Impact of circulating cathepsin K on the coronary calcification and the clinical outcome in chronic kidney disease patients

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• 作者：Yusuke Izumi ; Mutsuharu Hayashi ; Ryota Morimoto ; Xian Wu Cheng…
• 关键词：Cathepsin K (CatK) ; Chronic kidney disease (CKD) ; Coronary artery calcification (CAC) ; Brain natriuretic peptide (BNP)
• 刊名：Heart and Vessels
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：31
• 期：1
• 页码：6-14
• 全文大小：1,023 KB
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• 作者单位：Yusuke Izumi (1)
  Mutsuharu Hayashi (1) (2)
  Ryota Morimoto (1)
  Xian Wu Cheng (1)
  Hongxian Wu (1)
  Hideki Ishii (1)
  Yoshinari Yasuda (3)
  Daiji Yoshikawa (2)
  Hideo Izawa (2)
  Seiichi Matsuo (3)
  Yutaka Oiso (4)
  Toyoaki Murohara (1)
  
  1. Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Nagoya, Aichi, 466-8550, Japan
  2. Department of Cardiology, Fujita Health University Second Hospital, Nagoya, Japan
  3. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
  4. Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Cardiac Surgery
  Vascular Surgery
  Biomedical Engineering
  Interventional Radiology
  Ultrasound
  
• 出版者：Springer Japan
• ISSN：1615-2573

文摘

Chronic kidney disease (CKD) is a cause of coronary artery calcification (CAC) and an independent predictor of major adverse cardiac and cerebrovascular events (MACCE). Cathepsin K (CatK) is a lysosomal cysteine protease which affects vascular calcification and glucose metabolism disorder. We investigated the relationships among CatK, CAC, diabetes mellitus (DM) and MACCE in CKD patients. 113 consecutive CKD patients were enrolled. Their CAC was evaluated by computed tomography. Their plasma CatK level was measured by ELISA. They were divided into two groups by CatK levels and followed up for up to 3 years. The impact of CatK was analyzed in all participants, diabetic patients and non-diabetic patients. Kaplan–Meier analysis demonstrated a significant higher incidence of MACCE in the high CatK group (P = 0.028). The CatK level was significantly higher in patients with MACCE compared to that in patients without MACCE (P = 0.034). Cox’s model revealed the higher plasma CatK and BNP level as independent predictors of MACCE (P = 0.043 and P < 0.01, respectively). Only in non-diabetic patients, there was a significant correlation between CatK and CAC score, and high CatK group had a significant higher level of LDL-C and LDL-C/HDL-C ratio (P < 0.05 and P < 0.001, respectively) than low CatK group. And these lipid disorders were independent predictors of CatK elevation. In CKD patients, our results indicated an impact of higher CatK level on their MACCE. The significant association among the CatK level, CAC and MACCE was found in non-diabetic CKD patients.