Significant Association Between Bone-Specific Alkaline Phosphatase and Vascular Calcification of the Hand Arteries in Male Hemodialysis Patients

Ishimura, Eiji; Okuno, Senji; Okazaki, Hirokazu; Norimine, Kyoko; Yamakawa, Kenjiro; Yamakawa, Tomoyuki; Shoji, Shigeichi; Nishizawà, Yoshiki; Inaba, Masaaki

doi:10.1159/000355807

Cited by 24 publications

(20 citation statements)

References 34 publications

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“…In the prior study, bone-specific ALP was demonstrated to be associated with bone turn-over following renal transplantation [22]. Moreover, higher serum bone-specific ALP was reported to be associated with the presence of vascular calcification in male HD patients [23]. However, we did not examine the relationship of bone-specific ALP levels and mortality in HD patients in the present study.…”

Section: Discussionmentioning

confidence: 63%

Serum Alkaline Phosphatase Levels are Not Associated with Increased Death Risk in Prevalent Hemodialysis Patients: 5-Year Experience in a Single Hemodialysis Center

Zhu

Cheng

Lee

et al. 2016

Kidney Blood Press Res

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Background/Aims: Although high serum alkaline phosphatase (ALP) levels were reported as predictive factors for death risk in dialysis patients on the basis of large databank analyses, the real scenario in a single hemodialysis (HD) center is unknown. Methods: In this study, a 5-year cohort of 1126 prevalent HD patients in the largest HD center in Taiwan was studied. The associations of ALP levels expressed as baseline, time-average, and time-dependent with all-cause mortality and cardiovascular mortality were evaluated by using adjusted Cox regression models. Results: At baseline, levels of serum parathyroid hormone, calcium, and liver enzymes are increased in parallel with ALP quartiles. The hazard ratio (HR) for all-cause mortality was significantly increased in time-average and time-dependent ALP quartile in the unadjusted Cox analysis. The significance disappeared when multivariate adjusted Cox analysis was used. Similarly, HR was not significantly increased for cardiovascular mortality with ALP quartile expressed as baseline, time-average, and time-dependent in three models of Cox analyses. Conclusion: Our study demonstrated that serum ALP levels were not associated with increased death risk in prevalent HD patients over a 5-year interval.

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Section: Discussionmentioning

confidence: 63%

Serum Alkaline Phosphatase Levels are Not Associated with Increased Death Risk in Prevalent Hemodialysis Patients: 5-Year Experience in a Single Hemodialysis Center

Zhu

Cheng

Lee

et al. 2016

Kidney Blood Press Res

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“…Of the 46 studies included in this review, 26 (56%) were designed specifically to examine the relationship between OC and markers of calcification or atherosclerosis (20, 22, 24–27, 29–47). The other 20 studies evaluated OC among a number of measurements, as a covariate, or in secondary analyses (21, 23, 28, 48–61). Forty-four out of the 46 studies were cross-sectional in design.…”

Section: Resultsmentioning

confidence: 99%

“…In cases where no response from authors was obtained ( n = 8), they could not be included in the statistical analysis (20–27). One author declined to supply requested information (28). Studies were weighted by sample size, and statistical significance was set at p < 0.05.…”

Section: Methodsmentioning

confidence: 99%

Osteocalcin, Vascular Calcification, and Atherosclerosis: A Systematic Review and Meta-analysis

et al. 2017

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BackgroundOsteocalcin (OC) is an intriguing hormone, concomitantly being the most abundant non-collagenous peptide found in the mineralized matrix of bone, and expanding the endocrine function of the skeleton with far-reaching extra-osseous effects. A new line of enquiry between OC and vascular calcification has emerged in response to observations that the mechanism of vascular calcification resembles that of bone mineralisation. To date, studies have reported mixed results. This systematic review and meta-analysis aimed to identify any association between OC and vascular calcification and atherosclerosis.Methods and resultsDatabases were searched for original, peer reviewed human studies. A total of 1,453 articles were retrieved, of which 46 met the eligibility criteria. Overall 26 positive, 17 negative, and 29 neutral relationships were reported for assessments between OC (either concentration in blood, presence of OC-positive cells, or histological staining for OC) and extent of calcification or atherosclerosis. Studies that measured OC-positive cells or histological staining for OC reported positive relationships (11 studies). A higher percentage of Asian studies found a negative relationship (36%) in contrast to European studies (6%). Studies examining carboxylated and undercarboxylated forms of OC in the blood failed to report consistent results. The meta-analysis found no significant difference between OC concentration in the blood between patients with “atherosclerosis” and control (p = 0.13, n = 1,197).ConclusionNo definitive association was determined between OC and vascular calcification or atherosclerosis; however, the presence of OC-positive cells and histological staining had a consistent positive correlation with calcification or atherosclerosis. The review highlighted several themes, which may influence OC within differing populations leading to inconclusive results. Large, longitudinal studies are required to further current understanding of the clinical relevance of OC in vascular calcification and atherosclerosis.

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“…Only bone-specific alkaline phosphatase is statistically significantly higher in patients with vascular calcifications than in the other patients (p<0.05). Multi-variance analysis demonstrated a statistically reliable association (p<0.0001) between the bone-specific alkaline phosphatase logarithm on the one hand and the calcification of the vessels (15).…”

Section: Methodsmentioning

confidence: 89%

Tracing and comparing serum, specific, bone biomarkers in patients with secondary hyperparathyroidism

Staykova

Bocheva

2018

Scripta Scientifica Medica

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Bone and mineral disorders (BMDs) in chronic kidney disease (CKD) are increasingly being studied, and prophylaxis and treatment are conducted, but they still remain one of the most severe systemic illnesses in patients with CKD. In patients with end-stage CKD and secondary hyperparathyroidism, accompanying metabolic disorders of calcium and phosphorus homeostasis may lead to pathological changes in bone and blood vessels, which increase the risk of bone fractures and cardiovascular (CV) events. High levels of parathyroid hormone (PTH), calcium and phosphorus are associated with increased morbidity and mortality in dialysis patients. Dialysis treatment is a renal replacement method that continues the life of patients with CKD, temporarily improving existing bone pathology, but it more often accelerates its progression. Therefore, the symptoms, developmental and complications of BMD-CKD are demonstrated and manifested in patients with extracorporeal treatment. Treatment of BMD requires constant monitoring of CaP exchange, PTH, serum of Vitamin D levels and the protein bone markers-osteocalcin, bone alkaline phosphatase. Despite the systemic use of active metabolites of vitamin D, phosphate binders and calcimimetics, in many patients with secondary hyperparathyroidsm, inadequate biochemical control has been observed. In the Dialysis Clinic at St. Marina University Hospital, Varna, two groups of patients on hemodialysis (HD) and with CKD-2/3 stage with secondary hyperparathyroidism, were followed and had their serum biomarker levels compared-PTH, bone alkaline phosphatase (BAP), osteocalcin, and vitamin D. The results showed statistically significant differences between the two groups in the investigated serum levels of the indicators.

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Significant Association Between Bone-Specific Alkaline Phosphatase and Vascular Calcification of the Hand Arteries in Male Hemodialysis Patients

Cited by 24 publications

References 34 publications

Serum Alkaline Phosphatase Levels are Not Associated with Increased Death Risk in Prevalent Hemodialysis Patients: 5-Year Experience in a Single Hemodialysis Center

Serum Alkaline Phosphatase Levels are Not Associated with Increased Death Risk in Prevalent Hemodialysis Patients: 5-Year Experience in a Single Hemodialysis Center

Osteocalcin, Vascular Calcification, and Atherosclerosis: A Systematic Review and Meta-analysis

Tracing and comparing serum, specific, bone biomarkers in patients with secondary hyperparathyroidism

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