Relation of Wnt Signaling Pathway Inhibitors (Sclerostin and Dickkopf-1) to Left Ventricular Mass Index in Maintenance Hemodialysis Patients

• Published in: International journal of nephrology 2021, Vol.2021, p.2439868-11
• Main Authors: Bahie, Ahmed, Abdalbary, Mohamed M., El-Sayed, Dalia Younis, Elzehery, Rasha, El-Said, Ghada, El-Kannishy, Ghada, Abd El Wahab, Ahmed M.
• Format: Article
• Language: English
• Subjects: Age; Analysis; Blood pressure; Body mass index; Calcification; Cardiovascular disease; Comparative analysis; Coronary vessels; Diabetes; Enzymes; Females; Flow velocity; Glycoproteins; Heart enlargement; Heart failure; Hemodialysis; Hemoglobin; Hypertension; Kidney diseases; Laboratories; Medical research; Medicine, Experimental; Phosphatase; Phosphorus; Prognosis
• ISSN: 2090-214X; 2090-2158; 2090-2158
• DOI: 10.1155/2021/2439868

Background. Left ventricular hypertrophy (LVH) is common in hemodialysis (HD) patients. It predicts poor prognosis. Several inhibitors regulate Wnt canonical pathways like Dickkopf-related protein-1 (Dkk-1) and sclerostin. Objectives. To investigate the relationship between serum sclerostin, Dkk-1, left ventricular mass (LVM), and LVM index (LVMI) in HD patients. Methods. This is a cross-sectional study including 65 HD patients in our HD unit. Patients were divided into two groups according to LVMI (group 1 with LVMI  125 gm/m2 (N = 36)). Echocardiographic evaluation of the LVM, aortic, and mitral valves calcification (AVC and MVC) was done. Serum levels of sclerostin and Dkk-1 and patients’ clinical and biochemical data were recorded. Results. Group 2 showed significantly higher age, blood pressure, AVC, and MVC and significantly lower hemoglobin, sclerostin, and Dkk-1 levels. LVM and LVMI had a significant linear negative correlation to both serum sclerostin and Dkk-1 (r = −0.329 and −0.257, P=0.01 and 0.046 for LVM; r = −0.427 and −0.324, P=0.001 and 0.012 for LVMI, resp.). Serum Dkk-1 was an independent negative indicator for LVM and LVMI in multiple regression analyses (P=0.003 and 0.041 with 95% CI = −0.963 to −0.204 and −0.478 to −0.010, resp.). Conclusion. Serum sclerostin and Dkk-1 were significantly lower in HD patients with increased LVMI > 125 gm/m2, and both had a significant linear negative correlation with LVM and LVMI. Dkk-1 was a significant negative independent indicator for LVM and LVMI in HD patients.