent hormone that affects energy metabolism and vascular calcification. The relationship between serum OCN and vascular function in patients with chronic kidney disease (CKD) is uncertain. This study investigated the association between serum OCN and vascular function as expressed with reactive hyperemia index (RHI) and augmentation index (AIx) measured by Endo-PAT 2000 device. This cross-sectional analysis was based on 256 pre-dialysis CKD patients who had completed the Endo-PAT 2000 test and serum OCN at the First Center of Chinese PLA Hospital from November 2017 to December 2019. Based on whether the RHI was less than 1.67, the patients were divided into endothelial dysfunction and normal endothelial function groups. Multiple logistic and linear regression were used to analyze the association between OCN and vascular function. Subgroup analyses were performed to examine the effects of OCN on vascular function in different CKD populations. After multivariate adjustment, CKD with low OCN were more likely to have endothelial dysfunction (OR: 0.794; 95%CI: 0.674-0.934; P = .006); on the contrary, patients with high OCN had a higher degree of arterial stiffness (standardized β: 0.174; P = .003). Subgroup analyses showed that higher OCN was associated with severe arterial stiffness but a better endothelial function in young (age < 65 years, P /P = .027/.011), male (P /P = .040/.016), patients with a history of hypertension (P /P = .004/.009) or diabetes (P /P = .005/.005), and in early CKD (P /P = .014/.015). In conclusion, serum OCN correlates with vascular function in CKD patients: beneficial for endothelial function but detrimental to arterial stiffness.
骨钙素 (OCN) 是一种骨源性、维生素 K 依赖性激素，可影响能量代谢和血管钙化。在慢性肾脏病 (CKD) 患者中，血清 OCN 与血管功能之间的关系尚不确定。本研究通过 Endo-PAT 2000 设备检测的反应性充血指数 (RHI) 和增强指数 (AIx) ，探讨了血清 OCN 与血管功能之间的关系。该横断面分析基于 2017 年 11 月至 2019 年 12 月在中国人民解放军第一中心医院完成 Endo-PAT 2000 检测和血清 OCN 的 256 例透析前 CKD 患者。根据 RHI 是否小于 1.67，将患者分为内皮功能障碍和正常内皮功能组。采用多变量逻辑回归和线性回归分析 OCN 与血管功能之间的关系。进行亚组分析以检查 OCN 对不同 CKD 人群血管功能的影响。在多变量调整后，低 OCN 的 CKD 更有可能出现内皮功能障碍 (OR：0.794；95%CI：0.674-0.934；P =.006)；相反，高 OCN 患者的动脉僵硬度更高 (标准化β：0.174；P =.003)。亚组分析表明，较高的 OCN 与严重的动脉僵硬度相关，但与年轻 (年龄 < 65 岁，P /P =.027/.011)、男性 (P /P =.040/.016)、有高血压 (P /P =.004/.009) 或糖尿病病史 (P /P =.005/.005) 以及早期 CKD (P /P =.014/.015) 的患者的内皮功能更好。总之，血清 OCN 与 CKD 患者的血管功能相关：对内皮功能有益，但对动脉僵硬度有害。
