Abstract :
[en] Background: Sclerostin is a potent inhibitor of bone formation,
but the meaning of its serum levels remains undetermined.
We evaluated the association between sclerostin levels
and clinical or biological data in hemodialyzed patients
(HD), notably parathormone (PTH), biomarkers of bone turnover,
vascular calcifications and mortality after 2 years. Methods:
164 HD patients were included in this observational
study. The calcification score was assessed with the Kauppila
method. Patients were followed for 2 years. Results: Median
sclerostin levels were significantly (p < 0.0001) higher in
HD versus healthy subjects (n = 94) (1,375 vs. 565 pg/ml, respectively).
In univariate analysis a significant association
(p < 0.05) was found between sclerostin and age, height, dialysis
vintage, albumin, troponin, homocysteine, PTH, C-terminal telopeptide of collagen type I, bone-specific alkaline
phosphatase and osteoprotegerin, but not with the calcification
score. In a multivariate model, the association remained
with age, height, dialysis vintage, troponin, homocysteine,
phosphate, PTH, but also with vascular calcifications. Association
was positive for all variables, except PTH and vascular
calcifications. The baseline sclerostin concentration was not
different in survivors and non-survivors. Conclusions: We
confirm a higher concentration of sclerostin in HD patients,
a positive association with age and a negative association
with PTH. A positive association with phosphate, homocysteine
and troponin calls for additional research. The clinical
interest of sclerostin to assess vascular calcifications in HD is
limited and no association was found between sclerostin
and mortality.
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