Teppei Okamoto1, Chikako Tsutaya2, Shingo Hatakeyama3, Sakae Konishi3, Kazutaka Okita3, Yoshimi Tanaka4,3, Kengo Imanishi4, Tooru Takashima4, Fumitada Saitoh4, Tadashi Suzuki2, Chikara Ohyama3. 1. Department of Urology, Oyokyo Kidney Research Institute Aomori Hospital, 101-1 Okabe, Ishie, Aomori, 038-0003, Japan. tepperococcus@yahoo.co.jp. 2. Oyokyo Kidney Research Institute, 90, Yamazaki, Ozawa, Hirosaki, 036-8243, Japan. 3. Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. 4. Department of Urology, Oyokyo Kidney Research Institute Aomori Hospital, 101-1 Okabe, Ishie, Aomori, 038-0003, Japan.
Abstract
PURPOSE: Fetuin-A, which plays a protective role against the atherosclerosis and progression of vascular calcification, is decreased in patients on hemodialysis (HD). Fetuin-A and serum butyrylcholinesterase (BChE) levels decrease during malnutrition. We explored whether BChE was independently related to fetuin-A in patients on HD. METHODS: Laboratory data including BChE and serum fetuin-A were acquired from 230 patients on HD between August 2017 and April 2018. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI). Abdominal aortic calcification index (ACI) was measured using computed tomography. Patients were stratified into two groups: low fetuin-A (< lowest quartile) and non-low fetuin-A (≥ lowest quartile) groups. Patient background, medication, and laboratory data were compared. The receiver operating characteristic analysis was conducted to determine the optimal cutoff values of BChE and GNRI for lower fetuin-A level. Factors independently related with lower fetuin-A levels were determined using multivariate logistic regression analysis. RESULTS: The lowest quartile value of fetuin-A and optimal cutoff values of BChE and GNRI were 0.213 g/L, 200 IU/L, and 92.6, respectively. The study included 57 and 173 patients in the low fetuin-A and non-low fetuin-A groups, respectively. Significant between-group differences were observed for age, C-reactive protein (CRP), history of cardiovascular disease, serum albumin, GNRI, and BChE. Multivariate analysis showed that BChE of < 200 IU/L [odds ratio (OR) 3.05], CRP (OR 2.49), and GNRI of < 92.6 (OR 2.34) were independent factors for lower fetuin-A level after adjusting for confounders. CONCLUSIONS: BChE was a significant independent marker for fetuin-A levels in patients on HD, in addition to GNRI.
PURPOSE:Fetuin-A, which plays a protective role against the atherosclerosis and progression of vascular calcification, is decreased in patients on hemodialysis (HD). Fetuin-A and serum butyrylcholinesterase (BChE) levels decrease during malnutrition. We explored whether BChE was independently related to fetuin-A in patients on HD. METHODS: Laboratory data including BChE and serum fetuin-A were acquired from 230 patients on HD between August 2017 and April 2018. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI). Abdominal aortic calcification index (ACI) was measured using computed tomography. Patients were stratified into two groups: low fetuin-A (< lowest quartile) and non-low fetuin-A (≥ lowest quartile) groups. Patient background, medication, and laboratory data were compared. The receiver operating characteristic analysis was conducted to determine the optimal cutoff values of BChE and GNRI for lower fetuin-A level. Factors independently related with lower fetuin-A levels were determined using multivariate logistic regression analysis. RESULTS: The lowest quartile value of fetuin-A and optimal cutoff values of BChE and GNRI were 0.213 g/L, 200 IU/L, and 92.6, respectively. The study included 57 and 173 patients in the low fetuin-A and non-low fetuin-A groups, respectively. Significant between-group differences were observed for age, C-reactive protein (CRP), history of cardiovascular disease, serum albumin, GNRI, and BChE. Multivariate analysis showed that BChE of < 200 IU/L [odds ratio (OR) 3.05], CRP (OR 2.49), and GNRI of < 92.6 (OR 2.34) were independent factors for lower fetuin-A level after adjusting for confounders. CONCLUSIONS:BChE was a significant independent marker for fetuin-A levels in patients on HD, in addition to GNRI.
Authors: Markus Ketteler; Philipp Bongartz; Ralf Westenfeld; Joachim Ernst Wildberger; Andreas Horst Mahnken; Roland Böhm; Thomas Metzger; Christoph Wanner; Willi Jahnen-Dechent; Jürgen Floege Journal: Lancet Date: 2003-03-08 Impact factor: 79.321
Authors: S G Sukkar; F Gallo; C Borrini; A Vaccaro; C Marchello; R Boicelli; C Borgarelli; P Solari; C E Ratto; G Ravera Journal: Med J Nutrition Metab Date: 2012-06-22