The Vessels-Bone Axis: Iliac Artery Calcifications, Vertebral Fractures and Vitamin K from VIKI Study

Nutrients

Enrico Schileo¹  Fulvia Taddei¹  Cristina Politi²  Giovanni Tripepi²  Raffaele De Caterina³  Sandro Giannini⁴  Andrea Aghi⁴  Stefania Sella⁴  Maurizio Gallieni⁵  Markus Ketteler⁶  Giorgio Iervasi⁷  Roberto Vettor⁷  Maria Luisa Brandi⁸  Luisella Cianferotti⁸  Thomas L. Nickolas⁹  Maria Cristina Mereu^1,10  Martina Zaninotto^1,11  Mario Plebani^1,11  Maria Fusaro^1,12  Laura Cosmai^1,13  Giuseppe Cianciolo^1,14  Gaetano La Manna^1,14  Lorenzo Gasperoni^1,14  Maura Ravera^1,15  Serge Ferrari^1,16  Piergiorgio Messa^1,17 

[1] Bioengineering and Computing Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Ospedali Riuniti, 89124 Reggio Calabria, Italy;Cardiology, Cardiovascular Division, Pisa University Hospital, University of Pisa, Via Paradisa 2, 56126 Pisa, Italy;Clinica Medica 1, Department of Medicine, University of Padua, 35128 Padua, Italy;Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Università di Milano, 20157 Milano, Italy;Department of General Internal Medicine and Nephrology, Robert-Bosch-Krankenhaus, 70376 Stuttgart, Germany;Department of Medicine, University of Padova, 35128 Padova, Italy;Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy;Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA;Independent Researcher, 09100 Cagliari, Italy;Laboratory Medicine Unit, Department of Medicine, University of Padua, 35129 Padua, Italy;National Research Council (CNR), Institute of Clinical Physiology (IFC), 56124 Pisa, Italy;Nephrology Unit, ASST Fate Bene Fratelli Sacco, 20157 Milano, Italy;Nephrology, Dialysis and Renal Transplant Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy;Policlinico San Martino, 16132 Genova, Italy;Service des Maladies Osseuses, Département de Médecine, HUG, 1205 Genève, Switzerland;Unit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, 20157 Milan, Italy;

关键词: peripheral vascular disease;    epidemiology;    metabolic syndrome;    vitamin K;   

DOI  :  10.3390/nu13103567

来源: DOAJ

【 摘 要 】

Vascular calcification and fragility fractures are associated with high morbidity and mortality, especially in end-stage renal disease. We evaluated the relationship of iliac arteries calcifications (IACs) and abdominal aortic calcifications (AACs) with the risk for vertebral fractures (VFs) in hemodialysis patients. The VIKI study was a multicenter cross-sectional study involving 387 hemodialysis patients. The biochemical data included bone health markers, such as vitamin K levels, vitamin K-dependent proteins, vitamin 25(OH)D, alkaline phosphatase, parathormone, calcium, and phosphate. VF, IACs and AACs was determined through standardized spine radiograms. VF was defined as >20% reduction of vertebral body height, and VC were quantified by measuring the length of calcium deposits along the arteries. The prevalence of IACs and AACs were 56.1% and 80.6%, respectively. After adjusting for confounding variables, the presence of IACs was associated with 73% higher odds of VF (p = 0.028), whereas we found no association (p = 0.294) for AACs. IACs were associated with VF irrespective of calcification severity. Patients with IACs had lower levels of vitamin K2 and menaquinone 7 (0.99 vs. 1.15 ng/mL; p = 0.003), and this deficiency became greater with adjustment for triglycerides (0.57 vs. 0.87 ng/mL; p < 0.001). IACs, regardless of their extent, are a clinically relevant risk factor for VFs. The association is enhanced by adjusting for vitamin K, a main player in bone and vascular health. To our knowledge these results are the first in the literature. Prospective studies are needed to confirm these findings both in chronic kidney disease and in the general population.

【 授权许可】

Unknown