Key result
Elevated pre-transplant sclerostin is linked to greater five-year increases in abdominal aortic calcification scores.
Why the study?
The impact of circulating sclerostin levels on vascular calcification has shown conflicting results depending on the target population and vascular anatomy.
Are elevated pre-transplant sclerostin levels associated with the progression of post-transplant aortic calcifications and arterial stiffness in kidney transplant patients?
Cohort (n=591)
Are elevated pre-transplant sclerostin levels associated with the progression of post-transplant aortic calcifications and arterial stiffness in kidney transplant patients?
Elevated pre-transplant sclerostin levels are associated with faster progression of post-transplant aortic calcification and arterial stiffness over 5 years in kidney transplant patients.
Answers are grounded in this paper and cite their sources.
May support pre-transplant sclerostin assessment for vascular risk stratification in kidney transplant recipients; hypothesis-generating and requires prospective validation.
BACKGROUND: The impact of circulating sclerostin levels on vascular calcification has shown conflicting results depending on the target population and vascular anatomy. This study investigated the associations of sclerostin levels with vascular outcomes in kidney transplant patients. METHODS: In a prospective observational study of the Korean Cohort Study for Outcome in Patients with Kidney Transplantation, 591 patients with serum sclerostin level data prior to transplantation were analyzed. The main predictor was the pre-transplant sclerostin level. Vascular outcomes were the abdominal aortic calcification score and brachial-ankle pulse wave velocity measured at pre-transplant screening and three and five years after kidney transplantation. RESULTS: In linear regression analysis, sclerostin level positively correlated with changes in abdominal aortic calcification score between baseline and five years after kidney transplantation (coefficient of 0.73 [95% CI, 0.11-1.35] and 0.74 [95% CI, 0.06-1.42] for second and third tertiles, respectively, vs the first tertile). In a longitudinal analysis over five years, using generalized estimating equations, the coefficient of the interaction (sclerostin × time) was significant with a positive value, indicating that higher sclerostin levels were associated with faster increase in post-transplant abdominal aortic calcification score. Linear regression analysis revealed a positive association between pre-transplant sclerostin levels and changes in brachial-ankle pulse wave velocity (coefficient of 126.7 [95% CI, 35.6-217.8], third vs first tertile). Moreover, a significant interaction was identified between sclerostin levels and brachial-ankle pulse wave velocity at five years. CONCLUSIONS: Elevated pre-transplant sclerostin levels are associated with the progression of post-transplant aortic calcifications and arterial stiffness.
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Koh et al. (2023) conducted a cohort in Kidney transplantation (n=591). Elevated pre-transplant sclerostin levels vs. Lower sclerostin levels (first tertile) was evaluated on Changes in abdominal aortic calcification score between baseline and five years after kidney transplantation (coefficient 0.74, 95% CI 0.06-1.42). Elevated pre-transplant sclerostin levels were associated with a greater increase in abdominal aortic calcification score at five years.
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