Abstract
Background and Objectives: Sclerostin and Dickkopf-1 (DKK1) modulate osteoblastogenesis, but their role in bone loss in hemodialysis (HD) patients is inconclusive. This study investigated relationships among lumbar bone mineral density (BMD), serum sclerostin, and DKK1 in HD patients. Materials and Methods: Blood samples were obtained from 75 HD patients. Dual-energy X-ray absorptiometry measured lumbar BMD of the lumbar vertebrae (L2–L4). Enzyme-linked immunosorbent assay revealed serum sclerostin and DKK1 concentrations. Results: There were 10 (13.3%), 20 (26.7%), and 45 (60%) patients defined as presenting with osteoporosis, osteopenia, or normal BMD, respectively. Age, alkaline phosphatase, urea reduction rate, fractional clearance index for urea, sclerostin level, and percentage of female patients are significantly negatively associated with the lumbar BMD and T-score, while the body mass index and waist circumference significantly positively associated with the lumbar BMD and T-score. Multivariate forward stepwise linear regression analysis indicated that serum sclerostin (β = −0.546, adjusted R2 change = 0.454; p < 0.001), age (β = −0.216, adjusted R2 change = 0.041; p = 0.007), and percentage of female HD patients (β = −0.288, adjusted R2 change = 0.072; p = 0.0018) were significantly negatively associated with lumbar BMD in HD patients. Conclusions: Advanced age, female gender, and serum sclerostin level, but not DKK1, were negatively associated with BMD in HD patients.
Highlights
The growing rate of chronic kidney disease (CKD), along with comorbidities, place a heavy burden on the general health and medical resources of society [1]
Values of DKK1 or intact parathyroid hormone (iPTH) showed no significant differences among these three groups
The major findings of this study indicated that advanced age and female gender were associated with lower lumbar bone mineral density (BMD), while the serum sclerostin level but not DKK1 was negatively associated with lumbar BMD in HD patients
Summary
The growing rate of chronic kidney disease (CKD), along with comorbidities, place a heavy burden on the general health and medical resources of society [1]. CKD is associated with a higher risk of fractures due to dysregulated bone metabolism and lower bone mineral density (BMD) as renal function worsens, which results in a substantially poor prognosis compared to that of the general population [2–4]. In hemodialysis (HD) patients, abnormal bone turnover presented as low bone mass and density was common, and 9.5–23% were defined as osteoporosis and. Risk factors associated with osteoporosis in CKD were multifactorial, including poor nutrition, vitamin D deficiency, hyperparathyroidism, metabolic acidosis, limited physical activity, and CKD-related metabolic mineral bone disease [8]. Two recently and intensively studied factors known as sclerostin and Dickkopf-1 (DKK1), which are. Sclerostin and Dickkopf-1 (DKK1) modulate osteoblastogenesis, but their role in bone loss in hemodialysis (HD) patients is inconclusive. This study investigated relationships among lumbar bone mineral density (BMD), serum sclerostin, and DKK1 in HD patients.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
