Abstract: 【Abstract】Objective To investigate the serum sclerostin level and explore its relationship with brachialankle pulse wave velocity (baPWV) in maintenance hemodialysis (MHD) patients. Methods A total of 110 stable MHD patients undergoing hemodialysis for at least three months and 40 healthy individuals as the controls were enrolled in the study. Serum level of sclerostin was measured by ELISA and baPWV was determined. Their baseline characteristics and laboratory measurements were collected, and correlation analysis of sclerostin with baPWV and other parameters was performed. Results Serum sclerostin level and baPWV were significantly higher in MHD patients as compared with those in healthy controls (73.34±30.08 ng/L vs. 21.13±13.69 ng/L, t=5.654, P＜0.001 for serum sclerostin; 1875.96±375.38 cm/s vs. 1343.14±131.38 cm/s, t=3.722, P＜0.001 for baPWV). Sclerostin level was positively correlated with intact parathyroid hormone (iPTH) (r=0.397, P＜0.001), phosphorus (P) (r=0.364, P＜0.001), high sensitive c-reactive protein (hsCRP) (r=0.536, P＜0.001), and mean arterial pressure (MAP) (r=0.397, P=0.037). Multivariate stepwise regression showed that hsCRP (β=0.286, P=0.021), P (β=0.218, P=0.027) and iPTH (β=0.196, P=0.033) were the independent risk factors for sclerostin. Based on baPWV value, the degree of arterial sclerosis in MHD patients can be categorized into non-, slight, moderate and severe arteriosclerosis. The incidence of arteriosclerosis (baPWV ＞1400 cm/s) was 91.8% in this series of MHD patients. Sclerostin (F=16.043, P＜0.001), hsCRP (F=3.552, P=0.021), MAP (F=4.736, P=0.010) and age (F=9.074, P＜0.001) were significantly higher in baPWV ≥1800 m/s patients. In MHD patients, baPWV was positively correlated with age (r= 0.368, P＜0.001), MAP (r=0.397, P＜0.001), sclerostin (r=0.571, P＜0.001), P (r=0.224, P=0.035) and hs-CRP (r=0.278, P= 0.008). Multivariate stepwise regression showed that sclerostin level was still the independent risk factors for baPWV in MHD patients (OR=1.292, 95% CI=1.017～1.641, P=0.012) after adjusting age and MAP. Conclusion The incidence of arteriosclerosis is high in MHD patients. Serum sclerostin level may relate to arterial stiffness. Higher sclerostin level is the independent risk factors for arteriosclerosis.

Key words: Hemodialysis, Sclerostin, Brachial-ankle pulse wave velocity, Arteriosclerosis