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The relationship between coronary artery calcification and bone metabolic markers in maintenance hemodialysis
Lin Xiong1,2, Qi-Qi Chen1,2, Yong Cheng3,4
1Department of Nephrology, The Affiliated Hospital of Southwest Medical University, 25th Taiping Street, Luzhou, 646000, Sichuan, China.
Insights
Coronary artery calcification (CAC) in maintenance hemodialysis (MHD) patients is linked to bone metabolism. N-terminal mid-fragment of osteocalcin (N-MID OC) may serve as a reliable marker connecting vascular calcification and bone health in MHD patients.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Coronary artery calcification (CAC) is a common complication in maintenance hemodialysis (MHD) patients.
- Understanding factors influencing CAC and its relationship with bone metabolism is crucial for patient management.
Purpose of the Study:
- To investigate the influencing factors of CAC in MHD patients.
- To explore the association between CAC and bone metabolism markers.
- To identify a potential marker linking vascular and bone calcification in MHD patients.
Main Methods:
- 123 MHD patients were enrolled.
- CAC assessed using multislice spiral computed tomography (MSCT) and Agaston scoring.
- Measured routine laboratory parameters and serum bone metabolism markers (e.g., iPTH, N-MID OC, β-CTX).
Main Results:
- 69.92% of MHD patients had CAC.
- Risk factors for CAC included age, BMI, triglycerides, glucose, phosphorus, and calcium-phosphorus product.
- N-terminal mid-fragment of osteocalcin (N-MID OC) and β-CTX were negatively correlated with CAC and identified as protective factors.
Conclusions:
- Elevated phosphorus and calcium-phosphorus product are independent risk factors for CAC in MHD patients.
- Magnesium may be a protective factor against CAC.
- N-MID OC shows potential as a reliable marker linking vascular calcification and bone metabolism in MHD patients.
Background:
To study the influencing factors for coronary artery calcification (CAC) in maintenance hemodialysis (MHD) patients and the relationship between CAC and bone metabolism markers and to attempt to find a reliable marker linking vascular calcification and bone metabolism in MHD patients.
Methods:
A total of 123 patients were enrolled. CAC was assessed by multislice spiral computed tomography (MSCT), and the CAC score (CACS) was evaluated using the Agaston method. Routine laboratory parameters, including triglycerides (TG), total cholesterol (TC), glucose (Glu), calcium (Ca), phosphorus (P), magnesium (Mg), etc., were measured. Serum markers of bone metabolism, such as alkaline phosphatase(ALP), calcitonin (CT), 25-hydroxy vitamin D [25-(OH)D], intact parathyroid hormone (iPTH), total type I procollagen amino-terminal peptide (tPINP), N-terminal mid-fragment of osteocalcin (N-MID OC), and β-type I collagen crosslinked carboxyl-terminal peptide (β-CTX), were also measured.
Results:
Among 123 MHD patients, 37 patients (30.08%) did not have CAC, and 86 patients (69.92%) had CAC, including 41 patients (47.67%) with mild calcification and 45 patients (52.33%) with moderate to severe calcification. Age, Body Mass Index(BMI), the prevalence of hypertension and diabetes mellitus, TC, Glu, P, and Ca×P in the calcification group were higher than those in the noncalcification group, whereas Mg, iPTH, tPINP, N-MID OC, and β-CTX were lower than those in the noncalcified group (P < 0.05). Compared with the mild calcification group (0
Conclusions:
Elevated serum P and Ca×P were independent risk factors for CAC in MHD patients, and serum Mg may be an independent protective factor for CAC. CAC was closely related to abnormal bone metabolism and bone metabolic markers in MHD patients. Relatively low bone turnover can promote the occurrence and development of CAC. N-MID OC may be a reliable bone metabolic marker linking vascular calcification and bone metabolism in MHD patients.
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