The Relationship Between Osteoprotegerin/RANKL Axis and Arterial Stiffness in Osteopenic/Osteoporotic Renal Transplantation Recipients
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Tarih
2015
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Kardiyovasküler hastalıklar böbrek transplantasyonu (Btx) olan hastalarda mortalitenin ana nedenleri arasındadır. Osteoprotegerin (OPG), osteoblastlar tarafından üretilir ve BTxli hastalarda artmış kardiyovasküler risk ile bağlantılıdır. Normal popülasyonda OPG, serumda NF-?B ligandının (RANKL) bir reseptörü olarak davranır ve bu etkileşimin kemik erimesi ve vasküler fonksiyonlar üzerinde önemli bir rol oynadığı tespit edilmiştir. Literatürde Btxli hastalarda bu etkileşimle ilgili yeterli bilgi bulunmamaktadır. Bu nedenle, çalışmamızda Btxli hastalarda OPG, RANKL, osteoporoz ve arteriyel sertlik arasındaki ilişki araştırılmıştır. GEREÇ ve YÖNTEMLER: Bu kesitsel çalışmaya 80 erişkin Btxli hasta dahil edilmiştir. Femur boynu mineral yoğunluğu dual-enerji X-ışını soğurma (DEXA) yöntemiyle elde edildi. Serum OPG ve RANKL ELISA yöntemi ile ölçüldü. Nabız dalga analizi karotid ve nabız dalga hızı (NDH) makinesi kullanılarak femoral arterlerden ölçüldü. BULGULAR: Hastalar osteopeni/osteoporoz grubu (n:56) ve normal (n: 24) olarak iki gruba ayrıldı. Vücut kitle indeksi normal gruba göre osteopenik/osteoporotik grupta anlamlı olarak daha düşüktü. Nabız dalga hızı ile yaş (r: 0,204, p: 0,072), OPG (r: 0,219, p: 0,052), kalsiyumxfosfat çarpımı (r: 605, p 0,001) ve sistolik kan basıncı (r: 0,198 , p: 0,058) arasında pozitif korelasyon saptanırken, NDH ile RANKL (r: -0,261, p: 0,020) ve kreatinin klirensi (r: -0,220, p: 0,051) arasında negatif korelasyon tespit edildi. Lineer regresyon analizinde nabız dalga hızının bağımsız belirleyicisi olarak kalsiyum x fosfat çarpımı bulundu. Ancak kreatinin klirensi, RANKL osteoprotegerin ve sistolik kan basıncı NDHnın bağımsız öngördürücüsü olarak tespit edilmedi. SONUÇ: Çalışmamızda, böbrek nakilli hastalarda arteriyel sertliği gösteren nabız dalga hızı OPG ve RANKL ile değil fakat kalsiyum ve fosfor çarpımı ile bağımsız olarak ilişkili bulunmuştur.
OBJECTIVE: Cardiovascular diseases are the main reason of death in patients with renal transplantation (Rtx). Osteoprotegerin (OPG) is produced by osteoblasts and is linked to increased cardiovascular risk in Rtx. OPG acts as a decoy receptor binding receptor activator of nuclear factor kappa-B ligand (RANKL) and this interaction plays a role in bone resorption and vascular function. This study aimed to investigate the relation between OPG, RANKL, osteoporosis and arterial stiffness in Rtx patients. MATERIAL and METHODS: This cross-sectional study included 80 adult Rtx recipients. Femoral neck mineral density was obtained by dual-energy X-ray absorptiometry. Serum OPG and RANKL were measured by the ELISA method. Pulse-wave analysis was measured in the carotid and femoral arteries using a pulse wave velocity (PWV) machine. RESULTS: Patients were divided into two groups as normal (n:24) and osteopenia/osteoporosis group (n:56). Body mass index was significantly lower in the osteopenic/osteoporotic group compared to the normal group. Pulse wave velocity was positively correlated with age (r:0.204,p:0.072), osteoprotegerin (r:0.219,p:0.052), calcium x phosphate product (r:0.605,p:>0.001), and systolic blood pressure (r:0.198,p:0.058) and negatively correlated with RANKL (r:-0.261,p:0.020) and creatinine clearance (r:-0.220,p:0.051). PWV was independently predicted by calcium x phosphate product but not creatinine clearance, RANKL, osteoprotegerin and systolic blood pressure. CONCLUSION: In our study, serum calcium x phosphate product but not OPG and RANKL levels were found to be the main predictor of arterial stiffness in Rtx patients.
OBJECTIVE: Cardiovascular diseases are the main reason of death in patients with renal transplantation (Rtx). Osteoprotegerin (OPG) is produced by osteoblasts and is linked to increased cardiovascular risk in Rtx. OPG acts as a decoy receptor binding receptor activator of nuclear factor kappa-B ligand (RANKL) and this interaction plays a role in bone resorption and vascular function. This study aimed to investigate the relation between OPG, RANKL, osteoporosis and arterial stiffness in Rtx patients. MATERIAL and METHODS: This cross-sectional study included 80 adult Rtx recipients. Femoral neck mineral density was obtained by dual-energy X-ray absorptiometry. Serum OPG and RANKL were measured by the ELISA method. Pulse-wave analysis was measured in the carotid and femoral arteries using a pulse wave velocity (PWV) machine. RESULTS: Patients were divided into two groups as normal (n:24) and osteopenia/osteoporosis group (n:56). Body mass index was significantly lower in the osteopenic/osteoporotic group compared to the normal group. Pulse wave velocity was positively correlated with age (r:0.204,p:0.072), osteoprotegerin (r:0.219,p:0.052), calcium x phosphate product (r:0.605,p:>0.001), and systolic blood pressure (r:0.198,p:0.058) and negatively correlated with RANKL (r:-0.261,p:0.020) and creatinine clearance (r:-0.220,p:0.051). PWV was independently predicted by calcium x phosphate product but not creatinine clearance, RANKL, osteoprotegerin and systolic blood pressure. CONCLUSION: In our study, serum calcium x phosphate product but not OPG and RANKL levels were found to be the main predictor of arterial stiffness in Rtx patients.
Açıklama
Anahtar Kelimeler
Renal transplantation, Osteoporosis, Osteoprotegerin, RANKL, Pulse wave velocity, Böbrek nakli, Osteoporoz, Osteoprotegerin, Nabız dalga hızı
Kaynak
Türk Nefroloji Diyaliz ve Transplantasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
24
Sayı
2
Künye
Türkmen, K., Koçyiğit, İ., Koçyiğit, İ., Doğan, E, Güngör, Ö., Örsçelik, Ö., Karakükcü, Ç., Eroğlu, E., Ünal, A., Doğan, A., Sipahioğlu, M. H., Tokgöz, B., Oymak, O. (2015). The relationship between osteoprotegerin/RANKLE axis and arterial stiffness in osteopenic/osteoporotic renal transplantation recipients. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 24, 2, 181-188.
