Mean corpuscular volume is associated with endothelial dysfunction and predicts composite cardiovascular events in patients with chronic kidney disease

Yalcin Solak, Mahmut Ilker Yilmaz, Mutlu Saglam, Seref Demirbas, Samet Verim, Hilmi Umut Unal, Abduzhappar Gaipov, Yusuf Oguz, Mehmet Kayrak, Kayser Caglar, Abdulgaffar Vural, Suleyman Turk, Adrian Covic, Mehmet Kanbay

Research output: Contribution to journalArticle

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Abstract

Aim Mean corpuscular volume (MCV) is a measure of size of red blood cells. Recently a few studies showed an association of macrocytosis with all-cause mortality. We aimed to assess the relationship of MCV with cardiovascular (CV) morbidity and mortality in patients with chronic kidney disease (CKD), and the effect of MCV on endothelial function. Methods This is an observational cohort study with a prospectively maintained cohort of patients with stage 1-5 CKD. Estimated glomerular filtration rate (eGFR), flow mediated dilatation (FMD) and laboratory values were measured at baseline. Multivariate linear and Cox regression analyses were used to predict independent associations of FMD and composite CV events, respectively. Results A total of 309 patients were included in the study. In contrast to anaemia MCV did not show a significant change among CKD groups. MCV was an independent predictor of FMD in addition to serum haemoglobin, CRP, diabetes, systolic blood pressure (SBP) and eGFR. Median MCV value was 85 fl. Kaplan-Meier analysis showed that at 38 months the survival rate was 97.6% in the group with MCV < 85 compared to 81.6% in the arm with MCV ≥ 85 (P < 0.001, log-rank test). Cox regression analysis showed MCV as a predictor of composite CV events independent of major confounding factors. Conclusion This is the first study in the literature showing an independent association of MCV and FMD. Our results also determined MCV as an independent predictor of composite CV events independent of anaemia, inflammation, diabetes and eGFR in patients with CKD. Summary at a Glance In CKD patients, this study clearly demonstrated that the mean corpuscular volume (MCV) is independently associated with composite cardiovascular events as well as flow mediated dilatation.

Original languageEnglish (US)
Pages (from-to)728-735
Number of pages8
JournalNephrology
Volume18
Issue number11
DOIs
StatePublished - Jan 1 2013

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Erythrocyte Indices
Chronic Renal Insufficiency
Dilatation
Glomerular Filtration Rate
Anemia
Regression Analysis
Blood Pressure
Mortality
Kaplan-Meier Estimate
Observational Studies
Linear Models
Hemoglobins
Cohort Studies
Survival Rate
Erythrocytes

All Science Journal Classification (ASJC) codes

  • Nephrology

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Mean corpuscular volume is associated with endothelial dysfunction and predicts composite cardiovascular events in patients with chronic kidney disease. / Solak, Yalcin; Yilmaz, Mahmut Ilker; Saglam, Mutlu; Demirbas, Seref; Verim, Samet; Unal, Hilmi Umut; Gaipov, Abduzhappar; Oguz, Yusuf; Kayrak, Mehmet; Caglar, Kayser; Vural, Abdulgaffar; Turk, Suleyman; Covic, Adrian; Kanbay, Mehmet.

In: Nephrology, Vol. 18, No. 11, 01.01.2013, p. 728-735.

Research output: Contribution to journalArticle

Solak, Y, Yilmaz, MI, Saglam, M, Demirbas, S, Verim, S, Unal, HU, Gaipov, A, Oguz, Y, Kayrak, M, Caglar, K, Vural, A, Turk, S, Covic, A & Kanbay, M 2013, 'Mean corpuscular volume is associated with endothelial dysfunction and predicts composite cardiovascular events in patients with chronic kidney disease', Nephrology, vol. 18, no. 11, pp. 728-735. https://doi.org/10.1111/nep.12130
Solak, Yalcin ; Yilmaz, Mahmut Ilker ; Saglam, Mutlu ; Demirbas, Seref ; Verim, Samet ; Unal, Hilmi Umut ; Gaipov, Abduzhappar ; Oguz, Yusuf ; Kayrak, Mehmet ; Caglar, Kayser ; Vural, Abdulgaffar ; Turk, Suleyman ; Covic, Adrian ; Kanbay, Mehmet. / Mean corpuscular volume is associated with endothelial dysfunction and predicts composite cardiovascular events in patients with chronic kidney disease. In: Nephrology. 2013 ; Vol. 18, No. 11. pp. 728-735.
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abstract = "Aim Mean corpuscular volume (MCV) is a measure of size of red blood cells. Recently a few studies showed an association of macrocytosis with all-cause mortality. We aimed to assess the relationship of MCV with cardiovascular (CV) morbidity and mortality in patients with chronic kidney disease (CKD), and the effect of MCV on endothelial function. Methods This is an observational cohort study with a prospectively maintained cohort of patients with stage 1-5 CKD. Estimated glomerular filtration rate (eGFR), flow mediated dilatation (FMD) and laboratory values were measured at baseline. Multivariate linear and Cox regression analyses were used to predict independent associations of FMD and composite CV events, respectively. Results A total of 309 patients were included in the study. In contrast to anaemia MCV did not show a significant change among CKD groups. MCV was an independent predictor of FMD in addition to serum haemoglobin, CRP, diabetes, systolic blood pressure (SBP) and eGFR. Median MCV value was 85 fl. Kaplan-Meier analysis showed that at 38 months the survival rate was 97.6{\%} in the group with MCV < 85 compared to 81.6{\%} in the arm with MCV ≥ 85 (P < 0.001, log-rank test). Cox regression analysis showed MCV as a predictor of composite CV events independent of major confounding factors. Conclusion This is the first study in the literature showing an independent association of MCV and FMD. Our results also determined MCV as an independent predictor of composite CV events independent of anaemia, inflammation, diabetes and eGFR in patients with CKD. Summary at a Glance In CKD patients, this study clearly demonstrated that the mean corpuscular volume (MCV) is independently associated with composite cardiovascular events as well as flow mediated dilatation.",
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T1 - Mean corpuscular volume is associated with endothelial dysfunction and predicts composite cardiovascular events in patients with chronic kidney disease

AU - Solak, Yalcin

AU - Yilmaz, Mahmut Ilker

AU - Saglam, Mutlu

AU - Demirbas, Seref

AU - Verim, Samet

AU - Unal, Hilmi Umut

AU - Gaipov, Abduzhappar

AU - Oguz, Yusuf

AU - Kayrak, Mehmet

AU - Caglar, Kayser

AU - Vural, Abdulgaffar

AU - Turk, Suleyman

AU - Covic, Adrian

AU - Kanbay, Mehmet

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Aim Mean corpuscular volume (MCV) is a measure of size of red blood cells. Recently a few studies showed an association of macrocytosis with all-cause mortality. We aimed to assess the relationship of MCV with cardiovascular (CV) morbidity and mortality in patients with chronic kidney disease (CKD), and the effect of MCV on endothelial function. Methods This is an observational cohort study with a prospectively maintained cohort of patients with stage 1-5 CKD. Estimated glomerular filtration rate (eGFR), flow mediated dilatation (FMD) and laboratory values were measured at baseline. Multivariate linear and Cox regression analyses were used to predict independent associations of FMD and composite CV events, respectively. Results A total of 309 patients were included in the study. In contrast to anaemia MCV did not show a significant change among CKD groups. MCV was an independent predictor of FMD in addition to serum haemoglobin, CRP, diabetes, systolic blood pressure (SBP) and eGFR. Median MCV value was 85 fl. Kaplan-Meier analysis showed that at 38 months the survival rate was 97.6% in the group with MCV < 85 compared to 81.6% in the arm with MCV ≥ 85 (P < 0.001, log-rank test). Cox regression analysis showed MCV as a predictor of composite CV events independent of major confounding factors. Conclusion This is the first study in the literature showing an independent association of MCV and FMD. Our results also determined MCV as an independent predictor of composite CV events independent of anaemia, inflammation, diabetes and eGFR in patients with CKD. Summary at a Glance In CKD patients, this study clearly demonstrated that the mean corpuscular volume (MCV) is independently associated with composite cardiovascular events as well as flow mediated dilatation.

AB - Aim Mean corpuscular volume (MCV) is a measure of size of red blood cells. Recently a few studies showed an association of macrocytosis with all-cause mortality. We aimed to assess the relationship of MCV with cardiovascular (CV) morbidity and mortality in patients with chronic kidney disease (CKD), and the effect of MCV on endothelial function. Methods This is an observational cohort study with a prospectively maintained cohort of patients with stage 1-5 CKD. Estimated glomerular filtration rate (eGFR), flow mediated dilatation (FMD) and laboratory values were measured at baseline. Multivariate linear and Cox regression analyses were used to predict independent associations of FMD and composite CV events, respectively. Results A total of 309 patients were included in the study. In contrast to anaemia MCV did not show a significant change among CKD groups. MCV was an independent predictor of FMD in addition to serum haemoglobin, CRP, diabetes, systolic blood pressure (SBP) and eGFR. Median MCV value was 85 fl. Kaplan-Meier analysis showed that at 38 months the survival rate was 97.6% in the group with MCV < 85 compared to 81.6% in the arm with MCV ≥ 85 (P < 0.001, log-rank test). Cox regression analysis showed MCV as a predictor of composite CV events independent of major confounding factors. Conclusion This is the first study in the literature showing an independent association of MCV and FMD. Our results also determined MCV as an independent predictor of composite CV events independent of anaemia, inflammation, diabetes and eGFR in patients with CKD. Summary at a Glance In CKD patients, this study clearly demonstrated that the mean corpuscular volume (MCV) is independently associated with composite cardiovascular events as well as flow mediated dilatation.

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U2 - 10.1111/nep.12130

DO - 10.1111/nep.12130

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JF - Nephrology

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