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Inflammation modifies the association of osteoprotegerin with mortality in chronic kidney disease.
J Nephrol. 2009 Nov-Dec; 22(6):774-82.JN

Abstract

BACKGROUND

The production and expression of osteoprotegerin (OPG), a bone regulating protein, is regulated by inflammatory cytokines.

METHODS

As clinical and experimental studies have implicated OPG in atherogenesis, we investigated serum OPG in relation to inflammation, endothelial dysfunction and oxidative stress markers in 265 chronic kidney disease (CKD) stage 5 patients. Cardiovascular disease (CVD), carotid plaques (n=69) and mortality (5 years) in relation to OPG were also analyzed, and the impact of inflammation on the association of OPG with mortality was evaluated.

RESULTS

OPG correlated positively with circulating surrogate markers of inflammatory, endothelial dysfunction and oxidative stress. Patients with clinical CVD or carotid plaques had higher concentrations of OPG than their respective counterparts. Increased OPG levels per se were related to higher cardiovascular and all-cause mortality even after adjustment for age, sex, C-reactive protein, diabetes mellitus and baseline CVD. Moreover, the presence of inflammation further and independently aggravated the hazard ratios (HR) for both cardiovascular (HR=2.8; 95% confidence interval [95% CI], 1.3-6.4; p=0.01) and all-cause (HR=2.5; 95% CI, 1.4-4.5; p<0.01) mortality.

CONCLUSIONS

Elevated OPG levels are associated with surrogate markers of inflammation, endothelial dysfunction, oxidative stress and CVD in CKD patients. Moreover, inflammation and OPG levels seem to have additive effects on survival.

Authors+Show Affiliations

Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19967657

Citation

Matsubara, Keisuke, et al. "Inflammation Modifies the Association of Osteoprotegerin With Mortality in Chronic Kidney Disease." Journal of Nephrology, vol. 22, no. 6, 2009, pp. 774-82.
Matsubara K, Stenvinkel P, Qureshi AR, et al. Inflammation modifies the association of osteoprotegerin with mortality in chronic kidney disease. J Nephrol. 2009;22(6):774-82.
Matsubara, K., Stenvinkel, P., Qureshi, A. R., Carrero, J. J., Axelsson, J., Heimbürger, O., Bárány, P., Alvestrand, A., Lindholm, B., & Suliman, M. E. (2009). Inflammation modifies the association of osteoprotegerin with mortality in chronic kidney disease. Journal of Nephrology, 22(6), 774-82.
Matsubara K, et al. Inflammation Modifies the Association of Osteoprotegerin With Mortality in Chronic Kidney Disease. J Nephrol. 2009 Nov-Dec;22(6):774-82. PubMed PMID: 19967657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inflammation modifies the association of osteoprotegerin with mortality in chronic kidney disease. AU - Matsubara,Keisuke, AU - Stenvinkel,Peter, AU - Qureshi,Abdul Rashid, AU - Carrero,Juan Jesús, AU - Axelsson,Jonas, AU - Heimbürger,Olof, AU - Bárány,Peter, AU - Alvestrand,Anders, AU - Lindholm,Bengt, AU - Suliman,Mohamed E, PY - 2009/12/8/entrez PY - 2009/12/8/pubmed PY - 2010/2/24/medline SP - 774 EP - 82 JF - Journal of nephrology JO - J Nephrol VL - 22 IS - 6 N2 - BACKGROUND: The production and expression of osteoprotegerin (OPG), a bone regulating protein, is regulated by inflammatory cytokines. METHODS: As clinical and experimental studies have implicated OPG in atherogenesis, we investigated serum OPG in relation to inflammation, endothelial dysfunction and oxidative stress markers in 265 chronic kidney disease (CKD) stage 5 patients. Cardiovascular disease (CVD), carotid plaques (n=69) and mortality (5 years) in relation to OPG were also analyzed, and the impact of inflammation on the association of OPG with mortality was evaluated. RESULTS: OPG correlated positively with circulating surrogate markers of inflammatory, endothelial dysfunction and oxidative stress. Patients with clinical CVD or carotid plaques had higher concentrations of OPG than their respective counterparts. Increased OPG levels per se were related to higher cardiovascular and all-cause mortality even after adjustment for age, sex, C-reactive protein, diabetes mellitus and baseline CVD. Moreover, the presence of inflammation further and independently aggravated the hazard ratios (HR) for both cardiovascular (HR=2.8; 95% confidence interval [95% CI], 1.3-6.4; p=0.01) and all-cause (HR=2.5; 95% CI, 1.4-4.5; p<0.01) mortality. CONCLUSIONS: Elevated OPG levels are associated with surrogate markers of inflammation, endothelial dysfunction, oxidative stress and CVD in CKD patients. Moreover, inflammation and OPG levels seem to have additive effects on survival. SN - 1121-8428 UR - https://www.unboundmedicine.com/medline/citation/19967657/Inflammation_modifies_the_association_of_osteoprotegerin_with_mortality_in_chronic_kidney_disease_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=19967657.ui DB - PRIME DP - Unbound Medicine ER -