Ｏｂｊｅｃｔｉｖｅ：To investigate the association of serum sclerostin (SOST) level with  coronary artery calcifications (CAC),and cardiovascular events in maintenance hemodialysis (MHD) patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of 112 stable MHD patients were enrolled in the study,followed up 24 months.Their baseline characteristics and laboratory measurements were collected.Serum SOST was determined by ELISA，CAC score (CACs) was measured by multislice computed tomography (MSCT).The relationship between SOST and CACs was analyzed and the predictive value of SOST for CVD were assessed.
Ｒｅｓｕｌｔｓ：CAC (Agatston score>100) was present in 5803% (65/112) patients,the median CACs was 238 (0,4106).The median serum SOST level was 7230 (2018,19312) ng/L.According to CACs,the patients were divided into three groups:CACs<100 group,CACs101~400 group and CACs>400 group. In comparison with the CACs＜100 group， serum SOST level was significantly  higher in CACs>400 group [(9039±2055) ng/L vs (5737±2325) ng/L,P<001].Spearman correlation analysis discovered that CACs was positively correlated with SOST (r=0483,P=0000).Logistic regression analysis showed that the risk of moderatesevere CAC increased in association with elevated SOST (Wald=8186,OR=1053,95%CI,1016～1091,P=0004).At 24 months,there were 57 newonset CVD events and among which 9 cases died.KaplanMeier survival curve showed that there were significantly statistical differences in  cumulative incidence of CVD events between different CACs groups  (Logrank test χ2=59629，P<0001).The cumulative incidence of CVD  between median SOST groups was equally statistically significant (Logrank test χ2=21343，P<0001).Cox regression analysis showed that higher SOST and CACs were independent risk factors of CVD events.The area under the ROC curve (AUC) of SOST and CACs for CVD was 0796 and  0861 respectively.When SOST and CACs were detected at the same time to predict CVD events,the AUC was 0897.
Ｃｏｎｃｌｕｓｉｏｎ：The incidence of CAC is high in MHD patients,serum SOST level is associated with CACs.Higher SOST and CACs are independent risk factors for CVD events. SOST and CACs may have predictive value for CVD in MHD patients.