The Serum Level And Significance Of Sclerostin In Early Chronic Kidney Disease

Objective:In this study,the serum levels of sclerostin and serum creatinine?Cre?,PTH,25?OH?D₃,ALP,Alb,Ca,P,24h urinary protein were measured in healthy control group,CKD1,CKD2 and CKD3 groups,to further explore the feasibility of sclerostin as a biomarker of calcium and phosphorus metabolism in CKD early response and its role in the pathogenesis of CKD-MBD.Methods:Forty-five patients with CKD1-3 were hospitalized in Department of Nephrology,the First Affiliated Hospital of Dalian Medical University from October2016 to October 2017.Among them,15 were CKD1,13 were CKD2,17 were CKD3,between the age of 16-76 years old.All patients were in line with the United States in2002 K/DOQI definition of CKD standards,except for the group of patients with glucocorticoid,immunosuppressor,calcium,vitamin D and other drug applications recently.According to glomerular filtration rate?eGFR?,patients were divided into CKD1 group,CKD2 group and CKD3 group.11 healthy subjects were collected from the health examination department of Dalian Medical University in October 2017 as a healthy control group.The general information and laboratory indexes of each group were collected:Cre,Alb,WBC,HB,TC,TG,HLD-C,LDH-C,ALP,25?OH?D₃,Ca,P,PTH,24h urine protein?24h Upro?and so on.Serum levels of sclerostin in healthy controls and CKD1-3 groups were determined by ELISA.Statistical analysis of data using SPSS22.0 software,the normal distribution of measurement data with?±S said,the number of samples were compared using ANOVA analysis,the same number of incomplete comparison of the same group by LSD test,correlation analysis using Pearson Related,are bilateral test,the results of P<0.05 for the difference was statistically significant.Result:1.Serum sclerostatin levels in healthy control group compared with CKD1no significant difference?P>0.05?,but the indicators in CKD1,CKD2 and CKD3 group serum levels showed an increasing trend;Serum sclerostin levels in CKD2 group and CKD1 group was significantly different?P<0.05?,CKD3 group and CKD1 group,CKD2 stage group was significantly increased,and both were significantly different?P<0.05?.2.The serum concentration of PTH gradually increased with the progression of CKD,especially to the CKD3 stage,which was significantly different from that of the first two periods?P<0.05?,but there was no significant difference between CKD stage 1and 2.3.The serum levels of sclerostin gradually increased with the progression of chronic kidney disease,negatively correlated with eGFR,25?OH?D₃ and HDH-C?P<0.05?,and positively correlated with Scre and ALP,No correlation with age,gender,PTH,Alb.4.25?OH?D₃ had no significant change in CKD1-3 stage,but negative correlation with sclerostin,total cholesterol,LDH-C and 24hUpro?P<0.05?.Conclusion:1.Serum levels of sclerostin increased early in chronic kidney disease,indicating that early in patients with chronic kidney disease there is a mineral and bone metabolism disorders.2.In the CKD stage 2,sclerostin gradually increased with the decline of renal function,and much earlier than 25?OH?D₃,serum calcium,phosphorus,PTH in CKD changes,suggesting that it may be used as CKD early prediction Index of Mineral and Bone Metabolic Disorders in Chronic Kidney Disease.