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Low serum butyrylcholinesterase is independently related to low fetuin-A in patients on hemodialysis: a cross-sectional study

  • Nephrology - Original Paper
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Abstract

Purpose

Fetuin-A, which plays a protective role against the atherosclerosis and progression of vascular calcification, is decreased in patients on hemodialysis (HD). Fetuin-A and serum butyrylcholinesterase (BChE) levels decrease during malnutrition. We explored whether BChE was independently related to fetuin-A in patients on HD.

Methods

Laboratory data including BChE and serum fetuin-A were acquired from 230 patients on HD between August 2017 and April 2018. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI). Abdominal aortic calcification index (ACI) was measured using computed tomography. Patients were stratified into two groups: low fetuin-A (< lowest quartile) and non-low fetuin-A (≥ lowest quartile) groups. Patient background, medication, and laboratory data were compared. The receiver operating characteristic analysis was conducted to determine the optimal cutoff values of BChE and GNRI for lower fetuin-A level. Factors independently related with lower fetuin-A levels were determined using multivariate logistic regression analysis.

Results

The lowest quartile value of fetuin-A and optimal cutoff values of BChE and GNRI were 0.213 g/L, 200 IU/L, and 92.6, respectively. The study included 57 and 173 patients in the low fetuin-A and non-low fetuin-A groups, respectively. Significant between-group differences were observed for age, C-reactive protein (CRP), history of cardiovascular disease, serum albumin, GNRI, and BChE. Multivariate analysis showed that BChE of < 200 IU/L [odds ratio (OR) 3.05], CRP (OR 2.49), and GNRI of < 92.6 (OR 2.34) were independent factors for lower fetuin-A level after adjusting for confounders.

Conclusions

BChE was a significant independent marker for fetuin-A levels in patients on HD, in addition to GNRI.

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Acknowledgements

We thank Sakiko Fujita, Akiko Kimura, Mieko Kawamura, Chizu Kawase, Kumiko Sato, and Masahiko Tezuka for their invaluable help with data collection. We would also like to appreciate Enago (http://www.enago.jp) for English language support.

Funding

This work was supported by a Grant-in-Aid for Scientific Research (Grant Nos. 15H02563, 15K15579, 17K11119) from the Japan Society for the Promotion of Science.

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Authors and Affiliations

  1. Department of Urology, Oyokyo Kidney Research Institute Aomori Hospital, 101-1 Okabe, Ishie, Aomori, 038-0003, Japan

    Teppei Okamoto, Yoshimi Tanaka, Kengo Imanishi, Tooru Takashima & Fumitada Saitoh

  2. Oyokyo Kidney Research Institute, 90, Yamazaki, Ozawa, Hirosaki, 036-8243, Japan

    Chikako Tsutaya & Tadashi Suzuki

  3. Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan

    Shingo Hatakeyama, Sakae Konishi, Kazutaka Okita, Yoshimi Tanaka & Chikara Ohyama

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  1. Teppei Okamoto
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  2. Chikako Tsutaya
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Correspondence to Teppei Okamoto.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Okamoto, T., Tsutaya, C., Hatakeyama, S. et al. Low serum butyrylcholinesterase is independently related to low fetuin-A in patients on hemodialysis: a cross-sectional study. Int Urol Nephrol 50, 1713–1720 (2018). https://doi.org/10.1007/s11255-018-1957-z

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  • DOI: https://doi.org/10.1007/s11255-018-1957-z

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