The relationship between sclerostin and carotid artery atherosclerosis in patients with stage 3–5 chronic kidney disease

Abstract

Purpose Sclerostin is an antagonist of the Wnt/β-catenin pathway. We previously reported that sclerostin is closely related to carotid artery atherosclerosis and long-term outcome in hemodialysis patients. The present study investigated the association between sclerostin, renal function, and carotid artery atherosclerosis in non-dialysis patients with stage 3-5 chronic kidney disease (CKD 3-5ND). Methods A total of 140 patients with CKD 3-5ND were enrolled in this cross-sectional study. The Chronic Kidney Disease Epidemiology Collaboration equation was used to calculate estimated glomerular filtration rate (eGFR). Atherosclerotic plaques in the carotid artery were detected by B-mode Doppler ultrasound. Blood samples were collected to assess serum sclerostin levels. Unconditional logistic regression analysis was used to identify risk factors for carotid atherosclerotic plaques. Results The median eGFR was 24.9 ml/min/1.73 m 2 (interquartile range [IQR] 10.0-40.3 ml/min/1.73 m 2) and median serum sclerostin level was 46.76 pmol/l (IQR 30.18-67.56 pmol/l). Carotid atherosclerotic plaques were detected in 104 subjects (74.3%). There was a negative association between sclerostin level and eGFR (r = − 0.214, p = 0.011). Unconditional logistic regression analysis revealed that sclerostin level was an independent risk factor for the occurrence of carotid plaques, with an odds ratio (95% confidence interval) of 1.026 (1.003, 1.051). Conclusion Serum sclerostin increases with declining renal function in patients with CKD 3-5ND. Sclerostin is an independent risk factor for carotid atherosclerosis.

Role of Sclerostin in Cardiovascular Disease

“…Fourteen studies examining the association between serum sclerostin concentration and arterial stiffness or atherosclerosis severity were identified. 48,[56][57][58][59][60][61][62][63][64][65][66][67][68] Twelve studies reported significant positive associations, 48,[56][57][58][59][60][61][62][63][64][65][66] while one study reported a negative association 67 and one study reported no association. 68 Higher serum sclerostin has been associated with coronary, carotid, and peripheral atherosclerosis.…”

“…68 Higher serum sclerostin has been associated with coronary, carotid, and peripheral atherosclerosis. [56][57][58][59] In contrast, Milovanova et al 67 reported an inverse association of serum sclerostin concentration with symptoms of coronary heart disease (CHD) in patients with ESRF. Multiple studies have demonstrated a significant association between serum sclerostin concentration and higher arterial stiffness (Table 3).…”

“…37 In multiple other studies, the site of blood collection and the method of serum isolation and storage were not clearly reported. 28,30,[44][45][46]50,52,54,57,60,61,63,66,67 This may have influenced the concentrations of sclerostin measured. Lastly, the included studies recruited varying populations of participants including healthy individuals, different age groups, postmenopausal women and patients with a history of rheumatoid arthritis, diabetes, obesity, ESRF, CKD, and CHD.…”

Serum osteoprotegerin level in hemodialysis patients using low‐flux reused dialyzer in relation to atherosclerosis

“…Our result was similar to that of other authors. Zhao B. et al 22 found 74.3% of patients with carotid atherosclerotic plaques in a study enrolled by 140 CKD patients (44.3% diabetes). Yu L. et al 23 conducted a study with 330 MHD patients with an average age was 63.43 years old, median hemodialysis duration was 69 months, 16.4% diabetes, and the presence of atherosclerosis was 57.3% (189 cases).…”

The Impact of Sclerostin Levels on Long-Term Prognosis in Patients Undergoing Coronary Angiography: A Personalized Approach with 9-Year Follow-Up

“…Morales-Santana et al observed that in subjects with diabetes type 2, sclerostin levels were strictly associated with increased carotid intima-media thickness ( p < 0.05), carotid plaques ( p < 0.01), and aortic calcification ( p < 0.01) [ 9 ]. Kirkpantur et al also proved that sclerostin levels correlated with carotid intima-media thickness in subjects undergoing hemodialysis [ 7 ], whereas Zhao et al proved this in subjects with CKD stage 3–5 [ 24 ]. In a similar study, Chen et al showed that sclerostin levels were not only linked with carotid artery atherosclerosis but also with all-cause deaths [ 25 ].…”