The relationship between the Spine Deformity Index, biochemical parameters of bone metabolism and vascular calcifications: results from the Epidemiological VERtebral FRACtures iTalian Study (EVERFRACT) in dialysis patients

Fusaro, Maria; Gallieni, Maurizio; Noale, Marianna; Tripepi, Giovanni; Miozzo, Davide; Plebani, Mario; Zaninotto, Martina; Guglielmi, Giuseppe; Miotto, Diego; Fabris, Fabrizio; Piccoli, Antônio; Vilei, Maria Teresa; Sella, Stefania; Morachiello, P; Stoppa, Fabrizio; Rossini, Maurizio; Giannini, Sandro

doi:10.1515/cclm-2014-0194

Cited by 6 publications

(6 citation statements)

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“…In fact, higher total BGP levels were found associated with lower abdominal aortic calcification progression rate and lower mortality in a 10 year-long prospective study in elderly Caucasian subjects, showing total BGP as an independent factor of cardiovascular risk and mortality (17). Moreover, in the hemodialysis population we showed that low levels of total-BGP are associated with vertebral fractures, aortic and iliac calcifications (5). Finally, a recent review reported low BGP levels as a biomarker of abdominal aortic calcification in patients with diabetes (18).…”

Section: Discussionmentioning

confidence: 60%

“…BGP also has a protective role in vascular calcifications in humans (5), acting under the genetic control of vitamin D. Vitamin D deficiency is highly prevalent in CKD patients, suggesting that the protective role of vitamin D on vascular calcification (6) may be mediated by a reduced expression of BGP and other vitamin K dependent proteins involved in calcification pathways, such as Matrix Gla Protein, a potent inhibitor of vascular calcifications (7). Levels of BGP in DM patients on hemodialysis (HD) have been poorly described.…”

Section: Introductionmentioning

confidence: 99%

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Osteocalcin (bone GLA protein) levels, vascular calcifications, vertebral fractures and mortality in hemodialysis patients with diabetes mellitus

et al. 2019

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Osteocalcin (bone GLA protein) levels, vascular calcifications, vertebral fractures and mortality in hemodialysis patients with diabetes mellitus

et al. 2019

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“…In humans, a 10 years prospective study in elderly Caucasian men showed that BGP levels might be an independent indicator of cardiovascular risk and mortality, with higher total BGP concentrations being associated with lower abdominal aortic calcification (AAC) progression rate and lower mortality [18]. Moreover, we showed that low levels of BGP are associated to vertebral fracture (VF), aortic and iliac calcifications [19].…”

Section: Discussionmentioning

confidence: 75%

Cigarette Smoking is Associated with Decreased Bone Gla-protein (BGP) Levels in Hemodialysis Patients

Fusaro

Gallieni

Aghi

et al. 2018

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lower phosphate levels (4.25 (3.7, 5.3)) vs (4.86 (4.0, 5.6)) mg/dl, respectively, p= 0.008), albumin 50 (3.8 (3.5, 4.0)) vs (3.9 (3.6, 4.2)) g/dL, respectively, p= 0.001). Lower BGP levels were associated 51 with aortic calcification (p< 0.001), iliac calcification (p=0.042) and vertebral fractures (p=0.023). 52The regression model showed that smoking is associated with a significant reduction of total BGP 53 levels by about 18% (p=0.01). 54Conclusion: This is the first clinical study in a haemodialysis population which identifies cigarette 55 smoking as a potential inhibitor of BGP activity, a protective agent in bone and vascular health. 56 Smoking is a risk factor for osteoporosis [6] and vascular calcification [7]. Nicotine and non-71 nicotine tobacco smoke components have been shown to depress osteoblast activity. Gao et al. 72 showed that smoke exposure inhibited bone formation and increased bone resorption. Lumbar spine 73 and femur Bone Mass Density (BMD) was lower in 4-month smoke-exposed female rats than 74 controls. However, there was no significant difference in serum BGP levels between smoke-75 exposed rats and controls [8]. 76The objective of this secondary analysis of the vitamin K Italian (VIKI) study, an observational 77 study designed to assess the prevalence of vitamin K deficiency in haemodialysis patients, was to 78 assess the association between cigarette smoking and BGP levels in an end stage renal disease 79 (ESRD) population. We hypothesized that BGP levels would be lower in smokers than never 80 smokers, and that lower BGP levels would be related to fractures and severity of prevalent vascular 81 calcification. 82 83 5 PATIENTS AND METHODS 84This study is a secondary analysis of the VIKI study, involving 18 dialysis centres in Italy [9]. All 85 the local ethics committees approved the study, which was conducted according to the regulations 86 in force related to observational studies. Approval dates ranged from July 14, 2008 to October 26, 87 2009. Patient enrolment took place between November 2008 and November 2009, and follow-up to 88 assess vital status was performed in December 2011. We included adult patients of both genders 89 who had been on haemodialysis for >1 year, provided that they gave their informed consent, in 90 writing, for the use of their medical records for the study. We excluded patients who had a life 91 expectancy <6 months, cancer (with the exception of basal cell carcinoma), coagulation disorders, 92 or conditions that according to the investigator could interfere with the study outcome. Study 93 subjects were administered a questionnaire to ascertain smoking status (i.e. current, past or never 94 smoker). 95 Laboratory determination 96 Parathyroid hormone (PTH) 97The method for quantitative determination of PTH in serum was the automated LIAISON ® N-98 Tact ® PTH Assay 310910 (DiaSorin Inc., Stillwater MN, USA), a direct, 2-site, sandwich-type 99 chemiluminescence immunoassay (CLIA) carried out on the LIAISON ® (DiaSorin Inc., Stillwater 100 MN, USA) ...

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“…Consistently, we found that PK deficiency was the strongest predictor of vertebral fractures in hemodialysis patients [65]. Prevalence of vertebral fractures was 55%, with a significant association between severity of fractures and lower levels of total BGP [66]. Currently, there is very little literature on the role of vitamin K supplementation in osteoporosis prevention in men and women.…”

Section: Discussionmentioning

confidence: 81%

Non-Traditional Aspects of Renal Diets: Focus on Fiber, Alkali and Vitamin K1 Intake

et al. 2017

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Renal diets for advanced chronic kidney disease (CKD) are structured to achieve a lower protein, phosphate and sodium intake, while supplying adequate energy. The aim of this nutritional intervention is to prevent or correct signs, symptoms and complications of renal insufficiency, delaying the start of dialysis and preserving nutritional status. This paper focuses on three additional aspects of renal diets that can play an important role in the management of CKD patients: the vitamin K1 and fiber content, and the alkalizing potential. We examined the energy and nutrients composition of four types of renal diets according to their protein content: normal diet (ND, 0.8 g protein/kg body weight (bw)), low protein diet (LPD, 0.6 g protein/kg bw), vegan diet (VD, 0.7 g protein/kg bw), very low protein diet (VLPD, 0.3 g protein/kg bw). Fiber content is much higher in the VD and in the VLPD than in the ND or LPD. Vitamin K1 content seems to follow the same trend, but vitamin K2 content, which could not be investigated, might have a different pattern. The net endogenous acid production (NEAP) value decreases from the ND and LPD to the vegetarian diets, namely VD and VLPD; the same finding occurred for the potential renal acid load (PRAL). In conclusion, renal diets may provide additional benefits, and this is the case of vegetarian diets. Namely, VD and VLPD also provide high amounts of fibers and Vitamin K1, with a very low acid load. These features may have favorable effects on Vitamin K1 status, intestinal microbiota and acid-base balance. Hence, we can speculate as to the potential beneficial effects on vascular calcification and bone disease, on protein metabolism, on colonic environment and circulating levels of microbial-derived uremic toxins. In the case of vegetarian diets, attention must be paid to serum potassium levels.

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The relationship between the Spine Deformity Index, biochemical parameters of bone metabolism and vascular calcifications: results from the Epidemiological VERtebral FRACtures iTalian Study (EVERFRACT) in dialysis patients

Abstract: We conclude that the severity of VFs was associated with age, atherogenic factors and bone metabolism markers.

Cited by 6 publications

References 35 publications

Osteocalcin (bone GLA protein) levels, vascular calcifications, vertebral fractures and mortality in hemodialysis patients with diabetes mellitus

Osteocalcin (bone GLA protein) levels, vascular calcifications, vertebral fractures and mortality in hemodialysis patients with diabetes mellitus

Cigarette Smoking is Associated with Decreased Bone Gla-protein (BGP) Levels in Hemodialysis Patients

Non-Traditional Aspects of Renal Diets: Focus on Fiber, Alkali and Vitamin K1 Intake

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