title: Association of bone-derived biomarkers with vascular calcification in chronic hemodialysis patients.
abstract: BACKGROUND
  Abdominal aortic calcification (AAC) is commonly observed in chronic dialysis patients and is associated with cardiovascular and all-cause mortality. We investigated the factors associated with AAC and analyze the relationship between bone-derived biomarkers and AAC.
  
  
  METHODS
  We enrolled 227 stable hemodialysis patients. Vascular calcifications were assessed using lateral lumbar radiography of the abdominal aorta. Demographic data were collected and serum levels of biochemical and bone-derived biomarkers, including sclerostin, Dickkopf-1 (DKK-1), and fibroblast growth factor 23 (FGF23), were measured.
  
  
  RESULTS
  One hundred sixty-one patients (71.0%) had AAC. Patients with AAC score≧13 were older, with higher body mass index (BMI), serum calcium, calcium phosphate product, high-sensitivity C-reactive protein (hsCRP), and FGF23 levels. Sclerostin and DKK-1 levels were inversely associated with AAC severity, and FGF23 was directly related to vascular calcification. Hypertension, vascular disease, hsCRP, FGF23, and sclerostin were independent AAC determinants.
  
  
  CONCLUSIONS
  Chronic hemodialysis patients have a high prevalence of vascular calcifications. Levels of circulating sclerostin, DKK-1, and FGF23 were related to AAC severity. Sclerostin and FGF23 were independently associated with AAC.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yueh-Ting
authors.initials: YT
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Hwee-Yeong
authors.initials: HY
authors.lastname: Ng
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Terry Ting-Yu
authors.initials: TT
authors.lastname: Chiu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Lung-Chih
authors.initials: LC
authors.lastname: Li
authors.affiliation: Division of Hema-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Sung-Nan
authors.initials: SN
authors.lastname: Pei
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Wei-Hung
authors.initials: WH
authors.lastname: Kuo
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address: chientel@gmail.com.
authors.forename: Chien-Te
authors.initials: CT
authors.lastname: Lee
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000368:Aged; D015415:Biomarkers / Q000097:blood; D019485:Bone Morphogenetic Proteins / Q000097:blood*; D001842:Bone and Bones / Q000378:metabolism*; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D005819:Genetic Markers; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D061205:Vascular Calcification / Q000097:blood* / Q000175:diagnosis
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D015415:Biomarkers; D019485:Bone Morphogenetic Proteins; C501126:DKK1 protein, human; C000717427:FGF23 protein, human; D005819:Genetic Markers; D036341:Intercellular Signaling Peptides and Proteins; C422903:SOST protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23
keywords: DKK-1; FGF23; Hemodialysis; Sclerostin; Vascular calcification