Fetuin-A and kidney function in persons with coronary artery disease-data from the heart and soul study

被引:63
作者
Ix, Joachim H.
Chertow, Glenn M.
Shlipak, Michael G.
Brandenburg, Vincent M.
Ketteler, Markus
Whooley, Mary A.
机构
[1] Univ Calif San Francisco, Dept Med, Div Nephrol, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
[3] VA Med Ctr, Gen Internal Med Sect, San Francisco, CA USA
[4] Univ Hosp, Rhein Westfal TH Aachen, Dept Nephrol & Clin Immunol, Aachen, Germany
关键词
calcium; chronic kidney disease; fetuin-A; alpha-2-Heremans-Schmid-glycoprotein; vascular calcification; phosphorus;
D O I
10.1093/ndt/gfl204
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background. Fetuin-A is a serum protein that inhibits ectopic vascular calcification and is present in lower concentrations in end-stage renal disease than in healthy controls. Whether fetuin-A concentrations are also lower in the setting of mild-to-moderate chronic kidney disease (CKD) is unknown. Methods. We evaluated the associations of several parameters of kidney function including measured 24 h urinary creatinine clearance (CrCl), estimated glomerular filtration rate (GFR) by the Mayo Clinic quadratic GFR equation (qGFR), serum cystatin-C concentrations, and urinary albumin-to-creatinine ratio with serum fetuin-A concentrations in 970 outpatients with coronary artery disease. We used general linear models to determine the adjusted mean fetuin-A concentrations within each kidney function category. Results. The mean age of the study sample was 67 years, 82% were male, 71% had hypertension and 26% had diabetes mellitus. In adjusted analysis, we observed no significant differences in mean fetuin-A concentrations across groups defined by CrCl, qGFR, or albumin-to-creatinine ratio groups. For example, adjusted mean fetuin-A concentrations were 0.66 g/l in participants with CrCl > 90, 60-90 and 45-60 ml/min/1.73 m(2), and 0.65 g/l in participants with CrCl < 45 ml/min/1.73 m(2). Higher serum cystatin-C (indicating worse kidney function) was associated with higher adjusted mean serum fetuin-A concentrations (lowest quartile 0.62 g/l, highest quartile 0.68 g/l; P for trend < 0.001). Conclusions. Among ambulatory patients with coronary artery disease, there is no evidence that mild-to-moderate CKD is associated with lower concentrations of serum fetuin-A compared with persons with normal renal function. The mechanisms explaining the association between CKD and vascular calcification remain elusive.
引用
收藏
页码:2144 / 2151
页数:8
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