Serum Sclerostin Is Associated with Peripheral and Central Systolic Blood Pressure in Pediatric Patients with Primary Hypertension.

Piotr Skrzypczyk,Małgorzata Pańczyk-Tomaszewska,Anna Stelmaszczyk-Emmel,Michał Szyszka,Elżbieta Górska,Anna Ofiara

doi:10.3390/jcm10163574

Piotr Skrzypczyk, Małgorzata Pańczyk-Tomaszewska + Show 4 more

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https://doi.org/10.3390/jcm10163574

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Abstract

Recent studies showed the significance of the canonical Wnt/beta-catenin pathway and its inhibitor—sclerostin, in the formation of arterial damage, cardiovascular morbidity, and mortality. The study aimed to assess serum sclerostin concentration and its relationship with blood pressure, arterial damage, and calcium-phosphate metabolism in children and adolescents with primary hypertension (PH). Serum sclerostin concentration (pmol/L) was evaluated in 60 pediatric patients with PH and 20 healthy children. In the study group, we also assessed calcium-phosphate metabolism, office peripheral and central blood pressure, 24 h ambulatory blood pressure, and parameters of arterial damage. Serum sclerostin did not differ significantly between patients with PH and the control group (36.6 ± 10.6 vs. 41.0 ± 11.9 (pmol/L), p = 0.119). In the whole study group, sclerostin concentration correlated positively with height Z-score, phosphate, and alkaline phosphatase, and negatively with age, peripheral systolic and mean blood pressure, and central systolic and mean blood pressure. In multivariate analysis, systolic blood pressure (SBP) and height expressed as Z-scores were the significant determinants of serum sclerostin in the studied children: height Z-score (β = 0.224, (95%CI, 0.017–0.430)), SBP Z-score (β = −0.216, (95%CI, −0.417 to −0.016)). In conclusion, our results suggest a significant association between sclerostin and blood pressure in the pediatric population.

Highlights

It is estimated that arterial hypertension (AH) affects 3–5% of the pediatric population, and its frequency increases with the age of the children studied [1]
In children with primary hypertension (PH), we showed no difference in serum sclerostin concentration between boys and girls (38.2 ± 10.0 vs. 34.1 ± 11.2, p = 0.142) and between patients treated and untreated with antihypertensive agents (34.3 ± 10.6 vs. 38.3 ± 10.4, p = 0.151)
In a subanalysis of 35 untreated patients with primary hypertension, we found trends towards a negative correlation between serum sclerostin and peripheral systolic blood pressure (SBP) (r = −0.323, p = 0.058), SBP Z-score (r = −0.299, p = 0.081), central systolic blood pressure (AoSBP)) (r = −0.311, p = 0.069), central pulse pressure (AoPP) (r = −0.292, p = 0.088), E-tracking pressure strain elasticity modulus

Summary

Introduction

It is estimated that arterial hypertension (AH) affects 3–5% of the pediatric population, and its frequency increases with the age of the children studied [1]. The importance of calcium-phosphate disorders, including vitamin D, in the development of AH and target-organ damage has become the subject of intensive research in recent years [4]. It is known that sclerostin, alongside the Dickkopf-1 protein (Dkk-1) is the most important inhibitor of the Wnt/beta-catenin pathway. Wnt ligands connect to the frizzled receptor and LRP5/6 (low-density lipoprotein receptor-related protein) coreceptor, stabilizing the beta-catenin structure, inducing its transfer to the nucleus, and affecting the transcription of genes encoding the proteins responsible for bone formation.

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