투석 환자에서 혈관 석회화, 동맥 경직, 염증, 영양 상태와의 상관관계
Vascular Calcification Scores are Associated with Arterial Stiffness, Inflammation, and Nutrition in Hemodialysis Patients
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Background/Aims: The vascular calcification (VC) score on a plain X-ray is associated with cardiovascular disease and mortalityin hemodialysis (HD) patients. This study examined the correlations among the VC scores for the hands and pelvis X-rays, arterialstiffness, inflammation, and nutrition in HD patients. Methods: VC was evaluated using plain x-rays of the hands and pelvis. Patients were categorized into the VC (+) (VC score ≥ 3) orVC (-) (VC score < 3) groups. We measured the pulse wave velocity (PWV), ankle brachial index (ABI), and augmentation index(AI). Results: The mean age of the patients was 55.6 ± 13.2 years. The prevalence of diabetes mellitus (DM) was significantly higher inthe VC (+) group than in the VC (-) group (87.5 vs. 34.2%, p < 0.05). The serum PTH (98.4 ± 141.9 vs. 183.6 ± 231.3 pg/mL,p < 0.05) and albumin (3.7 ± 0.5 vs. 3.9 ± 0.3 g/dL, p < 0.05) levels were significantly lower and PWV was significantly (p < 0.05)higher in the VC (+) group. In multiple linear regression analysis, only the presence of diabetes mellitus was significantly related tothe VC score. Conclusions: The VC score was associated with the serum PTH and albumin, as well as with vascular stiffness. C-reactive proteindid not show any significant association with the VC score.
Abstract
Background/Aims: The vascular calcification (VC) score on a plain X-ray is associated with cardiovascular disease and mortalityin hemodialysis (HD) patients. This study examined the correlations among the VC scores for the hands and pelvis X-rays, arterialstiffness, inflammation, and nutrition in HD patients. Methods: VC was evaluated using plain x-rays of the hands and pelvis. Patients were categorized into the VC (+) (VC score ≥ 3) orVC (-) (VC score < 3) groups. We measured the pulse wave velocity (PWV), ankle brachial index (ABI), and augmentation index(AI). Results: The mean age of the patients was 55.6 ± 13.2 years. The prevalence of diabetes mellitus (DM) was significantly higher inthe VC (+) group than in the VC (-) group (87.5 vs. 34.2%, p < 0.05). The serum PTH (98.4 ± 141.9 vs. 183.6 ± 231.3 pg/mL,p < 0.05) and albumin (3.7 ± 0.5 vs. 3.9 ± 0.3 g/dL, p < 0.05) levels were significantly lower and PWV was significantly (p < 0.05)higher in the VC (+) group. In multiple linear regression analysis, only the presence of diabetes mellitus was significantly related tothe VC score. Conclusions: The VC score was associated with the serum PTH and albumin, as well as with vascular stiffness. C-reactive proteindid not show any significant association with the VC score.
참고문헌 (27)
- 김정민, "혈액투석 환자에서 관상동맥질환의 예측인자로서 단순방사선 촬영상 혈관 석회화 점수들간의 비교", Kidney Research and Clinical Practice, 29(2), pp.232~240 (2010), 대한신장학회
- Collins AJ, "Cardiovascular mortality in end-stage renal disease", Am J Med Sci, 325, pp.163~167 (2003)
- 이영기, "말기신질환 환자의 혈관석회화", Kidney Research and Clinical Practice, 29(6), pp.847~850 (2010), 대한신장학회
- Sigrist M, "Vascular calcification and cardiovascular function in chronic kidney disease", Nephrol Dial Transplant, 21, pp.707~714 (2006)
- Blacher J, "Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease", Hypertension, 38, pp.938~942 (2001)
- Adragao T, "A simple vascular calcification score predicts cardiovascular risk in haemodialysis patients", Nephrol Dial Transplant, 19, pp.1480~1488 (2004)
- 이영수, "말기신부전 환자에서 투석에 따른 혈관 경직도의 변화", Korean Circulation Journal, 34(9), pp.865~873 (2004), 대한심장학회
- Aoki A, "Associations between vascular calcification, arterial stiffness and bone mineral density in chronic hemodialysis patients", Geriatr Gerontol Int, 9, pp.246~252 (2009)
- 한기옥, "혈관 석회화의 분류, 동맥경화증 및 혈관의 석회화의 유발 기전", Endocrinology and Metabolism, 20(6), pp.556~560 (2005), 대한내분비학회
- 김수현, "혈액투석환자에서 만성염증반응이 혈관통로협착에 미치는 영향", Kidney Research and Clinical Practice, 25(5), pp.789~795 (2006), 대한신장학회
- Floege J, "Vascular calcification in patients with end-stage renal disease", Nephrol Dial Transplant, 19(5), pp.V59~66 (2004)
- Goodman WG, "Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis", N Engl J Med, 342, pp.1478~1483 (2000)
- Covic A, "Vascular calcification in chronic kidney disease", Clin Sci (Lond), 119, pp.111~121 (2010)
- Stenvinkel P, "Are there two types of malnutrition in chronic renal failure? evidence for relationships between malnutrition, inflammation and atherosclerosis (MIA syndrome)", Nephrol Dial Transplant, 15, pp.953~960 (2000)
- Bergstrom J, "Nutrition and mortality in hemodialysis", J Am Soc Nephrol, 6, pp.1329~1341 (1995)
- Zhang K, "Malnutrition, a new inducer for arterial calcification in hemodialysis patients", J Transl Med, 11, pp.66~ (2013)
- Dumler F, "Hypoalbuminemia is a marker of overhydration in chronic maintenance patients on dialysis", ASAIO J, 49, pp.282~286 (2003)
- Schindler R, "Causes and therapy of microinflammation in renal failure", Nephrol Dial Transplant, 19(5), pp.V34~40 (2004)
- Kanani PM, "Role of oxidant stress in endothelial dysfunction produced by experimental hyperhomocyst(e)- inemia in humans", Circulation, 100, pp.1161~1168 (1999)
- Zoccali C, "Inflammatory proteins as predictors of cardiovascular disease in patients with end-stage renal disease", Nephrol Dial Transplant, 19(5), pp.V67~72 (2004)
- Plata-Salaman CR, "Cytokines and anorexia: a brief overview", Semin Oncol, 25(1 Suppl 1), pp.64~72 (1998)
- Galassi A, "Accelerated vascular calcification and relative hypoparathyroidism in incident haemodialysis diabetic patients receiving calcium binders", Nephrol Dial Transplant, 21, pp.3215~3222 (2006)
- Blacher J, "Association between plasma homocysteine concentrations and cardiac hypertrophy in end-stage renal disease", J Nephrol, 12, pp.248~255 (1999)
- Coen G, "Calcimimetics, parathyroid hormone, and vascular calcification in chronic kidney disease", Kidney Int, 74, pp.1229~1231 (2008)
- Coen G, "Are PTH serum levels predictive of coronary calcifications in haemodialysis patients", Nephrol Dial Transplant, 22, pp.3262~3267 (2007)
- 이정은, "Serum osteoprotegerin is associated with vascular stiffness and the onset of new cardiovascular events in hemodialysis patients", The Korean Journal of Internal Medicine, 28(6), pp.668~677 (2013), 대한내과학회
- Sigrist MK, "Progressive vascular calcification over 2 years is associated with arterial stiffening and increased mortality in patients with stages 4 and 5 chronic kidney disease", Clin J Am Soc Nephrol, 2, pp.1241~1248 (2007)