Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients

• Published in: Scientific reports 2024-01, Vol.14 (1), p.939-939, Article 939
• Main Authors: Kim, Ji-Hwan, Noh, Hye-Mi, Song, Hong Ji, Lee, Sion, Kim, Sung Gyun, Kim, Jwa-Kyung
• Format: Article
• Language: English
• Subjects: 692/4019/592; 692/4022; 692/53/2423; Aortic arch; Calcification; Calcification (ectopic); Cardiovascular diseases; Galectin 3; Galectins; Heart Disease Risk Factors; Hemodialysis; Humanities and Social Sciences; Humans; Inflammation; Mortality; multidisciplinary; Renal Dialysis - adverse effects; Risk factors; Science; Science (multidisciplinary); Vascular Calcification
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-51383-2

Galectin-3 levels have been studied as a potential biomarker for predicting cardiovascular (CV) risk and mortality in hemodialysis (HD) patients. Recently, a close relationship between galectin-3 and vascular calcification (VC) has been reported. Here, we investigated the role of VC as a mediating factor in the association between galectin-3 and mortality. Serum galectin-3 and baseline aortic arch calcification (AoAC) score were measured in 477 incident HD patients. Mortality data were obtained at a median follow-up of 40 months. Causal mediation analysis was performed to examine the effect of vascular risk factors on galectin-3-related mortality. The prevalence of AoAC in HD patients was 57% (n = 272), and elevated galectin-3 levels were associated with a significantly increased risk of AoAC. When the galectin-3 level was divided by the median level of 37 ng/mL, a higher galectin group increased the risk of all-cause mortality by 1.71-fold (95% CI 1.02–2.92, p = 0.048), even after adjustment for multiple CV risk factors. Mediation analysis showed that both the direct effect of the galectin-3 on mortality (β = 0.0368, bootstrapped 95% CI [0.0113–0.0622]) and the indirect effects were significant. AoAC score and high-sensitivity CRP levels significantly mediated the association between galectin-3 and mortality (total indirect effects: β = 0.0188, bootstrapped 95% CI [0.0066–0.0352]). This study suggests that the association between high galectin-3 and mortality may be partially mediated by higher VC and inflammatory state in HD patients.