Abstract: 【Abstract】Objective To observe the correlation between vascular calcification (VC) and serum sclerostin level in uremia patients. Method Serum sclerostin levels were detected by ELISA in 56 patients who underwent arteriovenous fistula operation (AVF group), 56 maintenance hemodialysis patients (MHD group), and 56 normal individuals (control group). Their demographic data and biochemical indicators were collected. Abdominal CT was used to evaluate abdominal aortic calcification. Hematoxylin-eosin (HE) staining and alizarin red staining were used to examine the calcification of the radial artery in surgical samples. Result VC rate (F=29.973, P＜0.001), serum phosphorus (F=45.308, P＜0.001), magnesium (F=42.468, P＜0.001),
uric acid (F=16.049, P＜0.001), alkaline phosphatase (F=5.677, P=0.005), triglyceride (F=5.521, P=0.005),immunoreactive parathyroid hormone(F=22.001, P＜0.001) and serum sclerostin(F=202.458, P＜0.001) were significantly higher in AVF and MHD groups than in control group. Serum calcium(F=15.006,P＜0.001) and 25-OH-vitamin D (F=9.904, P=0.000) were lower in AVF and MHD groups than in control group. In AVF group, patients with radial artery calcification had older age (t=2.033, P=0.048), and higher serum phosphorus (t=4.170,P＜0.001), immunoreactive parathyroid hormone (t=-2.374, P=0.018) and serum sclerostin (t=9.709, P＜0.001) than those without radial artery calcification. In MHD group, patients with abdominal aortic calcification had older age (t=2.033, P=0.048), and higher levels of phosphorus (t=2.360, P=0.023), alkaline phosphatase (t=2.122, P=0.040), immunoreactive parathyroid hormone (t=2.130, P=0.039) and serum sclerostin (t=2.671, P=0.011) than those without abdominal aortic calcification. ROC curve analysis showed that the area under the curve of serum sclerostin for prediction of VC in AVF group was 0.895 (95% CI 0.815~0.976, P＜0.001); at the optimal cut-off value of serum sclerostin 5.55ng/ml, the sensitivity of for the diagnosis of VC was 82.4%, the specificity was 86.4%. The area under the curve of serum sclerostin for prediction of abdominal aortic calcification in MHD group was 0.746 (95% CI 0.593~0.898, P=0.007); at the optimal cut-off value of 6.8555ng/ml, the sensitivity for the diagnosis of abdominal aortic calcification was 71.4% and the specificity was 81.2%. Conclusion VC was positively correlated with age, serum phosphorus, immunoreactive parathyroid hormone and serum sclerostin.

Key words: Sclerostin, Vascular calcification, Stage 5 chronic kidney disease, Uremia