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Bone mineral density may be related to atherosclerosis in hemodialysis patients

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Abstract

Biological interactions between the bone and the blood vessels are gradually being clarified. To investigate the relationship between bone mineral density and atherosclerosis in hemodialysis patients, we examined the bone mineral density and the intima-media thickness of the carotid artery in 83 dialysis patients with non-diabetic nephropathy (44 men and 39 women) aged from 23 to 83 years. The duration of hemodialysis ranged from 2 to 344 months. The bone mineral density of the radius was measured by dual-energy X-ray adsorptiometry, and the ratio of this value to the standard value for the same age and gender was calculated (Z-score). As an index of atherosclerosis, the intima-media thickness of the carotid artery was measured by high resolution B-mode ultrasonography. Then the relationship between the Z-score and various factors was examined using Spearman's rank correlation analysis and multiple regression analysis. The Z-score showed a negative correlation with the duration of hemodialysis, the carotid intima-media thickness, and the levels of alkaline phosphatase, intact parathyroid hormone, and low-density lipoprotein cholesterol by Spearman's rank correlation analysis. In addition, the Z-score showed a positive correlation with the lipoprotein (a) level and a negative correlation with the duration of hemodialysis, intima-media thickness, intact parathyroid hormone, and low-density lipoprotein cholesterol by multiple regression analysis. These findings suggest that the decrease of bone mineral density in hemodialysis patients is correlated with secondary hyperparathyroidism and hyperlipidemia, which are factors known to promote atherosclerosis, and thus bone density changes might be related to the progression of atherosclerosis, or vice versa.

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References

  1. Fontain MA, Albert A, Dubois B et al. (2000) Fracture and bone mineral density in hemodialysis patients. Clin Nephrol 54:218–226

    Google Scholar 

  2. Kawagishi T, Nishizawa Y, Konishi T et al. (1995) High-resolution B-mode ultrasonography in evaluation of atherosclerosis in uremia. Kidney Int 48:820–826

    Google Scholar 

  3. Kennedy R, Case C, Fathi R et al. (2001) Does renal failure cause an atherosclerotic milieu in patients with end-stage renal disease? Am J Med 110:198–204

    Google Scholar 

  4. Uyama O, Yoshimoto Y, Yamamoto Y et al. (1997) Bone changes and carotid atherosclerosis in postmenopausal women. Stroke 28:1730–1732

    Google Scholar 

  5. von der Recke P, Hansen MA, Hassager C (1999) The association between low bone mass at the menopause and cardiovascular mortality. Am J Med 106:273–278

    Google Scholar 

  6. Benedetto FA, Mallamaci F, Tripepi G et al. (2001) Prognostic value of ultrasonographic measurement of carotid intima media thickness in dialysis patients. J Am Soc Nephrol 12:2458–2464

    Google Scholar 

  7. Katagiri M, Takahiro O, Harada T et al. (1994) Bone loss and bone metabolic markers in hyperparathyroidism. J Bone Miner Metab Suppl 12:81–85

    Google Scholar 

  8. Wendelhag I, Wiklund O, Wikstrand J (1993) Atherosclerotic changes in femoral and carotid arteries in familial hypercholesterolemia: ultrasonographic assessment of intima-media thickness and plaque occurrence. Arterioscler Thromb 13:1404–1411

    Google Scholar 

  9. Yamasaki Y, Kodama M, Nishizawa H et al. (2000) Carotid intima-media thickness in Japanese type 2 diabetic subjects: predictors of progression and relationship with incident coronary heart disease. Diabetes Care 23:1310–1315

    Google Scholar 

  10. Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18:499–502

    Google Scholar 

  11. Taal MW, Masud T, Green D et al. (1999) Risk factors for reduced bone density in haemodialysis patients. Nephrol Dial Transplant 14:1922–1928

    Google Scholar 

  12. Torsen K, Nordstrom P, Lorentzon R et al. (1999) The relation between bone mineral density, insulin-like growth factor 1, lipoprotein (a), body composition, and muscle strength in adolescent males. J Clin Endocrinol Metab 84:3025–3029

    Google Scholar 

  13. Parhami F, Morrow AD, Balucan J et al. (1997) Lipid oxidation products have opposite effects on calcifying vascular cell and bone cell differentiation. Arterioscler Thromb Vasc Biol 17:680–687

    Google Scholar 

  14. Nishizawa Y, Morii H (1997) Osteoporosis and atherosclerosis in chronic renal failure. Osteoporosis Int Suppl 7:188–192

    Google Scholar 

  15. Goodman WG, Goldin J, Kuizon BD et al. (2000) Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 342:1478–1483

    Google Scholar 

  16. Asou Y, Rittling SR, Yoshitake H et al. (2001) Osteopontin facilitates angiogenesis, accumulation of osteoclasts, and resorption in ectopic bone. Endocrinology 142:1325–1332

    Google Scholar 

  17. Min H, Morony S, Sarosi I et al. (2000) Osteoprotegerin reverses osteoporosis by inhibiting endosteal osteoclasts and prevents vascular calcification by blocking a process resembling osteoclastogenesis. J Exp Med 192:463–474

    Google Scholar 

  18. Shearer MJ (1995) Vitamin K. Lancet 345:229–234

    Google Scholar 

  19. Luo G, Ducy P, McKee MD et al. (1997) Spontaneous calcification of arteries and cartilage in mice lacking matrix GLA protein. Nature 386:78–81

    Google Scholar 

  20. Shino M (1988) Determination of endogenous vitamin K (phylloquinone and menaquinone-n) in plasma by high-performance liquid chromatography using platinum oxide catalyst reduction and fluorescence detection. Analyst 113: 393–397

    Google Scholar 

  21. Kohlmeier M, Saupe J, Shearer MJ et al. (1997) Bone health of adult hemodialysis patients is related to vitamin K status. Kidney Int 51:1218–1221

    Google Scholar 

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Correspondence to Noriaki Yorioka.

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Nakashima, A., Yorioka, N., Tanji, C. et al. Bone mineral density may be related to atherosclerosis in hemodialysis patients. Osteoporos Int 14, 369–373 (2003). https://doi.org/10.1007/s00198-002-1361-4

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  • DOI: https://doi.org/10.1007/s00198-002-1361-4

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