Coronary artery calcification and aortic valve calcification in patients with kidney failure : a sex-disaggregated study
Ward, Liam J. ; Laucyte-Cibulskiene, Agne LU
; Hernandez, Leah
; Ripsweden, Jonaz
; Stenvinkel, Peter
and Kublickiene, Karolina
(2023)
In Biology of Sex Differences
14(1).
- Abstract
Background: Chronic kidney disease (CKD) is linked to an increased cardiovascular disease (CVD) burden. Albeit underappreciated, sex differences are evident in CKD with females being more prone to CKD development, but males progressing more rapidly to kidney failure (KF). Cardiovascular remodelling is a hallmark of CKD with increased arterial and valvular calcification contributing to CKD. However, little is known regarding sex differences in calcific cardiovascular remodelling in KF patients. Thus, we hypothesise that sex differences are present in coronary artery calcification (CAC) and aortic valve calcification (AVC) in patients with KF. Methods: KF patients, males (n = 214) and females (n = 107), that had undergone computer... (More)
Background: Chronic kidney disease (CKD) is linked to an increased cardiovascular disease (CVD) burden. Albeit underappreciated, sex differences are evident in CKD with females being more prone to CKD development, but males progressing more rapidly to kidney failure (KF). Cardiovascular remodelling is a hallmark of CKD with increased arterial and valvular calcification contributing to CKD. However, little is known regarding sex differences in calcific cardiovascular remodelling in KF patients. Thus, we hypothesise that sex differences are present in coronary artery calcification (CAC) and aortic valve calcification (AVC) in patients with KF. Methods: KF patients, males (n = 214) and females (n = 107), that had undergone computer tomography (CT) assessment for CAC and AVC were selected from three CKD cohorts. All patients underwent non-contrast multi-detector cardiac CT scanning, with CAC and AVC scoring based on the Agatston method. Baseline biochemical measurements were retrieved from cohort databases, including plasma analyses for inflammation markers (IL-6, TNF, hsCRP) and oxidative stress by skin autofluorescence measuring advanced glycation end-products (AGE), amongst other variables. Results: Sex-disaggregated analyses revealed that CAC score was associated with age in both males and females (both p < 0.001). Age-adjusted analyses revealed that in males CAC was associated with diabetes mellitus (DM) (p = 0.018) and CVD (p = 0.011). Additionally, for females CAC associated with IL-6 (p = 0.005) and TNF (p = 0.004). In both females and males CAC associated with AGE (p = 0.042 and p = 0.05, respectively). CAC was associated with mortality for females (p = 0.015) independent of age. AVC in females was not reviewed due to low AVC-positive samples (n = 14). In males, in multivariable regression AVC was associated with age (p < 0.001) and inflammation, as measured by IL-6 (p = 0.010). Conclusions: In female KF patients inflammatory burden and oxidative stress were associated with CAC. Whereas in male KF patients oxidative stress and inflammation were associated with CAC and AVC, respectively. Our findings suggest a sex-specific biomarker signature for cardiovascular calcification that may affect the development of cardiovascular complications in males and females with KF.
(Less)
- author
- Ward, Liam J.
; Laucyte-Cibulskiene, Agne
LU
; Hernandez, Leah
; Ripsweden, Jonaz
; Stenvinkel, Peter
and Kublickiene, Karolina
- author collaboration
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Calcific aortic valve disease, Calcification, Cardiovascular disease, Chronic kidney disease, Inflammation, Oxidative stress, Vascular remodelling
- in
- Biology of Sex Differences
- volume
- 14
- issue
- 1
- article number
- 48
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:37443048
- scopus:85164846883
- ISSN
- 2042-6410
- DOI
- 10.1186/s13293-023-00530-x
- language
- English
- LU publication?
- yes
- id
- 7858b7ae-304e-44d3-b1cc-855574e1c0de
- date added to LUP
- 2023-08-28 15:46:18
- date last changed
- 2024-04-20 02:07:18
@article{7858b7ae-304e-44d3-b1cc-855574e1c0de,
abstract = {{<p>Background: Chronic kidney disease (CKD) is linked to an increased cardiovascular disease (CVD) burden. Albeit underappreciated, sex differences are evident in CKD with females being more prone to CKD development, but males progressing more rapidly to kidney failure (KF). Cardiovascular remodelling is a hallmark of CKD with increased arterial and valvular calcification contributing to CKD. However, little is known regarding sex differences in calcific cardiovascular remodelling in KF patients. Thus, we hypothesise that sex differences are present in coronary artery calcification (CAC) and aortic valve calcification (AVC) in patients with KF. Methods: KF patients, males (n = 214) and females (n = 107), that had undergone computer tomography (CT) assessment for CAC and AVC were selected from three CKD cohorts. All patients underwent non-contrast multi-detector cardiac CT scanning, with CAC and AVC scoring based on the Agatston method. Baseline biochemical measurements were retrieved from cohort databases, including plasma analyses for inflammation markers (IL-6, TNF, hsCRP) and oxidative stress by skin autofluorescence measuring advanced glycation end-products (AGE), amongst other variables. Results: Sex-disaggregated analyses revealed that CAC score was associated with age in both males and females (both p < 0.001). Age-adjusted analyses revealed that in males CAC was associated with diabetes mellitus (DM) (p = 0.018) and CVD (p = 0.011). Additionally, for females CAC associated with IL-6 (p = 0.005) and TNF (p = 0.004). In both females and males CAC associated with AGE (p = 0.042 and p = 0.05, respectively). CAC was associated with mortality for females (p = 0.015) independent of age. AVC in females was not reviewed due to low AVC-positive samples (n = 14). In males, in multivariable regression AVC was associated with age (p < 0.001) and inflammation, as measured by IL-6 (p = 0.010). Conclusions: In female KF patients inflammatory burden and oxidative stress were associated with CAC. Whereas in male KF patients oxidative stress and inflammation were associated with CAC and AVC, respectively. Our findings suggest a sex-specific biomarker signature for cardiovascular calcification that may affect the development of cardiovascular complications in males and females with KF.</p>}},
author = {{Ward, Liam J. and Laucyte-Cibulskiene, Agne and Hernandez, Leah and Ripsweden, Jonaz and Stenvinkel, Peter and Kublickiene, Karolina}},
issn = {{2042-6410}},
keywords = {{Calcific aortic valve disease; Calcification; Cardiovascular disease; Chronic kidney disease; Inflammation; Oxidative stress; Vascular remodelling}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Biology of Sex Differences}},
title = {{Coronary artery calcification and aortic valve calcification in patients with kidney failure : a sex-disaggregated study}},
url = {{http://dx.doi.org/10.1186/s13293-023-00530-x}},
doi = {{10.1186/s13293-023-00530-x}},
volume = {{14}},
year = {{2023}},
}