Background: Cardiac valve calcification (CVC) is common in hemodialysis (HD) patients, and associated with cardiovascular and all-cause mortality. Once believed to be a passive process, it is now understood that the Wnt signaling pathway has a major role. The aim of the current study was to assess the relationship between circulating DKK-1, a negative regulator of the Wnt signaling pathway, and CVC, as well as carotid intimal-medial thickness (CIMT) in HD patients. Methods: We enrolled 74 consecutive adults on maintenance HD. Echocardiographic calcification of the mitral valve (MV) and aortic valve (AV) were detected according to Wilkins score (range 0–4), and the study of Tenenbaum et al. [Int J Cardiol. 2004 Mar;94(1):7–13] (range 0–4), respectively. CVC severity was calculated by a supposed score (range 0–8) that represents the sum of calcification grade of MV and AV. CVC severity was classified into absent (CVC score = 0), mild (CVC score = 1–2), moderate (CVC score = 3–4), and severe (CVC score ≥5). Demographic and biochemical data were collected in addition to serum DKK-1 levels and CIMT. Results: CVC was present in 67 patients (91.0%). There was a highly significant negative correlation between serum DKK-1 level and CVC score (r = –0.492; p ≤ 0.001), as well as CIMT (r = –0.611; p ≤ 0.001). Age and CIMT were independent determinants of CVC. Conclusions: CVC is almost present in all HD patients. DKK-1 seems to have a direct relation with CVC and CIMT in HD patients. Age is the strongest independent determinant of CVC.
Cardiorenal Med

中文翻译：

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血液透析患者血清 Dickkopf-1 (DKK-1) 糖蛋白与心脏瓣膜钙化沉积和颈动脉内膜中层厚度之间的关系。

背景：心脏瓣膜钙化 (CVC) 在血液透析 (HD) 患者中很常见，并且与心血管和全因死亡率相关。曾经被认为是一个被动过程，现在了解到 Wnt 信号通路具有重要作用。本研究的目的是评估循环 DKK-1（Wnt 信号通路的负调节因子）与 CVC 以及 HD 患者颈动脉内膜中层厚度 (CIMT) 之间的关系。方法：我们连续招募了 74 名成人进行维护 HD。根据 Wilkins 评分（范围 0-4）和 Tenenbaum 等人的研究检测二尖瓣（MV）和主动脉瓣（AV）的超声心动图钙化。[国际心脏杂志。2004 年 3 月；94(1):7–13]（范围 0–4），分别。CVC 的严重程度是通过一个假定的评分（范围 0-8）来计算的，该评分代表 MV 和 AV 钙化等级的总和。CVC 严重程度分为缺失（CVC 评分 = 0）、轻度（CVC 评分 = 1-2）、中度（CVC 评分 = 3-4）和严重（CVC 评分 ≥ 5）。除了血清 DKK-1 水平和 CIMT 外，还收集了人口统计学和生化数据。结果： 67 名患者（91.0%）存在 CVC。血清 DKK-1 水平与 CVC 评分呈极显着负相关（r = –0.492；p ≤ 0.001），以及 CIMT（r = –0.611；p ≤ 0.001）。年龄和 CIMT 是 CVC 的独立决定因素。结论： CVC 几乎存在于所有 HD 患者中。DKK-1 似乎与 HD 患者的 CVC 和 CIMT 有直接关系。年龄是 CVC 最强的独立决定因素。
心肾医学