Abstract
Introduction Sclerostin has been reported to be a novel biomarker associated with the bone-vascular axis. In this study, we determined the relationships between serum sclerostin and all-cause mortality, the prevalence of cardiovascular events (CVEs), and coronary artery calcifications (CACs) in dialysis patients. Methods A total of 165 dialysis patients (84 hemodialysis [HD] and 81 peritoneal dialysis [PD]) were enrolled in this study. We performed multivariable linear regression analysis to test the relationships between serum sclerostin levels and demographics and clinical parameters. We also performed Cox proportional hazard regression analysis to determine independent predictors of overall survival and CVEs. Results The median serum sclerostin level was 250.9 pg/mL in dialysis patients. Kaplan–Meier analysis showed that both overall and CVE-free survival rates were significantly lower in the high serum sclerostin group (serum sclerostin level >250.9 pg/mL) compared to the low serum sclerostin group (serum sclerostin level ≤250.9 pg/mL) in patients with PD (p < 0.05). In patients with HD, only CVE-free survival rates notably declined in the high serum sclerostin group compared to the low serum sclerostin group (p = 0.029). However, serum sclerostin level was only an independent predictor of all-cause mortality and CVEs in patients with PD after adjusting for confounding factors (p < 0.05), and therefore was not an independent predictor for patients with HD (p > 0.05). Conclusions A low serum sclerostin was associated with better overall survival and lower prevalence of CVEs in patients with PD, but had no relationships in patients with HD. We found that serum sclerostin level was not correlated with CACs in either patients with HD or PD.
Highlights
Sclerostin has been reported to be a novel biomarker associated with the bonevascular axis
We investigated the associations between serum sclerostin levels and all-cause mortality, cardiovascular events (CVEs), and CACs in dialysis patients, as assessed by chest computed tomography (CT)
Based on the Spearman correlation analysis, the serum sclerostin levels were positively associated with diabetes (p 1⁄4 0.004), but negatively associated with dialysis duration (p 1⁄4 0.036), diastolic BP (p 1⁄4 0.002), and intact parathyroid hormone (iPTH) (p 1⁄4 0.037) in the HD group
Summary
Sclerostin has been reported to be a novel biomarker associated with the bonevascular axis. We determined the relationships between serum sclerostin and allcause mortality, the prevalence of cardiovascular events (CVEs), and coronary artery calcifications (CACs) in dialysis patients. We performed Cox proportional hazard regression analysis to determine independent predictors of overall survival and CVEs. Results: The median serum sclerostin level was 250.9 pg/mL in dialysis patients. There is accumulating evidence that the Wnt/b-catenin pathway is involved in bonevascular cross-talk [11,12] These discoveries have prompted some to speculate that sclerostin may play an extra-skeletal role in VCs [13]. Previous studies have shown a positive or negative relationship, as well as no correlation, between circulating sclerostin levels and VCs across different populations, and such inconsistent results have been reported between
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