Document Detail


Serum fetuin-A levels link inflammation and cardiovascular calcification in hemodialysis patients.
MedLine Citation:
PMID:  16968979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality in hemodialysis (HD). An elevated incidence of cardiovascular calcifications (CVC) is observed in HD. Fetuin-A is an important inhibitor of CVC. Reduced fetuin-A levels associate with inflammation and increased cardiovascular (CV) mortality in HD. In this study we investigated the association of fetuin-A levels and CVC. METHOD: We evaluated a cohort of 115 patients (67 males), aged 63 +/- 16 years with a HD vintage >or=9 months. Presence of CVC was assessed by ultrasound imaging of the abdominal aorta, common carotid arteries, bilateral ilio-femoral axis, aortic and mitral cardiac valves. The presence of CVC was analyzed as a CVC score (CVCS) (0-7) according to the number of CVC sites. Patients were arbitrary stratified in three groups: group I (CVCS = 0), group II (0 < CVCS < 6) and group III (CVCS >or= 6). Patients without CVC were younger, non-diabetic and with a negative history for CV events. RESULTS: Patients with evidence of CVC in more than 5 sites had lower serum fetuin-A levels (0.41 +/- 0.22 g/l) compared to patients with CVCS = 0 (0.51 +/- 0.17 g/l, p = 0.048). In addition a worse CVCS was associated with higher serum levels of C-reactive protein (p = 0.002) and fibrinogen (p < 0.001). Serum fetuin-A levels lower than 0.290 g/l were associated with higher risk of a worse CVCS, independently from traditional risk factors. CONCLUSION: Chronic inflammation in HD patients leads to lower serum fetuin-A levels. The present study confirms the independent and significant association between reduced serum fetuin-A levels and multi-site CVC in HD.
Authors:
Mario Cozzolino; Andrea Galassi; Maria Luisa Biondi; Olivia Turri; Sergio Papagni; Nicola Mongelli; Luigi Civita; Maurizio Gallieni; Diego Brancaccio
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Publication Detail:
Type:  Journal Article     Date:  2006-09-12
Journal Detail:
Title:  American journal of nephrology     Volume:  26     ISSN:  0250-8095     ISO Abbreviation:  Am. J. Nephrol.     Publication Date:  2006  
Date Detail:
Created Date:  2006-12-28     Completed Date:  2007-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109361     Medline TA:  Am J Nephrol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  423-9     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2006 S. Karger AG, Basel.
Affiliation:
Renal Division, S. Paolo Hospital, University of Milan, Milan, Italy. mariocozzolino@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Markers / blood
Blood Proteins / metabolism*
Calcinosis / blood*,  pathology*,  ultrasonography
Cardiovascular Diseases / blood*,  pathology*,  ultrasonography
Female
Humans
Inflammation / blood,  ultrasonography
Male
Middle Aged
Renal Dialysis*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Blood Proteins; 0/alpha2HS glycoprotein

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