Clinical significance of serum levels of osteoproteherin and sclerostin in assessment of vascular calcification in chronic kidney disease stage 3–5

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Aim. To clarify the mechanisms of the effect of osteoprotegerin (OPG) and sclerostin on vascular calcification and the state of the cardiovascular system in chronic kidney disease (CKD).

Materials and methods. A total of 110 patients aged 18 to 65 years with CKD stages 3–5D were examined. OPG, sclerostin, intact parathyroid hormone, and serum troponin I were determined using the commercial "Enzyme-linked Immunosorbent Assay Kit for Sclerostin" from Cloude-Clone Corp. (USA) by enzyme-linked immunosorbent assay.

Results. An increase in sclerostin and OPG levels was revealed, which significantly correlated with a decrease in glomerular filtration rate, as well as an increase in left ventricle myocardial mass index and peak systolic blood flow in the aortic arch.

Conclusion. Changes in the regulation of bone-mineral metabolism, in which the proteins inhibitors of bone metabolism, OPG and sclerostin, as well as the interactive interaction between the vascular and skeletal systems, play a decisive role in the development of lesions of the cardiovascular system caused by vascular calcification in CKD.

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Fatima Dzgoeva

North Ossetian State Medical Academy

编辑信件的主要联系方式.
Email: fdzgoeva@mail.ru
ORCID iD: 0000-0002-7314-9063

д-р мед. наук, проф. каф. внутренних болезней №5

俄罗斯联邦, Vladikavkaz

Oleg Remizov

North Ossetian State Medical Academy

Email: fdzgoeva@mail.ru
ORCID iD: 0000-0003-4175-5365

д-р мед. наук, проф. каф. лучевой диагностики с лучевой терапией и онкологией

俄罗斯联邦, Vladikavkaz

Victoria Botcieva

North Ossetian State Medical Academy

Email: fdzgoeva@mail.ru
ORCID iD: 0000-0002-0539-8666

аспирант каф. биохимии

俄罗斯联邦, Vladikavkaz

Victoria Goloeva

North Ossetian State Medical Academy

Email: fdzgoeva@mail.ru
ORCID iD: 0000-0001-5310-889X

аспирант каф. внутренних болезней №5

俄罗斯联邦, Vladikavkaz

Nina Malakhova

North Ossetian State Medical Academy

Email: fdzgoeva@mail.ru
ORCID iD: 0000-0001-5564-9948

аспирант каф. акушерства и гинекологии №1

俄罗斯联邦, Vladikavkaz

Zarina Ikoeva

North Ossetian State Medical Academy

Email: fdzgoeva@mail.ru
ORCID iD: 0000-0002-4183-2335

аспирант каф. внутренних болезней №5

俄罗斯联邦, Vladikavkaz

参考

  1. Pereira L, Frazão JM. The bone-vessel axis in chronic kidney disease: An update on biochemical players and its future role in laboratory medicine. Clin Chim Acta. 2020;508:221-27. doi: 10.1016/j.cca.2020.05.023
  2. Sieklucka B, Domaniewski T, Zieminska M, et al. Сorrelation between OPG/RANKL/RANK axis, vitaminD status, PTH and vascular calcification in the adenin-indused model of chronic kidney Disease. Nephrol Dial Transplant. 2020;35(Suppl. 3):gfaa142.P0690. doi: 10.1093/ndt/gfaa142.P0690
  3. Rochette L, Meloux A, Rigal E, et al. The Role of Osteoprotegerin in Vascular Calcification and Bone Metabolism: The Basis for Developing New Therapeutics. Calcif Tissue Int. 2019;105(3):239-51. doi: 10.1007/s00223-019-00573-6
  4. Drechsler C, Evenepoel P, Vervloet MG, et al. NECOSAD Study Group. High levels of circulating sclerostin are associated with better cardiovascular survival in incident dialysis patients: results from the NECOSAD study. Nephrol Dial Transplant. 2015;30(2):288-93. doi: 10.1093/ndt/gfu301
  5. Palmer SC, Teixeira-Pinto A, Saglimbene V, et al. Association of Drug Effects on Serum Parathyroid Hormone, Phosphorus, and Calcium Levels With Mortality in CKD: A Meta-analysis. Am J Kidney Dis. 2015;66(6):962-71. doi: 10.1053/j.ajkd.2015.03.036
  6. Wu J, Li X, Gao F, et al. Osteoprotegerin SNP associations with coronary artery disease and ischemic stroke risk: a meta-analysis. Biosci Rep. 2020;40(10):BSR20202156. doi: 10.1042/BSR20202156
  7. Дзгоева Ф.У., Сопоев М.Ю., Саламова Э.Э., и др. Остеопротегерин и RANKL: роль в развитии сердечно-сосудистых осложнений у больных с терминальной стадией почечной недостаточности, получающих гемодиализ. Нефрология. 2017;21(5):28-35 [Dzgoeva FU, Sopoev MYu, Salamova EE, et al. Osteoprotegerin and RANKL: a role in the development of cardiovascular complications in patients with terminal stage of renal failure receiving hemodialysis. Nephrology (Saint-Petersburg). 2017;21(5):28-35 (in Russian)]. doi: 10.24884/1561-6274-2017-21-5-28-35
  8. Stavrinou E, Sarafidis PA, Koumaras C, et al. Increased Sclerostin, but Not Dickkopf-1 Protein, Is Associated with Elevated Pulse Wave Velocity in Hemodialysis Subjects. Kidney Blood Press Res. 2019; 44(4):679-89. doi: 10.1159/000501205
  9. Claes KJ, Viaene L, Heye S, et al. Sclerostin: another vascular calcification inhibitor? J Clin Endocrinol Metab. 2013;98:3221-8. doi: 10.1210/jc.2013-1521
  10. Cejka D, Herberth J, Branscum AJ, et al. Sclerostin and Dickkopf-1 in renal osteodystrophy. Clin J Am Soc Nephrol. 2011;6(4):877-82. doi: 10.2215/CJN.06550810
  11. Pelletier S, Dubourg L, Carlier MC, et al. The relation between renal function and serum sclerostin in adult patients with CKD. Clin J Am Soc Nephrol. 2013;8(5):819-23. doi: 10.2215/CJN.07670712
  12. Thambiah S, Roplekar R, Manghat P, et al. Circulating sclerostin and Dickkopf-1 (DKK1) in predialysis chronic kidney disease (CKD): relationship with bone density and arterial stiffness. Calcif Tissue Int. 2012;90(6):473-80. doi: 10.1007/s00223-012-9595-4

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2. Fig. 1. Correlation between serum osteoprotegerin (OPG) and LVMI in the patient group as a whole (n=110). A strong direct relationship was revealed that grows with an increase in the concentration of OPG and the value of LVMI (Spearman analysis).

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3. Fig. 2. Correlations between sclerostin level and LVMI in the patient group as a whole (n=110). The revealed direct relationship is highly reliable, but less pronounced than the dependence of OPG and LVMI (Spearman analysis).

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