{"title":"长期华法林治疗和骨质疏松和动脉粥样硬化的生物标志物","authors":"Sayaka Namba , Minako Yamaoka-Tojo , Takehiro Hashikata , Yuki Ikeda , Lisa Kitasato , Takuya Hashimoto , Takao Shimohama , Taiki Tojo , Naonobu Takahira , Takashi Masuda , Junya Ako","doi":"10.1016/j.bbacli.2015.08.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Stroke prevention by warfarin, a vitamin K antagonist, has been an integral part in the management of atrial fibrillation. Vitamin K-dependent matrix Gla protein (MGP) has been known as a potent inhibitor of arterial calcification and osteoporosis. Therefore, we hypothesized that warfarin therapy affects bone mineral metabolism, vascular calcification, and vascular endothelial dysfunction.</p></div><div><h3>Methods</h3><p>We studied 42 atrial fibrillation patients at high-risk for atherosclerosis having one or more coronary risk factors. Twenty-four patients had been treated with warfarin for at least 12<!--> <!-->months (WF group), and 18 patients without warfarin (non-WF group). Bone alkaline phosphatase (BAP) and under carboxylated osteocalcin (ucOC) and receptor activator of nuclear factor-kappa B ligand (RANKL) were measured as bone metabolism markers. Reactive hyperemia-peripheral arterial tonometry (RH-PAT) index measured by Endo-PAT2000 was used as an indicator of vascular endothelial function.</p></div><div><h3>Results</h3><p>There were no significant differences in patient background characteristics and other clinical indicators between the two groups. In WF group, the ucOC levels were significantly higher than those in the non-WF group (10.3<!--> <!-->±<!--> <!-->0.8 vs. 3.4<!--> <!-->±<!--> <!-->0.9<!--> <!-->ng/mL; <em>P</em> <!--><<!--> <!-->0.01), similarly, the RANKL levels in the WF group were higher than those in the non-WF group (0.60<!--> <!-->±<!--> <!-->0.06 vs. 0.37<!--> <!-->±<!--> <!-->0.05<!--> <!-->ng/mL; <em>P</em> <!-->=<!--> <!-->0.007). Moreover, RH-PAT index was significantly lower in the WF group compared to those in the non-WF group (1.48<!--> <!-->±<!--> <!-->0.11 vs. 1.88<!--> <!-->±<!--> <!-->0.12; <em>P</em> <!-->=<!--> <!-->0.017).</p></div><div><h3>Conclusions</h3><p>Long-term warfarin therapy may be associated with bone mineral loss and vascular calcification in 60–80<!--> <!-->year old hypertensive patients.</p></div>","PeriodicalId":72344,"journal":{"name":"BBA clinical","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbacli.2015.08.002","citationCount":"42","resultStr":"{\"title\":\"Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis\",\"authors\":\"Sayaka Namba , Minako Yamaoka-Tojo , Takehiro Hashikata , Yuki Ikeda , Lisa Kitasato , Takuya Hashimoto , Takao Shimohama , Taiki Tojo , Naonobu Takahira , Takashi Masuda , Junya Ako\",\"doi\":\"10.1016/j.bbacli.2015.08.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Stroke prevention by warfarin, a vitamin K antagonist, has been an integral part in the management of atrial fibrillation. Vitamin K-dependent matrix Gla protein (MGP) has been known as a potent inhibitor of arterial calcification and osteoporosis. Therefore, we hypothesized that warfarin therapy affects bone mineral metabolism, vascular calcification, and vascular endothelial dysfunction.</p></div><div><h3>Methods</h3><p>We studied 42 atrial fibrillation patients at high-risk for atherosclerosis having one or more coronary risk factors. Twenty-four patients had been treated with warfarin for at least 12<!--> <!-->months (WF group), and 18 patients without warfarin (non-WF group). Bone alkaline phosphatase (BAP) and under carboxylated osteocalcin (ucOC) and receptor activator of nuclear factor-kappa B ligand (RANKL) were measured as bone metabolism markers. Reactive hyperemia-peripheral arterial tonometry (RH-PAT) index measured by Endo-PAT2000 was used as an indicator of vascular endothelial function.</p></div><div><h3>Results</h3><p>There were no significant differences in patient background characteristics and other clinical indicators between the two groups. In WF group, the ucOC levels were significantly higher than those in the non-WF group (10.3<!--> <!-->±<!--> <!-->0.8 vs. 3.4<!--> <!-->±<!--> <!-->0.9<!--> <!-->ng/mL; <em>P</em> <!--><<!--> <!-->0.01), similarly, the RANKL levels in the WF group were higher than those in the non-WF group (0.60<!--> <!-->±<!--> <!-->0.06 vs. 0.37<!--> <!-->±<!--> <!-->0.05<!--> <!-->ng/mL; <em>P</em> <!-->=<!--> <!-->0.007). Moreover, RH-PAT index was significantly lower in the WF group compared to those in the non-WF group (1.48<!--> <!-->±<!--> <!-->0.11 vs. 1.88<!--> <!-->±<!--> <!-->0.12; <em>P</em> <!-->=<!--> <!-->0.017).</p></div><div><h3>Conclusions</h3><p>Long-term warfarin therapy may be associated with bone mineral loss and vascular calcification in 60–80<!--> <!-->year old hypertensive patients.</p></div>\",\"PeriodicalId\":72344,\"journal\":{\"name\":\"BBA clinical\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.bbacli.2015.08.002\",\"citationCount\":\"42\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BBA clinical\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2214647415000896\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BBA clinical","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214647415000896","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis
Background
Stroke prevention by warfarin, a vitamin K antagonist, has been an integral part in the management of atrial fibrillation. Vitamin K-dependent matrix Gla protein (MGP) has been known as a potent inhibitor of arterial calcification and osteoporosis. Therefore, we hypothesized that warfarin therapy affects bone mineral metabolism, vascular calcification, and vascular endothelial dysfunction.
Methods
We studied 42 atrial fibrillation patients at high-risk for atherosclerosis having one or more coronary risk factors. Twenty-four patients had been treated with warfarin for at least 12 months (WF group), and 18 patients without warfarin (non-WF group). Bone alkaline phosphatase (BAP) and under carboxylated osteocalcin (ucOC) and receptor activator of nuclear factor-kappa B ligand (RANKL) were measured as bone metabolism markers. Reactive hyperemia-peripheral arterial tonometry (RH-PAT) index measured by Endo-PAT2000 was used as an indicator of vascular endothelial function.
Results
There were no significant differences in patient background characteristics and other clinical indicators between the two groups. In WF group, the ucOC levels were significantly higher than those in the non-WF group (10.3 ± 0.8 vs. 3.4 ± 0.9 ng/mL; P < 0.01), similarly, the RANKL levels in the WF group were higher than those in the non-WF group (0.60 ± 0.06 vs. 0.37 ± 0.05 ng/mL; P = 0.007). Moreover, RH-PAT index was significantly lower in the WF group compared to those in the non-WF group (1.48 ± 0.11 vs. 1.88 ± 0.12; P = 0.017).
Conclusions
Long-term warfarin therapy may be associated with bone mineral loss and vascular calcification in 60–80 year old hypertensive patients.