Cigarette Smoking is Associated with Decreased Bone Gla-protein (BGP) Levels in Hemodialysis Patients

Curr Vasc Pharmacol. 2018;16(6):603-609. doi: 10.2174/1570161115666170919182421.

Abstract

Background: Bone Gamma-carboxyglutamic acid (Gla)-protein (BGP or osteocalcin) is a vitamin K-dependent protein involved in the regulation of bone mineralization. Smoking is a risk factor for osteoporosis.

Methods: We carried out a secondary analysis of the Vitamin K Italian (VIKI) study to investigate the association between cigarette smoking and BGP levels in patients with end stage renal disease. Data were collected in 370 haemodialysis patients, 37% (136) smokers (or ex-smokers) and 63% (234) nonsmokers. Vascular calcifications and vertebral fractures (quantitative morphometry) were identified on spine radiographs.

Results: Smokers had significantly lower BGP levels (152 vs. 204 µg/L, p=0.003). Smokers had lower plasma phosphate levels (4.2 vs. 4.7 mg/dl, p<0.01). Lower BGP levels were associated with aortic calcification (p<0.001), iliac calcification (p=0.042) and vertebral fractures (p=0.023). In addition, the regression model showed that smoking is associated with a significant reduction of total BGP levels by about 18% (p=0.01).

Conclusion: This is the first clinical study in a haemodialysis population, which identifies cigarette smoking as a potential factor that can lower BGP levels, a protective agent in bone and vascular health.

Keywords: BGP; bone; haemodialysis; osteocalcin; smoke; vascular calcification; vertebral fractures..

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Cigarette Smoking / adverse effects
  • Cigarette Smoking / blood*
  • Cigarette Smoking / epidemiology
  • Down-Regulation
  • Female
  • Humans
  • Italy / epidemiology
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Non-Smokers
  • Osteocalcin / blood*
  • Osteoporotic Fractures / blood
  • Osteoporotic Fractures / diagnostic imaging
  • Osteoporotic Fractures / epidemiology
  • Renal Dialysis*
  • Risk Factors
  • Smokers*
  • Spinal Fractures / blood
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / epidemiology
  • Vascular Calcification / blood
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / epidemiology

Substances

  • BGLAP protein, human
  • Biomarkers
  • Osteocalcin