Serum fetuin-A levels link inflammation and cardiovascular calcification in hemodialysis patients.

Abstract

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
• Journal: American journal of nephrology (Am J Nephrol) Vol. 26 Issue 5 Pg. 423-9 ( 2006) ISSN: 0250-8095 [Print] Switzerland
• PMID: 16968979 (Publication Type: Journal Article)
• Copyright: Copyright (c) 2006 S. Karger AG, Basel.

Chemical References

• AHSG protein, human
• Biomarkers
• Blood Proteins
• alpha-2-HS-Glycoprotein

Topics

• Adult
• Aged
• Biomarkers (blood)
• Blood Proteins (metabolism)
• Calcinosis (blood, diagnostic imaging, pathology)
• Cardiovascular Diseases (blood, diagnostic imaging, pathology)
• Female
• Humans
• Inflammation (blood, diagnostic imaging)
• Male
• Middle Aged
• Renal Dialysis
• Ultrasonography
• alpha-2-HS-Glycoprotein