Sclerostin and Dickkopf-1 in Renal Osteodystrophy
Sclerostin and Dickkopf-1 in Renal Osteodystrophy
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DOI：
10.2215/cjn.06550810
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发表时间：
2011-04-01
影响因子：
9.8
通讯作者：
Malluche, Hartmut H.
中科院分区：
文献类型：
--
作者：
Cejka, Daniel;Herberth, Johann;Malluche, Hartmut H.
背景与目的血清蛋白sclerostin和Dickkopf-1（Dkk-1）是经典wnt信号的可溶性抑制剂，最近被鉴定为甲状旁腺激素（PTH）信号转导的组分。本研究调查sclerostin和Dkk-1之间的关联与骨转换，矿化和体积的组织形态计量学参数在5期慢性肾脏疾病透析患者（CKD-5D）的设计，设置，参与者，和测量在一项横断面研究中，60 CKD-5D患者进行骨活检，然后进行组织形态计量学。结果血清硬化素与iPTH水平呈负相关。在未调整的分析中，sclerostin与周转率、成骨细胞数量和功能的组织形态计量学参数呈负相关。在校正分析中，sclerostin仍然是骨转换和成骨细胞数量参数的强预测因子。在回归分析中观察到sclerostin和松质骨体积之间的相关性丢失。硬化蛋白对高骨转换和成骨细胞数量的阳性预测上级优于iPTH。相比之下，iPTH在高骨转换的阴性预测方面优于sclerostin上级，并且在成骨细胞数量方面具有与sclerostin相似的预测值。Dkk-1的血清水平没有与iPTH或任何histomorphometric parameter.Conclusions我们的数据描述了一个很有前途的作用，血清测量sclerostin除了iPTH在诊断CKD-5D患者的高骨转换，而Dkk-1的测量似乎并不适用于此目的。J Am Soc Nephrol 6：877-882，2011. doi：10.2215/CJN.06550810
Background and objectives The serum proteins sclerostin and Dickkopf-1 (Dkk-1) are soluble inhibitors of canonical wnt signaling and were recently identified as components of parathyroid hormone (PTH) signal transduction. This study investigated the associations between sclerostin and Dkk-1 with histomorphometric parameters of bone turnover, mineralization, and volume in stage 5 chronic kidney disease patients on dialysis (CKD-5D).Design, setting, participants, & measurements In a cross-sectional study, 60 CKD-5D patients underwent bone biopsies followed by histomorphometry. Levels of sclerostin, Dkk-1, and intact PTH (iPTH) were determined in blood.Results Serum levels of sclerostin and iPTH correlated negatively. In unadjusted analyses, sclerostin correlated negatively with histomorphometric parameters of turnover, osteoblastic number, and function. In adjusted analyses, sclerostin remained a strong predictor of parameters of bone turnover and osteoblast number. An observed correlation between sclerostin and cancellous bone volume was lost in regression analyses. Sclerostin was superior to iPTH for the positive prediction of high bone turnover and number of osteoblasts. In contrast, iPTH was superior to sclerostin for the negative prediction for high bone turnover and had similar predictive values than sclerostin for the number of osteoblasts. Serum levels of Dkk-1 did not correlate with iPTH or with any histomorphometric parameter.Conclusions Our data describe a promising role for serum measurements of sclerostin in addition to iPTH in the diagnosis of high bone turnover in CKD-5D patients, whereas measurements of Dkk-1 do not seem to be useful for this purpose. J Am Soc Nephrol 6: 877-882, 2011. doi: 10.2215/CJN.06550810