Increased Elastin Degradation in Pseudoxanthoma Elasticum Is Associated with Peripheral Arterial Disease Independent of Calcification
Abstract
:1. Introduction
2. Methods
2.1. Participants and Demographics
2.2. Plasma Desmosines
2.3. Arterial Calcification and Vascular Function Tests
2.4. Pulmonary Abnormalities
2.5. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Association of Plasma Desmosine with Ankle Brachial Index and Peripheral Arterial Disease
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
Disclosures
References
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Characteristic | PXE (n = 93) | Control (n = 72) | p Value |
---|---|---|---|
Age, years | 57 ± 9 | 60 ± 10 | 0.10 |
Female sex, n (%) | 51 (55%) | 30 (42%) | 0.09 |
Body mass index | 26.1 ± 3.7 | 25.4 ± 4.1 | 0.32 |
Systolic blood pressure (mmHg) | 135 ± 18 | 131 ± 16 | 0.21 |
Diastolic blood pressure (mmHg) | 77 ± 10 | 78 ± 10 | 0.53 |
Revascularization surgery (PTA or bypass) | 7 (8%) | ||
Blood pressure lowering medication, n (%) | 27 (29%) | ||
Lipid lowering medication, n (%) | 62 (67%) | ||
Smoking current, n (%) | 15 (16%) | ||
Smoking former, n (%) | 61 (66%) | ||
Diabetes mellitus 2, n (%) | 5 (5%) | ||
LDL cholesterol (mmol/L) | 3.0 ± 1.1 | 3.4 ± 1.2 | <0.01 * |
Glomerular filtration rate (mL/min/1.73 m²) | 90 (80–90) | 90 (82–90) | 0.82 |
Desmosines (ng/L) | 350 (290–410) | 320 (280–360) | 0.02 * |
Arterial calcification mass | PXE (n = 93) | - | |
Peripheral arteries, mass score | 1190 (262–1892) | - | |
Total, mass score | 2281 (946–4951) | - | |
Arterial function test | PXE (n = 92) | - | |
Ankle brachial index, resting | 0.92 ± 0.19 | ||
Peripheral arterial disease (ABI < 0.9), resting, n (%) | 34 (37%) | ||
Ankle brachial index, exercise | 0.80 ± 0.26 | - | |
Peripheral arterial disease (ABI < 0.9), exercise, n (%) | 52 (57%) | - | |
Fontaine classification | PXE (n = 93) | ||
No PAD | 41 (44%) | ||
Fontaine 1: asymptomatic | 31 (33%) | ||
Fontaine 2: claudication | 21 (23%) | ||
Pulmonary abnormalities | |||
Pulmonary abnormalities, n (%) | 11 (12%) | - | |
Emphysema, n (%) | 8 (9%) | - | |
Trace (<1% of lung volume) | 4 (4%) | - | |
Mild (1–5% of lung volume) | 3 (3%) | - | |
Moderate (5–20% of lung volume) | 1 (1%) | - | |
Pulmonary fibrosis, n (%) | 2 (2%) | - | |
Bronchiectasis, n (%) | 1 (1%) | - |
Total Group (n = 93) | Age and Sex Adjusted β (95%CI) | Age, Sex, BMI, Smoking, and DM Adjusted β (95%CI) | Age, Sex, BMI, Smoking, DM, and Pulmonary Abnormalities Adjusted β (95%CI) |
---|---|---|---|
Peripheral arterial calcification mass | 17 (−9; 43) | 15 (−11; 40) | 7 (−17; 31) |
Total arterial calcification mass | 26 (−8; 60) | 25 (−9; 59) | 12 (−21; 45) |
Ankle brachial index | −72 (−132; −12) * | −77 (−140; −13) * | −68 (−132; −3) * |
Peripheral arterial disease | 42 (10; 73) ** | 44 (11; 77) ** | 40 (7; 73) * |
Fontaine classification | 35 (12; 59) ** | 41 (17; 64) ** | 30 (6; 53) * |
Patients with CT and blood collection on same day (n = 73) | |||
Peripheral arterial calcification mass | 57 (10; 104) * | 54 (9; 99) * | 28 (−16; 72) |
Total arterial calcification mass | 59 (7; 110) * | 55 (4; 105) * | 22 (−28; 72) |
Patients with pulmonary abnormalities excluded (n = 82) | |||
Peripheral arterial calcification mass | 3 (−19; 25) | 3 (−19; 25) | - |
Total arterial calcification mass | −1 (−30; 28) | −0 (−31; 30) | - |
Ankle brachial index | −57 (−119; 5) | −69 (−135; −3) * | - |
Peripheral arterial disease | 34 (2; 67) * | 38 (5; 72) * | - |
Fontaine classification | 25 (5; 46) * | 30 (8; 52) ** | - |
Adjusted for Peripheral Arterial Calcification β/OR (95%CI) | p-Value for Interaction | Adjusted for Total Arterial Calcification β/OR (95%CI) | p-Value for Interaction | |
---|---|---|---|---|
Ankle brachial index | −0.71 (−1.38; −0.03) * | 0.63 | −0.71 (−1.39; −0.03) * | 0.57 |
Peripheral arterial disease | 1.01 (1.00; 1.02) * | 0.09 | 1.01 (1.00; 1.02) * | 0.65 |
Fontaine classification | 1.01 (1.00; 1.01) * | 0.07 | 1.01 (1.00; 1.01) * | 0.38 |
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Bartstra, J.W.; Spiering, W.; van den Ouweland, J.M.W.; Mali, W.P.T.M.; Janssen, R.; de Jong, P.A. Increased Elastin Degradation in Pseudoxanthoma Elasticum Is Associated with Peripheral Arterial Disease Independent of Calcification. J. Clin. Med. 2020, 9, 2771. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9092771
Bartstra JW, Spiering W, van den Ouweland JMW, Mali WPTM, Janssen R, de Jong PA. Increased Elastin Degradation in Pseudoxanthoma Elasticum Is Associated with Peripheral Arterial Disease Independent of Calcification. Journal of Clinical Medicine. 2020; 9(9):2771. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9092771
Chicago/Turabian StyleBartstra, Jonas W., Wilko Spiering, Jody M. W. van den Ouweland, Willem P. T. M. Mali, Rob Janssen, and Pim A. de Jong. 2020. "Increased Elastin Degradation in Pseudoxanthoma Elasticum Is Associated with Peripheral Arterial Disease Independent of Calcification" Journal of Clinical Medicine 9, no. 9: 2771. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9092771