BACKGROUND: Vascular calcification is highly prevalent in chronic kidney disease (CKD) patients. This calcification leads to arterial stiffening. Fetuin-A is an endogenous inhibitor of vascular calcification and has been associated with arterial stiffness and mortality in dialysis patients. We tested the relationship between fetuin-A and change in arterial stiffness in CKD stages 3 and 4. METHODS: We measured fetuin-A concentrations in 92 patients with CKD stages 3 and 4 and studied the association with clinical, biochemical and vascular parameters including arterial stiffness measured by carotid-femoral pulse wave velocity (PWV) at 0 and 12 months. RESULTS: Fetuin-A was significantly lower in the non-diabetic group (n = 73) compared to the diabetic group (n = 19, P = 0.018). There was a significant interaction between diabetic status and fetuin-A concentration. Univariate analysis of the non-diabetic group showed association between change in aortic stiffness over 1 year with fetuin-A (r = -0.481, P < 0.0001) and systolic blood pressure (r = 0.389, P = 0.001) and baseline PWV (r = 0.240, P = 0.041). In multivariate analysis, fetuin-A, systolic blood pressure and baseline PWV independently predicted change in carotid-femoral PWV at 1 year (beta = -0.355, P = or< 0.001; beta = 0.426, P < 0.001; and beta = -0.383, P < 0.001, respectively; model R(2) = 0.455). CONCLUSIONS: In patients with non-diabetic CKD stages 3 and 4, fetuin-A is an independent risk factor for progressive arterial stiffness.
BACKGROUND:Vascular calcification is highly prevalent in chronic kidney disease (CKD) patients. This calcification leads to arterial stiffening. Fetuin-A is an endogenous inhibitor of vascular calcification and has been associated with arterial stiffness and mortality in dialysis patients. We tested the relationship between fetuin-A and change in arterial stiffness in CKD stages 3 and 4. METHODS: We measured fetuin-A concentrations in 92 patients with CKD stages 3 and 4 and studied the association with clinical, biochemical and vascular parameters including arterial stiffness measured by carotid-femoral pulse wave velocity (PWV) at 0 and 12 months. RESULTS:Fetuin-A was significantly lower in the non-diabetic group (n = 73) compared to the diabetic group (n = 19, P = 0.018). There was a significant interaction between diabetic status and fetuin-A concentration. Univariate analysis of the non-diabetic group showed association between change in aortic stiffness over 1 year with fetuin-A (r = -0.481, P < 0.0001) and systolic blood pressure (r = 0.389, P = 0.001) and baseline PWV (r = 0.240, P = 0.041). In multivariate analysis, fetuin-A, systolic blood pressure and baseline PWV independently predicted change in carotid-femoral PWV at 1 year (beta = -0.355, P = or< 0.001; beta = 0.426, P < 0.001; and beta = -0.383, P < 0.001, respectively; model R(2) = 0.455). CONCLUSIONS: In patients with non-diabetic CKD stages 3 and 4, fetuin-A is an independent risk factor for progressive arterial stiffness.
Authors: Piya Chaemsaithong; Roberto Romero; Adi L Tarca; Steven J Korzeniewski; Alyse G Schwartz; Jezid Miranda; Ahmed I Ahmed; Zhong Dong; Sonia S Hassan; Lami Yeo; Tinnakorn Tinnakorn Journal: J Matern Fetal Neonatal Med Date: 2014-09-29
Authors: F Roshanzamir; M Miraghajani; M H Rouhani; M Mansourian; R Ghiasvand; S M Safavi Journal: J Endocrinol Invest Date: 2017-06-22 Impact factor: 4.256