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Association of bone-derived biomarkers with vascular calcification in chronic hemodialysis patients
Yueh-Ting Lee1, Hwee-Yeong Ng1, Terry Ting-Yu Chiu1
1Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Insights
Abdominal aortic calcification (AAC) is common in dialysis patients. Bone biomarkers sclerostin and FGF23 are independently associated with AAC severity, offering potential therapeutic targets.
Area of Science:
- Nephrology
- Cardiovascular Science
- Bone Metabolism
Background:
- Abdominal aortic calcification (AAC) is prevalent in chronic dialysis patients.
- AAC is linked to increased cardiovascular and all-cause mortality.
Purpose of the Study:
- Investigate factors associated with AAC in hemodialysis patients.
- Analyze the relationship between bone-derived biomarkers and AAC severity.
Main Methods:
- 227 stable hemodialysis patients were enrolled.
- Abdominal aortic calcification assessed via radiography; serum levels of sclerostin, DKK-1, and FGF23 measured.
Main Results:
- 71% of patients had AAC. Higher AAC scores correlated with older age, higher BMI, calcium, hsCRP, and FGF23.
- Sclerostin and DKK-1 inversely correlated with AAC; FGF23 directly correlated. Hypertension, vascular disease, hsCRP, FGF23, and sclerostin were independent AAC determinants.
Conclusions:
- Vascular calcification is highly prevalent in hemodialysis patients.
- Circulating sclerostin, DKK-1, and FGF23 levels relate to AAC severity.
- Sclerostin and FGF23 are independently associated with AAC.
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.
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