Abstract: Objective To explore the diagnostic value of serum Sclerostin and BALP in the diagnosis of osteoporosis in patients with peritoneal dialysis (PD).  Methods A total of 136 patients who were followed up in PD outpatient Department of Beijing Luhe Hospital affiliated to Capital Medical University from January 1 to 20, 2023 were selected as the study objects. Bone mineral density (BMD) T and Z values of proximal femur were measured in all enrolled patients, and the patients were divided into normal bone group and osteoporosis group according to the BMD values. Meanwhile, the general data, biochemistry, IPTH, Sclerostin and bone-specific alkaline phosphatase (BALP) were collected. The clinical data, biochemical indexes, serum Sclerostin and BALP levels were compared between the two groups. Multivariate Logistic regression was used to analyze the risk factors of osteoporosis in PD patients. Receiver operating characteristic (ROC) curve was drawn, and the area under ROC curve (AUC) was used to evaluate the diagnostic value of serum Sclerostin, BALP and their combined detection on osteoporosis in PD patients. Results  ①Among the 136 PD patients included in the study, 62 were males, with a median age of 58.00 (49.25, 65.00) and a median dialysis age of 36.00 (25.00, 49.75) months, 71 were osteoporosis patients (52.20%), 74 were diabetic patients (54.41%), and 64 were hypertensive patients (47.06%). There were significant differences in age (Z=-3.273, P=0.001), dialysis age (Z=-4.359, P<0.001) and diabetes mellitus (χ2=25.520, P<0.001) between the normal bone group (n=65) and the osteoporosis group (n=71). ②The results of multivariate Logistic regression analysis showed that age (OR=1.065, 95% CI, 1.005，1.128, P=0.034), dialysis duration (OR=1.042, 95% CI, 1.006～1.078, P=0.020), diabetes (OR=3.607,95% CI,1.217～10.687，P=0.021), Sclerostin (OR=1.012, 95% CI, 1.006～1.019，P＜0.001) and BALP (OR=1.212, 95% CI, 1.095～1.342, P＜0.001) were all risk factors affecting the occurrence of osteoporosis in PD patients (P<0.05). ③ROC curve analysis showed that the sensitivity of serum Sclerostin, BALP and their combination for the diagnosis of osteoporosis in peritoneal dialysis patients were 71.8%, 64.8% and 81.7%, and the specificity was 76.9%, 84.6% and 93.8%, respectively. The AUC was 0.817, 0.789 and 0.902, and the Jorden index was 0.494, 0.488 and 0.755, respectively.  Conclusion   Serum Sclerostin and BALP levels are independent risk factors for osteoporosis in PD patients, and the combined detection of serum Sclerostin and BALP is more effective in the diagnosis of osteoporosis in peritoneal dialysis patients.

Key words: Sclerostin, Bone-specific alkaline phosphatase, Peritoneal dialysis, Osteoporosis