Relationship Between Serum Sclerostin And Vascular Calcification And Bone Mineral Density In CKD5 Non-dialysis Patients

Objective:Vascular calcification and reduced bone mineral density(BMD)are common complications of end-stage renal disease(ESRD).The aim is to investigate the relationship between serum sclerostin and vascular calcification and bone mineral density in non-dialysis patients with CKD5,so as to provide clinical basis for predicting vascular calcification and treating reduced bone mineral density in patients with end-stage renal disease.Methods:1.From November 2018 to August 2019,61 patients with CKD 5 non-dialysis treated in our hospital were selected as the experimental group,and 56 healthy subjects in our hospital during the same period were selected as the normal control group.The biochemical indicators of the study subjects were collected,and the serum sclerostin levels of the study subjects were detected by ELISA,and the different indicators between the two groups were compared.2.Patients in the experimental group were divided into two groups according to whether there was vascular calcification or not(group A: there was vascular calcification at CKD5 stage,group B: there was not vascular calcification at CKD5 stage).Abdominal aortic calcification was examined by abdominal lateral x-ray and AACs was calculated;bone mineral density T values of lumbar spine and hip were measured by dual-energy X-ray absorptiometry.The correlation between serum sclerostin and bone mineral density T value,AACs and biochemical indexes was analyzed.P < 0.05 was considered statistically significant.Results:1.The levels of sclerostin,serum phosphorus,whole-segment parathyroid hormone,low-density lipoprotein,high-density lipoprotein,cholesterol and hypersensitive C-reactive protein in the experimental group were higher than those in the control group,and the differences were statistically significant(P <0.05).The levels of hemoglobin,albumin and prealbumin in the experimental group were lower than those in the control group,and the differences were statistically significant(P < 0.05).2.Group A: 32 patients in the stage of CKD5 without vascular calcification,with an average age of(58.00±11.84)years.Group B:29 patients in the stage of CKD5 with vascular calcification,with an average age of(62.69±12.71)years.There were no significant differences between group A and group B in general data such as gender and age(P > 0.05).The serum sclerostin level in group B was higher than that in group A,and the difference was statistically significant(P < 0.05).The bone mineral density T value in group B was lower than that in group A(P < 0.05).The levels of whole-segment parathyroid hormone,hypersensitive C-reactive protein and low density lipoprotein in group B were higher than those in group A.The differences were statistically significant(P < 0.05).There was no significant difference in calcium,phosphorus,cholesterol and triglyceride between the two groups(P>0.05).The results of Pearson correlation analysis showed that:serum sclerostin level was positively correlated with AACs(r=0.759,P<0.05),positively correlated with whole-segment parathyroid hormone(r=0.316,P<0.05),positively correlated with hypersensitive C-reactive protein(r=0.348,P<0.05),positively correlated with low-density lipoprotein(r=0.448,P<0.05),and negatively correlated with bone mineral density(r=-0.274,P < 0.05).And it has nothing to do with calcium,phosphorus,alkaline phosphatase,triglyceride,cholesterol.Conclusion:1.Vascular calcification is prevalent in CKD5 patients,and serum sclerostin can reflect the severity of vascular calcification;2.Serum sclerostin can reflect the degree of bone density reduction and participates in the progression of osteoporosis in patients with CKD5.