Department of Physical Medicine and Rehabilitation, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan.
Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan.
Medicina (Kaunas). 2022 Mar 4;58(3):385. doi: 10.3390/medicina58030385.
Background and Objectives: Sclerostin and Dickkopf-1 (DKK1) modulate osteoblastogenesis, but their role in bone loss in hemodialysis (HD) patients is inconclusive. This study investigated relationships among lumbar bone mineral density (BMD), serum sclerostin, and DKK1 in HD patients. Materials and Methods: Blood samples were obtained from 75 HD patients. Dual-energy X-ray absorptiometry measured lumbar BMD of the lumbar vertebrae (L2−L4). Enzyme-linked immunosorbent assay revealed serum sclerostin and DKK1 concentrations. Results: There were 10 (13.3%), 20 (26.7%), and 45 (60%) patients defined as presenting with osteoporosis, osteopenia, or normal BMD, respectively. Age, alkaline phosphatase, urea reduction rate, fractional clearance index for urea, sclerostin level, and percentage of female patients are significantly negatively associated with the lumbar BMD and T-score, while the body mass index and waist circumference significantly positively associated with the lumbar BMD and T-score. Multivariate forward stepwise linear regression analysis indicated that serum sclerostin (β = −0.546, adjusted R2 change = 0.454; p < 0.001), age (β = −0.216, adjusted R2 change = 0.041; p = 0.007), and percentage of female HD patients (β = −0.288, adjusted R2 change = 0.072; p = 0.0018) were significantly negatively associated with lumbar BMD in HD patients. Conclusions: Advanced age, female gender, and serum sclerostin level, but not DKK1, were negatively associated with BMD in HD patients.
骨硬化蛋白（sclerostin）和 Dickkopf-1（DKK1）可调节成骨细胞生成，但它们在血液透析（HD）患者中的骨丢失中的作用尚无定论。本研究旨在探讨 HD 患者腰椎骨密度（BMD）与血清 sclerostin 和 DKK1 之间的关系。
采集 75 例 HD 患者的血样，应用双能 X 射线吸收仪测量腰椎（L2-L4）的 BMD，采用酶联免疫吸附试验测定血清 sclerostin 和 DKK1 浓度。
10 例（13.3%）、20 例（26.7%）和 45 例（60%）患者分别被定义为骨质疏松、骨量减少和正常 BMD。年龄、碱性磷酸酶、尿素清除率、尿素分数清除指数、sclerostin 水平和女性患者比例与腰椎 BMD 和 T 评分显著负相关，而体重指数和腰围与腰椎 BMD 和 T 评分显著正相关。多元逐步线性回归分析表明，血清 sclerostin（β=-0.546，调整 R2 变化=0.454；p<0.001）、年龄（β=-0.216，调整 R2 变化=0.041；p=0.007）和女性 HD 患者比例（β=-0.288，调整 R2 变化=0.072；p=0.0018）与 HD 患者腰椎 BMD 显著负相关。
高龄、女性和血清 sclerostin 水平与 HD 患者的 BMD 呈负相关，而 DKK1 则与之无关。
