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The Vessels-Bone Axis: Iliac Artery Calcifications, Vertebral Fractures and Vitamin K from VIKI Study

National Research Council (CNR), Institute of Clinical Physiology (IFC), 56124 Pisa, Italy
Department of Medicine, University of Padova, 35128 Padova, Italy
CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Ospedali Riuniti, 89124 Reggio Calabria, Italy
Laboratory Medicine Unit, Department of Medicine, University of Padua, 35129 Padua, Italy
Clinica Medica 1, Department of Medicine, University of Padua, 35128 Padua, Italy
Bioengineering and Computing Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
Nephrology, Dialysis and Renal Transplant Unit, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy
Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Università di Milano, 20157 Milano, Italy
Nephrology Unit, ASST Fate Bene Fratelli Sacco, 20157 Milano, Italy
Unit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, 20157 Milan, Italy
Department of Clinical Sciences and Community Health, University of Milan, 20157 Milan, Italy
Policlinico San Martino, 16132 Genova, Italy
Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
Service des Maladies Osseuses, Département de Médecine, HUG, 1205 Genève, Switzerland
Department of General Internal Medicine and Nephrology, Robert-Bosch-Krankenhaus, 70376 Stuttgart, Germany
Independent Researcher, 09100 Cagliari, Italy
Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
Cardiology, Cardiovascular Division, Pisa University Hospital, University of Pisa, Via Paradisa 2, 56126 Pisa, Italy
Fondazione Villa Serena per la Ricerca, Città Sant’Angelo, 65013 Pescara, Italy
Author to whom correspondence should be addressed.
Academic Editor: LaVerne L. Brown
Nutrients 2021, 13(10), 3567;
Received: 23 August 2021 / Revised: 6 October 2021 / Accepted: 9 October 2021 / Published: 12 October 2021
Vascular calcification and fragility fractures are associated with high morbidity and mortality, especially in end-stage renal disease. We evaluated the relationship of iliac arteries calcifications (IACs) and abdominal aortic calcifications (AACs) with the risk for vertebral fractures (VFs) in hemodialysis patients. The VIKI study was a multicenter cross-sectional study involving 387 hemodialysis patients. The biochemical data included bone health markers, such as vitamin K levels, vitamin K-dependent proteins, vitamin 25(OH)D, alkaline phosphatase, parathormone, calcium, and phosphate. VF, IACs and AACs was determined through standardized spine radiograms. VF was defined as >20% reduction of vertebral body height, and VC were quantified by measuring the length of calcium deposits along the arteries. The prevalence of IACs and AACs were 56.1% and 80.6%, respectively. After adjusting for confounding variables, the presence of IACs was associated with 73% higher odds of VF (p = 0.028), whereas we found no association (p = 0.294) for AACs. IACs were associated with VF irrespective of calcification severity. Patients with IACs had lower levels of vitamin K2 and menaquinone 7 (0.99 vs. 1.15 ng/mL; p = 0.003), and this deficiency became greater with adjustment for triglycerides (0.57 vs. 0.87 ng/mL; p < 0.001). IACs, regardless of their extent, are a clinically relevant risk factor for VFs. The association is enhanced by adjusting for vitamin K, a main player in bone and vascular health. To our knowledge these results are the first in the literature. Prospective studies are needed to confirm these findings both in chronic kidney disease and in the general population. View Full-Text
Keywords: peripheral vascular disease; epidemiology; metabolic syndrome; vitamin K peripheral vascular disease; epidemiology; metabolic syndrome; vitamin K
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MDPI and ACS Style

Fusaro, M.; Tripepi, G.; Plebani, M.; Politi, C.; Aghi, A.; Taddei, F.; Schileo, E.; Zaninotto, M.; La Manna, G.; Cianciolo, G.; Gallieni, M.; Cosmai, L.; Messa, P.; Ravera, M.; Nickolas, T.L.; Ferrari, S.; Ketteler, M.; Iervasi, G.; Mereu, M.C.; Vettor, R.; Giannini, S.; Gasperoni, L.; Sella, S.; Brandi, M.L.; Cianferotti, L.; De Caterina, R. The Vessels-Bone Axis: Iliac Artery Calcifications, Vertebral Fractures and Vitamin K from VIKI Study. Nutrients 2021, 13, 3567.

AMA Style

Fusaro M, Tripepi G, Plebani M, Politi C, Aghi A, Taddei F, Schileo E, Zaninotto M, La Manna G, Cianciolo G, Gallieni M, Cosmai L, Messa P, Ravera M, Nickolas TL, Ferrari S, Ketteler M, Iervasi G, Mereu MC, Vettor R, Giannini S, Gasperoni L, Sella S, Brandi ML, Cianferotti L, De Caterina R. The Vessels-Bone Axis: Iliac Artery Calcifications, Vertebral Fractures and Vitamin K from VIKI Study. Nutrients. 2021; 13(10):3567.

Chicago/Turabian Style

Fusaro, Maria, Giovanni Tripepi, Mario Plebani, Cristina Politi, Andrea Aghi, Fulvia Taddei, Enrico Schileo, Martina Zaninotto, Gaetano La Manna, Giuseppe Cianciolo, Maurizio Gallieni, Laura Cosmai, Piergiorgio Messa, Maura Ravera, Thomas L. Nickolas, Serge Ferrari, Markus Ketteler, Giorgio Iervasi, Maria C. Mereu, Roberto Vettor, Sandro Giannini, Lorenzo Gasperoni, Stefania Sella, Maria L. Brandi, Luisella Cianferotti, and Raffaele De Caterina. 2021. "The Vessels-Bone Axis: Iliac Artery Calcifications, Vertebral Fractures and Vitamin K from VIKI Study" Nutrients 13, no. 10: 3567.

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