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Hermans, Marc M.H.; Vermeer, Cees; Kooman, Jeroen P.; Brandenburg, Vincent; Ketteler, Markus; Gladziwa, Ulrich; Rensma, Pieter L.; Leunissen, Karel M.L.; Schurgers, Leon J.

Undercarboxylated Matrix GLA Protein Levels Are Decreased in Dialysis Patients and Related to Parameters of Calcium-Phosphate Metabolism and Aortic Augmentation Index

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  • Media type: E-Article
  • Title: Undercarboxylated Matrix GLA Protein Levels Are Decreased in Dialysis Patients and Related to Parameters of Calcium-Phosphate Metabolism and Aortic Augmentation Index
  • Contributor: Hermans, Marc M.H.; Vermeer, Cees; Kooman, Jeroen P.; Brandenburg, Vincent; Ketteler, Markus; Gladziwa, Ulrich; Rensma, Pieter L.; Leunissen, Karel M.L.; Schurgers, Leon J.
  • imprint: S. Karger AG, 2007
  • Published in: Blood Purification, 25 (2007) 5-6, Seite 395-401
  • Language: English
  • DOI: 10.1159/000108629
  • ISSN: 0253-5068; 1421-9735
  • Keywords: Nephrology ; Hematology ; General Medicine
  • Origination:
  • Footnote:
  • Description: <jats:p>&lt;i&gt;Background:&lt;/i&gt; Vascular calcifications are related to cardiovascular mortality and morbidity in dialysis patients. Limited data exist on the role of calcification inhibitors, such as matrix-carboxyglutamic acid protein (MGP) in dialysis patients. &lt;i&gt;Methods:&lt;/i&gt; In 120 dialysis patients and 41 age-matched healthy controls, circulating undercarboxylated (uc) MGP levels were measured with a novel ELISA-based competitive assay. The association between ucMGP levels and determinants of bone mineral metabolism, including the calcification inhibitor fetuin-A, was studied. Moreover, the relation between ucMGP levels and arterial stiffness was investigated. &lt;i&gt;Results:&lt;/i&gt; The ucMGP level was significantly lower in dialysis patients compared to controls (173 ± 70 vs. 424 ± 126 nmol/l; p &lt; 0.0001). After adjustment for age, sex and duration of dialysis an independent negative association between time-averaged phosphate levels [regression coefficient β with 95% confidence interval = –64 (–107 to –21)] and a positive association between serum ucMGP and fetuin-A [131 (55–208)] was observed. Duration of dialysis was inversely correlated with ucMGP (r = –0.24, p = 0.007). ucMGP levels were not related to high-sensitivity C-reactive protein or time-averaged calcium levels. After adjustment for age, sex, cardiovascular disease, diabetes, height and mean arterial pressure, ucMGP level was negatively associated with the aortic augmentation index [–0.036 (–0.061 to –0.010)] but not with pulse wave velocity or pulse pressure. &lt;i&gt;Conclusion:&lt;/i&gt; Significantly lower serum ucMGP levels were observed in dialysis patients compared to healthy controls. ucMGP levels were inversely associated with phosphate and positively associated with serum fetuin-A levels. Furthermore, ucMGP levels were inversely associated with the aortic augmentation index. These data suggest that low ucMGP levels may be a marker of active calcification.</jats:p>