Title | Kidney function, bone-mineral metabolism markers, and future risk of peripheral artery disease. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Yang C, Kwak L, Ballew SH, Garimella PS, Jaar BG, Folsom AR, Heiss G, Selvin E, Lutsey PL, Coresh JJ |
Secondary Authors | Matsushita K |
Journal | Atherosclerosis |
Volume | 267 |
Pagination | 167-174 |
Date Published | 2017 Dec |
ISSN | 1879-1484 |
Keywords | beta 2-Microglobulin, Biomarkers, Body Mass Index, Bone and Bones, Bone Density, Calcium, Creatinine, Cystatin C, Female, Fibroblast Growth Factors, Follow-Up Studies, Glomerular Filtration Rate, Hospitalization, Humans, Incidence, Kidney, Kidney Function Tests, Male, Middle Aged, Parathyroid Hormone, Peripheral Arterial Disease, Phosphorus, Proportional Hazards Models, Prospective Studies, Risk Factors |
Abstract | BACKGROUND AND AIMS: Reduced kidney function is a risk factor for lower-extremity peripheral artery disease (PAD). However, the associations of novel filtration markers with PAD are yet to be quantified. Moreover, little is known on whether bone-mineral metabolism (BMM) markers are related to incident PAD beyond kidney function. METHODS: Using data from 12,472 participants at baseline (1990-1992) of the Atherosclerosis Risk in Communities (ARIC) study, we comprehensively quantified the associations of kidney related markers with incident PAD (defined as hospitalizations with diagnosis of lower-extremity atherosclerosis, revascularization, or amputation). Kidney related markers of interest included estimated glomerular filtration rate (eGFR) (based on creatinine, cystatin C, and both), cystatin C, beta-2 microglobulin (B2M), and BMM markers (serum fibroblast growth factor 23, parathyroid hormone, calcium, and phosphorus). RESULTS: During a median follow-up of 21 years, 471 participants developed incident PAD. Low eGFR was significantly associated with future PAD risk, with slightly stronger relationship when cystatin C was used (adjusted hazard ratio [HR] 6.3-8.3 for eGFR CONCLUSIONS: Kidney dysfunction was independently associated with future PAD risk, particularly when assessed with cystatin C and B2M. Among the BMM markers tested, phosphorus was most robustly associated with incident PAD beyond kidney function. Our results suggest the potential usefulness of novel filtration markers for PAD risk assessment and the possible role of phosphorus in the pathophysiology of PAD. |
DOI | 10.1016/j.atherosclerosis.2017.09.020 |
Alternate Journal | Atherosclerosis |
PubMed ID | 28992939 |
PubMed Central ID | PMC5705382 |
Grant List | HHSN268201100012C / HL / NHLBI NIH HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States R01 DK089174 / DK / NIDDK NIH HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States K24 DK106414 / DK / NIDDK NIH HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States |