SAT-059 SERUM SCLEROSTIN IS A PREDICTOR FOR CENTRAL ARTERIAL STIFFNESS IN CHRONIC HEMODIALYSIS PATIENTS

Abstract

Wnt/β-catenin signaling inhibitors such as sclerostin and Dickkopf-1 (DKK1) may avoid further vascular calcification. Vascular calcification is associated with arterial stiffness and osteoprogenitor cells play an important role in the bone–vascular axis which regulates calcium metabolism around the arterial wall. This study aims to investigate the relationship between serum sclerostin, DKK1 levels and carotid–femoral pulse wave velocity (cfPWV) among patients in hemodialysis (HD). Blood samples were obtained from 122 chronic HD patients that had received standard 4-hour dialysis 3 times per week. Patients with cfPWV values of >10 m/s were classified in the high central arterial stiffness group, whereas those with cfPWV values of ≤ 10 m/s were assigned to the control group. Serum sclerostin and Dickkopf-1 (DKK1) levels were quantified using commercially available enzyme-linked immunosorbent assays. Fifty-three HD patients (43.4%) who belonged to the high central arterial stiffness group were generally older (P = 0.004), higher incidence of diabetes mellitus (P < 0.001), hypertension (P = 0.020), average systolic blood pressures (SBP, P = 0.018), serum C-reactive protein (CRP, P = 0.003), and sclerostin levels (P = 0.002) than their counterparts in the control group. A multivariable logistic regression analysis identified sclerostin as an independent predictor of central arterial stiffness in hypertensive patients (odds ratio, 1.017; 95% confidence interval (CI), 1.007–1.027; P = 0.001). Multivariable forward stepwise linear regression analysis also showed that serum logarithmically transformed sclerostin level (log-sclerostin, β = 0.311, adjusted R2 change: 0.125, P < 0.0013) was positively associated with cfPWV values in patients with chronic HD. In this study, serum sclerostin level, but not DKK1, is found to be positively correlated with cfPWV values and is identified as an independent predictor of central arterial stiffness in chronic HD patients.