MP164HIGHER SERUM SCLEROSTIN LEVELS AND INSUFFICIENCY OF VITAMIN D ARE STRONGLY ASSOCIATED WITH VERTEBRAL FRACTURES IN HEMODIALYSIS PATIENTS: A CASE CONTROL STUDY

Abstract

Introduction and Aims: The aims of our study were to determine the prevalence of vertebral fracture and analyze associations between sclerostin serum levels and vertebral fractures in hemodialysis patients. Methods: Nintey-two hemodialysis patients and 100 controls matched for sex, age and body mass index were studied. Bone mineral density was measured by ultrasonography at calcaneus. The markers of bone turnover included serum osteocalcin, C-terminal telopeptide and sclerostin. All participants underwent radiography of the thoracic and lumbar spine to ascertain the presence of vertebral fractures. Results: Bone ultrasound parameter at calcaneus were significantly lower in hemodialysis patients compared with controls (68.58 ± 9.70 vs 77.18 ± 8.06; p<0.01); bone turnover markers and parathyroid hormone level were significantly higher, while serum of vitamin D was significantly lower in hemodialysis group (20.29 ± 4.05 vs 25.77 ± 7.60; p<0.01). One or more moderate or severe vertebral fractures were found in 38 hemodialysis patients, whereas in control group ten patients had a vertebral fracture. In hemodialysis group the comparison between patients with and without vertebral fractures showed that the patients with vertebral fractures had the serum sclerostin levels statistically higher than patients without vertebral fractures (1.72 ± 0.41 vs 0.79 ± 0.31; p<0.001), while serum levels of vitamin D was significantly lower in patients with vertebral fractures compared to the patients without vertebral fractures (20.26 ± 11.15 vs 27.28 ± 18.75; p<0.05). In univariate analysis vertebral fracture were associated with insufficiency of vitamin D and highest tertile serum sclerostin (OR 4.07, CI95% 1.65-10.05, p=0.002). Conclusions: Our data shows high prevalence of vertebral fractures in hemodialysis patients, insufficiency vitamin D levels and higher serum sclerostin levels that are strong associated with vertebral fractures.