title: High Serum Sclerostin Levels Are Associated with a Better Outcome in Haemodialysis Patients.
abstract: BACKGROUND
  Sclerostin is an osteocyte hormone that decreases osteoblastogenesis. Sclerostin may play a key role in osteoporosis and also in vascular calcification (VC). In chronic kidney disease and haemodialysis (HD) patients, serum sclerostin levels are high.
  
  
  OBJECTIVE
  To assess the correlation of serum sclerostin levels with VC, bone mineral density (BMD), and survival rate in HD patients.
  
  
  METHODS
  A cross-sectional study was conducted in prevalent HD patients to correlate serum sclerostin tertiles with the Kauppila aortic calcification score, BMD scores and survival rate.
  
  
  RESULTS
  We studied 207 patients who had a mean serum sclerostin level of 1.9 ± 0.7 ng/ml. Compared to patients in the 1st tertile of serum sclerostin levels (0.6-1.53 ng/ml), patients in the 3rd tertile (2.2-4.6 ng/ml) were significantly older (73.7 ± 12 vs. 64.7 ± 18 years), more frequently of the male gender (74 vs. 48%), had lower serum bone-specific alkaline phosphatases values (14 ± 9 vs. 20.4 ± 13 µg/l), were less frequently treated with alfacalcidol, displayed lower aortic calcification scores (9.5 ± 5 vs. 12.5 ± 7/24) and had higher BMD scores. Furthermore, patients of the 3rd tertile displayed a lower mortality rate compared to tertile 1 using multivariable adjusted Cox model (hazard ratio 0.5, 95% CI 0.25-0.93, p = 0.03). The main factors associated with VC score were age, diabetes, cardiovascular disease, CRP level and Warfarin use.
  
  
  CONCLUSIONS
  Our study of HD patients shows that higher serum sclerostin levels are associated with higher BMD, lower aortic calcification scores, and a better survival rate.
authors.affiliation: Nephrocare Tassin-Charcot, Nephrology Haemodialysis, Sainte Foy-les-Lyon, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Jean
authors.forename: Charles
authors.initials: C
authors.lastname: Chazot
authors.forename: Eric
authors.initials: E
authors.lastname: Bresson
authors.forename: Eric
authors.initials: E
authors.lastname: Zaoui
authors.forename: Etienne
authors.initials: E
authors.lastname: Cavalier
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000378:metabolism; D015415:Biomarkers; D015519:Bone Density; D019485:Bone Morphogenetic Proteins / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D005819:Genetic Markers; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000209:etiology
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D015415:Biomarkers; D019485:Bone Morphogenetic Proteins; D005819:Genetic Markers; C422903:SOST protein, human; D000469:Alkaline Phosphatase