The Correlation Analysis Of Serum Sclerostin And Vascular Calcification In Uremia Patients

Objective:To observe the clinical situation of vascular calcification and serum sclerostin level in uremic patients,to explore the relationship between serum sclerostin and vascular calcification,to analyze the related factors of vascular calcification.Method:A total of 56 uremia patients who did arteriovenous fistula operations in the Second Affiliated Hospital of Chongqing Medical University from January 2017 to June 2018 were selected as AVF group.According to age and gender matching,fifty-six patients with maintenance hemodialysis treatedin the Second Affiliated Hospital of Chongqing Medical University from September 2016 to June 2018 were selected as the MHD group.56 normal individuals in the physical examination center were selected as the control group.Blood samples and baseline characteristics of the study cohort were collected,Serum calcium(Ca)、phosphorus(P)、magnesium(Mg)、blood urea nitrogen(Bun)、creatinine(Cr)、uric acid(UA)、albumin(ALB)、alkaline phosphatase(AKP)、triglyceride(TG)、total cholesterol(TC)、low density lipoprotein(LDL)、high density lipoprotein(HDL)、hemoglobin(Hb)、25-hydroxyvitamin D、immunoreactive parathyroid hormone(iPTH)were tested;enzyme-linkedimmunosorbent assay(ELISA)was used to detect serum sclerostin levels;abdominal CT was used to evaluate abdominal aortic calcification;hematoxylin-eosin(HE)staining and alizarin red staining were used to observe the calcification of the radial artery.Result:Vascular calcification rate、serum phosphorus、magnesium、blood urea nitrogen、serum creatinine、uric acid、alkalinephosphorus、triglyceride、intact parathyroid hormone and serum sclerostin levels in the AVF group and the MHD group were significantly higher than those in the control group(P<0.05);serum calcium、albumin、low density lipoprotein、high density lipoprotein、hemoglobin、25-hydroxyvitamin D levels were lower than the control group(P<0.05).The levels of magnesium and hemoglobin in the AVF group were lower than those in the MHD group(P<0.05);there were no significant differences in vascular calcification rate,serum sclerostin level and other clinical indicators between the AVF group and the MHD group(P>0.05).In the AVF group,age、phosphorus、blood urea nitrogen、serum creatinine、intact parathyroid hormone and serum sclerostin levels were higher in the radial artery calcification group than those in the non-calcified group(P<0.05),total cholesterol levels were lower than the non-calcified group group(P<0.05).In MHD group,age、phosphorus、alkaline phosphorus、intact parathyroid hormone and serum sclerostin were higher in the abdominal aortic calcification group than non-calcified group(P<0.05),creatinine and uric acid levels were lowerthan the non-calcified group group(P<0.05).ROC curve analysis showed that the area under the curve of serum sclerostin for prediction of abdominal aortic calcification in MHD group was 0.746(95%CI:0.593~0.898,P=0.007)with the optimal cut-off value of 6.8555ng/ml,the sensitivity of 71.4% and the specificity of 81.2%.Conclusion : The vascular calcification of uremic patients was analyzed by two methods for assessing vascular calcification,it was found that vascular calcification was positively correlated with age 、 serum phosphorus、total parathyroid hormone and serum sclerostin levels.As an essential messenger between bones and vessel axis,sclerostin plays a key role in development and progression of vascular calcification and is closely related to vascular calcification.