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Elevated Circulating Osteoprotegerin and Renal Dysfunction Predict 15-Year Cardiovascular and All-Cause Mortality: A Prospective Study of Elderly Women.

Lewis JR, Lim WH, Ueland T, Wong G, Zhu K, Lim EM, Bollerslev J, Prince RL - PLoS ONE (2015)

Bottom Line: This relationship with mortality was independent of decline in renal function (P<0.05).The association between elevated OPG levels with CVD and all-cause mortality was more evident in elderly women with poorer renal function.Assessment of OPG in the context of renal function may be important in studies investigating its relationship with all-cause and CVD mortality.

View Article: PubMed Central - PubMed

Affiliation: University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia; Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia.

ABSTRACT

Background: Data on the predictive role of estimated glomerular filtration rate (eGFR) and osteoprotegerin (OPG) for cardiovascular (CVD) and all-cause mortality risk have been presented by our group and others. We now present data on the interactions between OPG with stage I to III chronic kidney disease (CKD) for all-cause and CVD mortality.

Methods and results: The setting was a 15-year study of 1,292 women over 70 years of age initially randomized to a 5-year controlled trial of 1.2 g of calcium daily. Serum OPG and creatinine levels with complete mortality records obtained from the Western Australian Data Linkage System were available. Interactions were detected between OPG levels and eGFR for both CVD and all-cause mortality (P < 0.05). Compared to participants with eGFR ≥60 ml/min/1.73 m2 and low OPG, participants with eGFR of <60 ml/min/1.73 m2 and elevated OPG had a 61% and 75% increased risk of all-cause and CVD mortality respectively (multivariate-adjusted HR, 1.61; 95% CI, 1.27-2.05; P < 0.001 and HR, 1.75; 95% CI, 1.22-2.55; P = 0.003). This relationship with mortality was independent of decline in renal function (P<0.05). Specific causes of death in individuals with elevated OPG and stage III CKD highlighted an excess of coronary heart disease, renal failure and chronic obstructive pulmonary disease deaths (P < 0.05).

Conclusion: The association between elevated OPG levels with CVD and all-cause mortality was more evident in elderly women with poorer renal function. Assessment of OPG in the context of renal function may be important in studies investigating its relationship with all-cause and CVD mortality.

No MeSH data available.


Related in: MedlinePlus

Multivariable model plus five-year change in eGFR-adjusted hazard ratio (HR) and 95% confidence interval for 10-year (2003–2013) all-cause (n = 339) and cardiovascular mortality (n = 135) in participants dichotomized by baseline OPG levels and eGFR.Multivariable-adjustments included 5-year change in CKD-EPI eGFR (n = 970), age, body mass index, smoking history, history of hormone replacement therapy, treatment code (calcium or placebo) and comorbidity score.
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pone.0134266.g004: Multivariable model plus five-year change in eGFR-adjusted hazard ratio (HR) and 95% confidence interval for 10-year (2003–2013) all-cause (n = 339) and cardiovascular mortality (n = 135) in participants dichotomized by baseline OPG levels and eGFR.Multivariable-adjustments included 5-year change in CKD-EPI eGFR (n = 970), age, body mass index, smoking history, history of hormone replacement therapy, treatment code (calcium or placebo) and comorbidity score.

Mentions: To assess whether the relationship between circulating OPG levels with mortality outcomes was attributed to long-term renal decline, a Cox regression model including the 5-year change in eGFR was created (Fig 4). For all-cause and CVD mortality, the association between elevated OPG levels and CKD remained unchanged. Five-year change in eGFR was independently associated with both all-cause (n = 339) and CVD mortality (n = 134; P = 0.007 and P = 0.019 respectively).


Elevated Circulating Osteoprotegerin and Renal Dysfunction Predict 15-Year Cardiovascular and All-Cause Mortality: A Prospective Study of Elderly Women.

Lewis JR, Lim WH, Ueland T, Wong G, Zhu K, Lim EM, Bollerslev J, Prince RL - PLoS ONE (2015)

Multivariable model plus five-year change in eGFR-adjusted hazard ratio (HR) and 95% confidence interval for 10-year (2003–2013) all-cause (n = 339) and cardiovascular mortality (n = 135) in participants dichotomized by baseline OPG levels and eGFR.Multivariable-adjustments included 5-year change in CKD-EPI eGFR (n = 970), age, body mass index, smoking history, history of hormone replacement therapy, treatment code (calcium or placebo) and comorbidity score.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4519299&req=5

pone.0134266.g004: Multivariable model plus five-year change in eGFR-adjusted hazard ratio (HR) and 95% confidence interval for 10-year (2003–2013) all-cause (n = 339) and cardiovascular mortality (n = 135) in participants dichotomized by baseline OPG levels and eGFR.Multivariable-adjustments included 5-year change in CKD-EPI eGFR (n = 970), age, body mass index, smoking history, history of hormone replacement therapy, treatment code (calcium or placebo) and comorbidity score.
Mentions: To assess whether the relationship between circulating OPG levels with mortality outcomes was attributed to long-term renal decline, a Cox regression model including the 5-year change in eGFR was created (Fig 4). For all-cause and CVD mortality, the association between elevated OPG levels and CKD remained unchanged. Five-year change in eGFR was independently associated with both all-cause (n = 339) and CVD mortality (n = 134; P = 0.007 and P = 0.019 respectively).

Bottom Line: This relationship with mortality was independent of decline in renal function (P<0.05).The association between elevated OPG levels with CVD and all-cause mortality was more evident in elderly women with poorer renal function.Assessment of OPG in the context of renal function may be important in studies investigating its relationship with all-cause and CVD mortality.

View Article: PubMed Central - PubMed

Affiliation: University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia; Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia.

ABSTRACT

Background: Data on the predictive role of estimated glomerular filtration rate (eGFR) and osteoprotegerin (OPG) for cardiovascular (CVD) and all-cause mortality risk have been presented by our group and others. We now present data on the interactions between OPG with stage I to III chronic kidney disease (CKD) for all-cause and CVD mortality.

Methods and results: The setting was a 15-year study of 1,292 women over 70 years of age initially randomized to a 5-year controlled trial of 1.2 g of calcium daily. Serum OPG and creatinine levels with complete mortality records obtained from the Western Australian Data Linkage System were available. Interactions were detected between OPG levels and eGFR for both CVD and all-cause mortality (P < 0.05). Compared to participants with eGFR ≥60 ml/min/1.73 m2 and low OPG, participants with eGFR of <60 ml/min/1.73 m2 and elevated OPG had a 61% and 75% increased risk of all-cause and CVD mortality respectively (multivariate-adjusted HR, 1.61; 95% CI, 1.27-2.05; P < 0.001 and HR, 1.75; 95% CI, 1.22-2.55; P = 0.003). This relationship with mortality was independent of decline in renal function (P<0.05). Specific causes of death in individuals with elevated OPG and stage III CKD highlighted an excess of coronary heart disease, renal failure and chronic obstructive pulmonary disease deaths (P < 0.05).

Conclusion: The association between elevated OPG levels with CVD and all-cause mortality was more evident in elderly women with poorer renal function. Assessment of OPG in the context of renal function may be important in studies investigating its relationship with all-cause and CVD mortality.

No MeSH data available.


Related in: MedlinePlus