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Prolactin levels, endothelial dysfunction, and the risk of cardiovascular events and mortality in patients with CKD.
Clin J Am Soc Nephrol. 2012 Feb; 7(2):207-15.CJ

Abstract

BACKGROUND AND OBJECTIVES

Both prolactin clearance and production are altered in CKD. In nonrenal populations, emerging evidence suggests that prolactin participates in the atherosclerotic process. Given the elevated cardiovascular risk of CKD, this study examined links between prolactinemia, vascular derangements, and outcomes.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

This observational study was conducted in two cohorts: one with 457 nondialyzed CKD patients (mean age 52±12 years; 229 men) with measurements of flow-mediated dilation (FMD) and carotid intima-media thickness and one with 173 hemodialysis patients (65±12 years; 111 men) with measurements of pulse wave velocity (PWV). Patients were followed for cardiovascular events (n=146, nondialyzed cohort) or death (n=79, hemodialysis cohort).

RESULTS

Prolactin levels increased along with reduced kidney function. Prolactin significantly and independently contributed to explain the variance of both FMD (in nondialyzed patients) and PWV (in hemodialysis patients), but not intima-media thickness. In Cox analyses, the risk of cardiovascular events in nondialyzed patients increased by 27% (hazard ratio [HR], 1.27; 95% confidence interval [95% CI], 1.17-1.38) for each 10 ng/ml increment of prolactin. Similarly, the risk for all-cause and cardiovascular mortality in hemodialysis patients increased by 12% (HR, 1.12; 95% CI, 1.06-1.17) and 15% (HR, 1.15; 95% CI, 1.08-1.21), respectively. This was true after multivariate adjustment for confounders and after adjustment within the purported causal pathway (FMD or PWV).

CONCLUSIONS

Prolactin levels directly associated with endothelial dysfunction/stiffness and with increased risk of cardiovascular events and mortality in two independent cohorts of CKD patients.

Authors+Show Affiliations

Divison of Renal Medicine, Karolinska Institutet, Sweden. juan.jesus.carrero@ki.seNo 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 availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22193237

Citation

Carrero, Juan Jesús, et al. "Prolactin Levels, Endothelial Dysfunction, and the Risk of Cardiovascular Events and Mortality in Patients With CKD." Clinical Journal of the American Society of Nephrology : CJASN, vol. 7, no. 2, 2012, pp. 207-15.
Carrero JJ, Kyriazis J, Sonmez A, et al. Prolactin levels, endothelial dysfunction, and the risk of cardiovascular events and mortality in patients with CKD. Clin J Am Soc Nephrol. 2012;7(2):207-15.
Carrero, J. J., Kyriazis, J., Sonmez, A., Tzanakis, I., Qureshi, A. R., Stenvinkel, P., Saglam, M., Stylianou, K., Yaman, H., Taslipinar, A., Vural, A., Gok, M., Yenicesu, M., Daphnis, E., & Yilmaz, M. I. (2012). Prolactin levels, endothelial dysfunction, and the risk of cardiovascular events and mortality in patients with CKD. Clinical Journal of the American Society of Nephrology : CJASN, 7(2), 207-15. https://doi.org/10.2215/CJN.06840711
Carrero JJ, et al. Prolactin Levels, Endothelial Dysfunction, and the Risk of Cardiovascular Events and Mortality in Patients With CKD. Clin J Am Soc Nephrol. 2012;7(2):207-15. PubMed PMID: 22193237.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prolactin levels, endothelial dysfunction, and the risk of cardiovascular events and mortality in patients with CKD. AU - Carrero,Juan Jesús, AU - Kyriazis,John, AU - Sonmez,Alper, AU - Tzanakis,Ioannis, AU - Qureshi,Abdul Rashid, AU - Stenvinkel,Peter, AU - Saglam,Mutlu, AU - Stylianou,Kostas, AU - Yaman,Halil, AU - Taslipinar,Abdullah, AU - Vural,Abdulgaffar, AU - Gok,Mahmut, AU - Yenicesu,Mujdat, AU - Daphnis,Eugene, AU - Yilmaz,Mahmut Ilker, Y1 - 2011/12/22/ PY - 2011/12/24/entrez PY - 2011/12/24/pubmed PY - 2012/6/13/medline SP - 207 EP - 15 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 7 IS - 2 N2 - BACKGROUND AND OBJECTIVES: Both prolactin clearance and production are altered in CKD. In nonrenal populations, emerging evidence suggests that prolactin participates in the atherosclerotic process. Given the elevated cardiovascular risk of CKD, this study examined links between prolactinemia, vascular derangements, and outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This observational study was conducted in two cohorts: one with 457 nondialyzed CKD patients (mean age 52±12 years; 229 men) with measurements of flow-mediated dilation (FMD) and carotid intima-media thickness and one with 173 hemodialysis patients (65±12 years; 111 men) with measurements of pulse wave velocity (PWV). Patients were followed for cardiovascular events (n=146, nondialyzed cohort) or death (n=79, hemodialysis cohort). RESULTS: Prolactin levels increased along with reduced kidney function. Prolactin significantly and independently contributed to explain the variance of both FMD (in nondialyzed patients) and PWV (in hemodialysis patients), but not intima-media thickness. In Cox analyses, the risk of cardiovascular events in nondialyzed patients increased by 27% (hazard ratio [HR], 1.27; 95% confidence interval [95% CI], 1.17-1.38) for each 10 ng/ml increment of prolactin. Similarly, the risk for all-cause and cardiovascular mortality in hemodialysis patients increased by 12% (HR, 1.12; 95% CI, 1.06-1.17) and 15% (HR, 1.15; 95% CI, 1.08-1.21), respectively. This was true after multivariate adjustment for confounders and after adjustment within the purported causal pathway (FMD or PWV). CONCLUSIONS: Prolactin levels directly associated with endothelial dysfunction/stiffness and with increased risk of cardiovascular events and mortality in two independent cohorts of CKD patients. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/22193237/Prolactin_levels_endothelial_dysfunction_and_the_risk_of_cardiovascular_events_and_mortality_in_patients_with_CKD_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=22193237 DB - PRIME DP - Unbound Medicine ER -