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International Urology and Nephrology
Published in: International Urology and Nephrology 9/2018

01-09-2018 | Nephrology - Original Paper

Low serum butyrylcholinesterase is independently related to low fetuin-A in patients on hemodialysis: a cross-sectional study

Authors: Teppei Okamoto, Chikako Tsutaya, Shingo Hatakeyama, Sakae Konishi, Kazutaka Okita, Yoshimi Tanaka, Kengo Imanishi, Tooru Takashima, Fumitada Saitoh, Tadashi Suzuki, Chikara Ohyama

Published in: International Urology and Nephrology | Issue 9/2018

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Abstract

Purpose

Fetuin-A, which plays a protective role against the atherosclerosis and progression of vascular calcification, is decreased in patients on hemodialysis (HD). Fetuin-A and serum butyrylcholinesterase (BChE) levels decrease during malnutrition. We explored whether BChE was independently related to fetuin-A in patients on HD.

Methods

Laboratory data including BChE and serum fetuin-A were acquired from 230 patients on HD between August 2017 and April 2018. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI). Abdominal aortic calcification index (ACI) was measured using computed tomography. Patients were stratified into two groups: low fetuin-A (< lowest quartile) and non-low fetuin-A (≥ lowest quartile) groups. Patient background, medication, and laboratory data were compared. The receiver operating characteristic analysis was conducted to determine the optimal cutoff values of BChE and GNRI for lower fetuin-A level. Factors independently related with lower fetuin-A levels were determined using multivariate logistic regression analysis.

Results

The lowest quartile value of fetuin-A and optimal cutoff values of BChE and GNRI were 0.213 g/L, 200 IU/L, and 92.6, respectively. The study included 57 and 173 patients in the low fetuin-A and non-low fetuin-A groups, respectively. Significant between-group differences were observed for age, C-reactive protein (CRP), history of cardiovascular disease, serum albumin, GNRI, and BChE. Multivariate analysis showed that BChE of < 200 IU/L [odds ratio (OR) 3.05], CRP (OR 2.49), and GNRI of < 92.6 (OR 2.34) were independent factors for lower fetuin-A level after adjusting for confounders.

Conclusions

BChE was a significant independent marker for fetuin-A levels in patients on HD, in addition to GNRI.
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Metadata
Title
Low serum butyrylcholinesterase is independently related to low fetuin-A in patients on hemodialysis: a cross-sectional study
Authors
Teppei Okamoto
Chikako Tsutaya
Shingo Hatakeyama
Sakae Konishi
Kazutaka Okita
Yoshimi Tanaka
Kengo Imanishi
Tooru Takashima
Fumitada Saitoh
Tadashi Suzuki
Chikara Ohyama
Publication date
01-09-2018
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 9/2018
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-018-1957-z

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