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KMID : 0882420070720050451
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Korean Journal of Medicine
2007 Volume.72 No. 5 p.451 ~ p.458
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Serum osteoprotegerin and fetuin-A level is associated with coronary artery calcification score in the patients with end-stage renal disease
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Kim Sang-Wook
Jung Hae-Hyuk
Han Heon
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Abstract
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Background : Coronary artery calcification is frequently seen in hemodialysis patients. The development and
progression of coronary artery calcification is similar to osteogenesis, and a naturally occurring serum inhibitor of
calcification may be involved. The aim of this study was to evaluate the relationship between coronary artery
calcification, bone remodeling related factor, serum osteoprotegerin (OPG), calcification inhibitor and the serum
fetuin-A levels in hemodialysis patients.
Methods : A total of 51 hemodialysis patient were assessed for their coronary artery calcium (CAC) scores
with using multirow spiral computed tomography and measuring the serum OPG level, the serum fetuin-A level,
the biochemical markers of inflammation, the lipid profile and the mineral metabolism.
Results : The mean serum OPG level was 3,561±1,160 pg/mL and the mean serum fetuin-A level was 28.5±
4.1 mg/dL. The CAC scores were significantly correlated with the duration of dialysis (p=0.0225), hs-CRP
(p=0.0392), serum phosphate (p=0.0341), Ca x P (p=0.0434), the serum OPG level (p=0.0026) and LDL-cholesterol
(p=0.0438), after adjusting for age, gender, BMI, smoking history and the presence of diabetes. Multiple regression
analysis showed that the CAC scores were significantly associated with the serum OPG level (p<0.0001) and the
serum phosphate level (p=0.0003). The subgroup of the patients with a CAC score greater than 400 (the severe
CAC group) had significantly higher OPG levels and lower fetuin-A levels than the groups of the patients with
lower CAC scores.
Conclusions : Our data suggest that the CAC scores in the patients undergoing hemodialysis were related with
higher serum OPG and higher serum phosphate levels. The serum fetuin-A level was significantly lower in the
patients with severe coronary artery calcification.(Korean J Med 72:451-458, 2007)
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KEYWORD
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Coronary disease, Calcification, Osteoprotegerin, Fetuin-A
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