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

Authors :
Maria Fusaro
Giovanni Tripepi
Mario Plebani
Cristina Politi
Andrea Aghi
Fulvia Taddei
Enrico Schileo
Martina Zaninotto
Gaetano La Manna
Giuseppe Cianciolo
Maurizio Gallieni
Laura Cosmai
Piergiorgio Messa
Maura Ravera
Thomas L. Nickolas
Serge Ferrari
Markus Ketteler
Giorgio Iervasi
Maria Cristina Mereu
Roberto Vettor
Sandro Giannini
Lorenzo Gasperoni
Stefania Sella
Maria Luisa Brandi
Luisella Cianferotti
Raffaele De Caterina
Source :
Nutrients, Vol 13, Iss 10, p 3567 (2021)
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

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.

Details

Language :
English
ISSN :
20726643
Volume :
13
Issue :
10
Database :
Directory of Open Access Journals
Journal :
Nutrients
Publication Type :
Academic Journal
Accession number :
edsdoj.b383b1f4b32f4f23b60d1aa869d17889
Document Type :
article
Full Text :
https://doi.org/10.3390/nu13103567