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Kidney function, bone-mineral metabolism markers, and future risk of peripheral artery disease.

TitleKidney function, bone-mineral metabolism markers, and future risk of peripheral artery disease.
Publication TypeJournal Article
Year of Publication2017
AuthorsYang C, Kwak L, Ballew SH, Garimella PS, Jaar BG, Folsom AR, Heiss G, Selvin E, Lutsey PL, Coresh JJ
Secondary AuthorsMatsushita K
JournalAtherosclerosis
Volume267
Pagination167-174
Date Published2017 Dec
ISSN1879-1484
Keywordsbeta 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.

DOI10.1016/j.atherosclerosis.2017.09.020
Alternate JournalAtherosclerosis
PubMed ID28992939
PubMed Central IDPMC5705382
Grant ListHHSN268201100012C / 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