The Relationship Between Serum Sclerostin And Arterial Stiffness In Peritoneal Dialysis Patients

Objective: This study is to evaluate the arterial stiffness in patients with PD,and to explore the correlation between serum sclerostin level and arterial stiffness by observing the Brachial-Ankle Pulse Wave Velocity(ba PWV)of PD patients in our hospital.Methods:73 continuous ambulatory peritoneal dialysis(continuous ambulatory peritoneal dialysis,CAPD)patients more than 3 months were randomly selected from the peritoneal dialysis center of our hospital in 2019.The basic data and biochemical indexes in patients with history of medication and other related data were collected.The calcification of abdominal aorta was evaluated by lateral abdominal plain film,and the calcification score of abdominal aorta was calculated by(AACs).All patients were recorded the ba PWV value by the arteriosclerosis detector in our hospital,at the same time patients serum were collected to detect the level of serum sclerostin by ELISA.SPSS21.0 was used to analyze the the risk factors of aortal calcification and arteriosclerosis in peritoneal dialysis patients,and to evaluate the predictive value of serum sclerostin level on arteriosclerosis and calcification of abdominal aorta.Results:1.Among 73 PD patients,39 were male(53.4%)and 34 were female(46.6%);the average age was 45.19 ± 12.34 years,the average dialysis age was 25(12,34)months,the average serum sclerostin was 138.45(89.75201.24)pg / ml,and the average ba PWV was 1539.64 ± 230.87cm/s.According to whether ba PWV ≥ 1400 cm / s,PD patients were divided into two groups: high ba PWV group(51 cases)(69.86%)and normal ba PWV group(22 cases)(30.14%).Single factor analysis showed that ba PWV was positively correlated with age,systolic pressure,diastolic pressure,pulse pressure difference,TG,hs CRP(P < 0.05),and negatively correlated with gender,ALB,i PTH,serum Mg(P < 0.05).The result of logistic regression analysis showed that only age and systolic blood pressure were independent risk factors for atherosclerosis.2.The result of correlation analysis showed that there was a positive correlation between the level of sclerostin and ba PWV(r=0.246 P=0.036);the average level of sclerostin in the high ba PWV group was higher than that in the normal group,but the difference was not statistically significant(P > 0.05).The area under AUC curve predicted by serum sclerostin level was 0.658(95% CI 0.497-0.780,P=0.062),which suggest that the accuracy of serum sclerostin level in predicting atherosclerosis was not statistically significant.3.31 cases(42.47%)had calcification of abdominal aorta,including 14 cases(45.16%)with mild calcification,11 cases(35.48%)with moderate calcification and 6 cases(19.35%)with severe calcification.Correlation analysis showed that the calcification of abdominal aorta was positively correlated with age,LDL,FBG,hs CRP and Hb A1c(P<0.05),but not with sclerostin and other indexes(P>0.05).The level of serum sclerostin in severe calcification group was higher than that in no,mild and moderate calcification group,but the difference was not statistically significant(P>0.05).Logistic regression analysis showed that age alone was an independent risk factor for abdominal aortic calcification(or=1.138,95% CI: 1.066-1.2165,P<0.001).4.Single factor correlation analysis showed that the calcification of abdominal aorta was positively correlated with ba PWV(r=0.33 P=0.005).Compared with the levels of ba PWV in four groups,we found that the mean value of ba PWV in the four groups gradually increased with the severity of the abdominal aorta calcification,and the difference between the two groups was statistically significant(P=0.039).Further analysis between the two groups showed that there was statistically significant difference between the non calcified group and the severe calcified group(P=0.022),and the difference between the other groups was not statistically significant(P>0.05)。Conclusion:The level of serum sclerostin was positively correlated with ba PWV,but not with the score of abdominal aortic calcification.The arteriosclerosis of PD patients is more serious than that of healthy people,besides age and systolic blood pressure were the independent risk factors of ba PWV,age was the independent risk factor of abdominal aortic calcification,and ba PWV gradually increased with the severity of abdominal aortic calcification.The accuracy of sclerostin in predicting arteriosclerosis in peritoneal dialysis patients needs further study.