Abstract: Objective  To analyze the relationship between serum sclerostin and dickkopf-1 (DKK-1) levels and coronary artery calcification (CAC) in peritoneal dialysis (PD) patients. Methods A total of 110 patients with continuous ambulatory peritoneal dialysis (CAPD) or daytime ambulatory peritoneal dialysis (DAPD) for more than 3 months were prospectively recruited. The coronary calcification score (CaCS) was calculated using the Agatston score from multi-slice spiral CT. Serum sclerostin and Dkk-1 were measured using ELISA. Logistic regression analysis was used to determine the risk factor for CAC in PD patients. Receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of sclerostin and DKK-1 levels for CAC.  Results  CAC was found in 72 (64.9%) patients, of which 23 CAC patients (27.3%) had higher CaCS, and 49 CAC patients (37.6%) had lower CaCS. Serum sclerostin and DKK-1 levels were positively correlated with moderate to severe CaCS (ρ=0.733, P＜0.001; ρ=0.796, P＜0.001). Logistic regression showed that higher serum sclerostin level (OR＝1.052, 95% CI:1.005～1.102, P=0.021) and higher DKK-1 level (OR=1.180, 95% CI:1.040～1.339, P=0.005) were the independent risk factors for CAC in PD patients. When the cut-off value of serum sclerostin was set at 240pg/ml, the area under curve (AUC) was 0.940 (95% CI:0.899～0.981, P＜0.001), the accuracy was 0.833 and the specificity was 0.974; when the cut-off value of serum DDK-1 was set at 37.05μg/ml, the area under curve (AUC) was 0.960 (95% CI 0.927～0.993, P＜0.001), the accuracy was 0.875 and the specificity was 0.949.  Conclusion  Higher serum sclerostin and DKK-1 levels are significantly associated with CAC in PD patients. Serum sclerostin and DKK-1 may play important roles in the pathogenesis of CAC in PD patients.

Key words: Sclerostin, Dickkopf-1, Peritoneal dialysis, Coronary artery calcification