Spartalis Michalis, Kasimatis Efstratios, Liakou Eleni, Sampani Erasmia, Lioulios Georgios, Christodoulou Michalis, Stai Stamatia, Moysidou Eleni, Efstratiadis George, Papagianni Aikaterini
Department of Nephrology, Aristotle University of Thessaloniki, "Hippokration" General Hospital, 54642 Thessaloniki, Greece.
Life (Basel). 2023 Feb 6;13(2):454. doi: 10.3390/life13020454.
Cardiovascular calcifications (CVC) are frequently observed in chronic kidney disease (CKD) patients and contribute to their cardiovascular mortality. The aim of the present study was to investigate the impact of osteoprotegerin (OPG)/Receptor Activator of NF-κΒ (RANK)/RANK ligand (RANKL) pathway in the development and evolution of CVCs in hemodialysis patients. In total, 80 hemodialysis patients were assessed for the presence of vascular (abdominal aorta and muscular arteries) calcifications and results were correlated to serum OPG and RANKL levels and the OPG/RANKL ratio. Traditional cardiovascular risk factors and mineral bone disease parameters were also estimated. The presence of VCs was also evaluated 5 years after the initiation of the study, and results were correlated to the initial serum OPG levels. Age, diabetes mellitus, coronary artery disease and OPG levels ( < 0.001) were associated with VCs, whereas RANKL levels were not. Multivariate analysis though revealed that only OPG levels were significantly associated with abdominal aorta calcifications ( = 0.026), but they were not correlated with the progression of VCs. Serum OPG levels are positively and independently associated with VCs in HD patients, but not with their progression. RANKL levels did not show any associations, whereas further studies are needed to establish the significance of OPG/RANKL ratio.
心血管钙化（CVC）在慢性肾脏病（CKD）患者中经常可见，并导致其心血管疾病死亡率升高。本研究的目的是探讨骨保护素（OPG）/核因子κB受体激活剂（RANK）/RANK配体（RANKL）通路在血液透析患者CVC发生和发展中的作用。总共对80例血液透析患者进行了血管（腹主动脉和肌性动脉）钙化情况评估，并将结果与血清OPG、RANKL水平及OPG/RANKL比值进行关联分析。同时还评估了传统心血管危险因素和矿物质骨病参数。在研究开始5年后，再次评估血管钙化情况，并将结果与初始血清OPG水平进行关联分析。年龄、糖尿病、冠状动脉疾病和OPG水平（<0.001）与血管钙化有关，而RANKL水平则无关。然而，多因素分析显示，只有OPG水平与腹主动脉钙化显著相关（=0.026），但与血管钙化进展无关。血液透析患者血清OPG水平与血管钙化呈正相关且独立相关，但与血管钙化进展无关。RANKL水平未显示出任何关联，而OPG/RANKL比值的意义还需要进一步研究来确定。
