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. 2019 Mar;51(3):519-526.
doi: 10.1007/s11255-018-2050-3. Epub 2018 Dec 24.

Relationship between plasma levels of sclerostin, calcium-phosphate disturbances, established markers of bone turnover, and inflammation in haemodialysis patients

Barbara Pietrzyk  1 , Katarzyna Wyskida  2 , Joanna Ficek  1 , Aureliusz Kolonko  3 , Rafał Ficek  3 , Andrzej Więcek  3 , Magdalena Olszanecka-Glinianowicz  2 , Jerzy Chudek  4   5
Affiliations

Relationship between plasma levels of sclerostin, calcium-phosphate disturbances, established markers of bone turnover, and inflammation in haemodialysis patients

Barbara Pietrzyk et al. Int Urol Nephrol. 2019 Mar.

Abstract

Purpose: Data concerning the relation between increased levels of circulating sclerostin (a physiological inhibitor of bone formation) and bone turnover in patients with chronic renal failure (CRF) are limited. Therefore, the aim of this study was to evaluate associations between plasma sclerostin levels and calcium-phosphate disturbances, markers of bone turnover as well as inflammation in haemodialysis (HD) patients.

Methods: In plasma samples obtained in 150 stable HD patients (92 men) aged 40-70 years, levels of sclerostin, fibroblast growth factor (cFGF23), osteocalcin, the N-terminal propeptide of type I procollagen, C-terminal telopeptide of the alpha chain of type I collagen (β-CTx), and inflammatory markers (IL-6 and TNF-α) in addition to routine parameters (calcium, phosphorus, parathyroid hormone-iPTH, 25-OH-D, alkaline phosphatase) were measured.

Results: Plasma sclerostin concentrations were significantly higher in HD men than women (2.61 vs. 1.88 ng/mL, p < 0.01). Patients with sclerostin levels above median were characterized by lower iPTH and IL-6, but higher cFGF23 and TNF-α (significantly only in men) concentrations. Plasma sclerostin concentration positively correlated with serum 25-OH-D (τ = 0.204), phosphorus (τ = 0.1482), and TNF-α (τ = 0.183) and inversely with iPTH (τ = - 0.255), alkaline phosphatase (τ = - 0.203), IL-6 (τ =- 0.201), and β-CTx (τ = - 0.099) levels. In multivariate regression analysis, variability of sclerostin levels was explained by sex and 25-OH-D and phosphorus levels.

Conclusions: Increased circulating sclerostin levels seem to reflect slower bone turnover in HD patients. Low levels of sclerostin are associated with vitamin D deficiency and good phosphates alignment.

Keywords: Calcium–phosphate disturbances; Chronic kidney disease-mineral and bone disorder (CKD-MBD); Haemodialysis patients; Renal osteodystrophy (ROD); Sclerostin.

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Conflict of interest statement

Conflict of interest

Authors declare that have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration with its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Plasma sclerostin concentration in relation to 25-OH-D ranges in haemodialysis men
Fig. 2
Fig. 2
Plasma sclerostin concentration in relation to phosphate alignment in haemodialysis men
See this image and copyright information in PMC

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