Tohoku J. Exp. Med., 2017 August, 242(4)
Higher Serum Levels of Osteoglycin Are Associated with All-Cause Mortality and Cardiovascular and Cerebrovascular Events in Patients with Advanced Chronic Kidney Disease
SEON HA BAEK,1 RAN-HUI CHA,2 SHIN WOOK KANG,3 CHEOL WHEE PARK,4 DAE RYONG CHA,5 SUNG GYUN KIM,6 SUN AE YOON,7 SEJOONG KIM,8,9 SANG YOUB HAN,10 JUNG HWAN PARK,11 JAE HYUN CHANG,12 CHUN SOO LIM,9,13 YON SU KIM9,14,15 and KI YOUNG NA8,9
1Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi-do, Republic of Korea
2Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
3Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
4Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
5Department of Internal Medicine, Korea University Ansan-Hospital, Korea University, Ansan, Gyeonggi-do, Republic of Korea
6Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Republic of Korea
7Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Gyeonggi-do, Republic of Korea
8Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea
9Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
10Department of Internal Medicine, Inje University Ilsan-Paik Hospital, Goyang, Gyeonggi-do, Republic of Korea
11Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
12Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Incheon, Republic of Korea
13Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
14Department of Medical Science, Seoul National University Graduate School, Seoul, Republic of Korea
15Kidney Research Institute, Seoul National University, Seoul, Republic of Korea
Patients with chronic kidney disease (CKD) have markedly increased rates of major adverse cardiovascular and cerebrovascular events (MACCEs) and mortality. Therefore, identifying early biomarkers predicting clinical outcomes in patients with CKD is critical. We aimed to determine whether osteoglycin, a basic component of the vascular extracellular matrix, was associated with MACCEs or all-cause mortality, using data from a prospective randomized controlled study, K-STAR (Kremezin STudy Against Renal disease progression in Korea: NCT 00860431). A total of 383 patients (mean age: 56.4 years, men/women = 252/131) with CKD stage 3 to 4 from the original trial were enrolled in the present study. We measured serum osteoglycin level and examined the impact of osteoglycin on clinical outcomes. The mean value of osteoglycin levels was 13.3 ± 9.4 ng/mL (healthy control: 5.3 ± 2.1 ng/mL). In multivariable analysis, lower levels of proteinuria and hemoglobin and higher levels of C-reactive protein were significantly associated with higher osteoglycin levels. Estimated glomerular filtration rate was not related to osteoglycin level. During a mean follow-up period of 56 months, 25 deaths, 61 MACCEs, and 76 composite outcomes (all-cause mortality or MACCEs) occurred. In the non-diabetic group, each 1-ng/mL increase in serum osteoglycin was associated with all-cause mortality and composite outcome (hazard ratio [HR] = 1.058, P = 0.031; HR = 1.041, P = 0.036). However, osteoglycin levels were not associated with mortality, MACCEs, or composite outcome in the diabetic group. Our results indicate that serum osteoglycin is a potential predictor of adverse outcomes in patients with CKD.
keywords —— all-cause mortality; biomarker; chronic kidney disease; diabetes mellitus; osteoglycin
© 2017 Tohoku University Medical Press
===============================
Tohoku J. Exp. Med., 2017, 242, 281-290
Correspondence: Ki Young Na, Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam, Gyeonggi-do 463-707, Republic of Korea.
e-mail: kyna@snubh.org