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Relationship between bone mineral density and serum osteoprotegerin in patients with chronic heart failure
Ying-Hsien Chen1, Yen-Wen Wu, Wei-Shiung Yang
1National Taiwan University College of Medicine, Taipei, Taiwan.
Insights
This study found that higher levels of osteoprotegerin (OPG) in heart failure (HF) patients are linked to lower bone mineral density (BMD), suggesting OPG could help identify individuals at risk for osteoporosis.
Area of Science:
- Cardiology
- Endocrinology
- Geriatrics
Background:
- Heart failure (HF) is associated with an increased risk of hip fractures.
- The relationship between circulating biomarkers and bone mineral density (BMD) in chronic HF patients is not well understood.
Purpose of the Study:
- To investigate the association between circulating biomarkers and BMD in stable chronic HF patients.
- To explore the potential role of biomarkers in predicting osteoporosis risk in HF.
Main Methods:
- Cross-sectional study of 115 stable chronic HF patients (left ventricular ejection fraction <45%).
- Dual-energy x-ray absorptiometry (DEXA) for hip and lumbar spine BMD.
- Biochemical assessments including B-type natriuretic peptide (BNP-32), myostatin, follistatin, and osteoprotegerin (OPG).
Main Results:
- Lower hip BMD Z scores were observed in NYHA class III patients compared to NYHA class II.
- Serum OPG levels were significantly higher in NYHA class III patients than in NYHA class I or II.
- A significant negative association was found between serum OPG and trochanteric BMD, persisting after multivariate analysis.
Conclusions:
- Serum OPG is inversely associated with trochanteric BMD in HF patients.
- OPG may serve as a predictor of BMD and a potential alternative to DEXA for identifying HF patients at risk of osteoporosis.
Purpose:
Heart failure (HF) had been reported with increased risk of hip fractures. However, the relationship between circulating biomarkers and bone mineral density (BMD) in chronic HF remained unclear.
Methods:
This is a cross-sectional study which recruited stable chronic HF from registry of the Heart Failure Center of National Taiwan University Hospital. Patients underwent dual-energy x-ray absorptiometry (DEXA) measurements at hip and lumbar spines and biochemical assessments including B-type natriuretic peptide (BNP-32), myostatin, follistatin and osteoprotegerin (OPG).
Results:
A total of 115 stable chronic HF individuals with left ventricular ejection fraction (EF) <45% (74% of male, mean age at 59) were recruited with 24 patients in NYHA class I, 73 patients in NYHA class II and 18 patients in NYHA class III. Results of BMD showed that Z scores of hip in NYHA III group (-0.12 ± 1.15) was significantly lower than who were NYHA II (0.58 ± 1.04). Serum OPG was significantly higher in subjects of NYHA III (9.3 ± 4.6 pmol/l) than NYHA II (7.4 ± 2.8 pmol/l) or NYHA I (6.8 ± 3.6 pmol/l) groups. There's a significant negative association between log transformed serum OPG and trochanteric BMD (R = -0.299, P = 0.001), which remained significant after multivariate analysis.
Conclusions:
Our study demonstrated an inverse association between serum OPG and trochanteric BMD in patients with HF. OPG may be a predictor of BMD and an alternative to DEXA for identifying at risk HF patients for osteoporosis.
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