Research Article Relation of Wnt Signaling Pathway Inhibitors (Sclerostin and Dickkopf-1) to Left Ventricular Mass Index in Maintenance Hemodialysis Patients Ahmed Bahie, 1 Mohamed M. Abdalbary, 1 Dalia Younis El-Sayed, 1 Rasha Elzehery, 2 Ghada El-Said, 1 Ghada El-Kannishy, 1 and Ahmed M. Abd El Wahab 1 1 Internal Medicine Department, Mansoura Nephrology and Dialysis Unit (MNDU), Mansoura Faculty of Medicine, Mansoura, Egypt 2 Department of Clinical Pathology, Mansoura University, Mansoura, Egypt Correspondence should be addressed to Ahmed M. Abd El Wahab; drabdoo34@gmail.com Received 6 June 2021; Revised 3 August 2021; Accepted 11 September 2021; Published 23 September 2021 Academic Editor: Martin Sedlacek Copyright © 2021 Ahmed Bahie et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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.is 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 < 125gm/m 2 (N � 29) and group 2 with LVMI > 125gm/m 2 (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 > 125gm/m 2 , 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. 1. Introduction Left ventricular hypertrophy (LVH) is common structural remodeling in patients with end-stage renal disease, and its presence predicts a poor prognosis [1]. Echocardiographic diagnosis of LVH is based on cutoff values developed from formula formed from population-based studies which indexed the left ventricular mass (LVM) to the body surface area (BSA) [2]. Wnt/β-catenin signaling pathway is an essential positive regulated signaling network for cardiovascular diseases [3]. β-Catenin increases the expression of target genes associated with cell adhesion and involves the regulation of angio- genesis and atherosclerosis [4]. In addition, β-catenin plays a crucial role in heart failure caused by afterload-induced cardiac hypertrophy [5]. It interacts with the transforming growth factor-β (TGF-β) signaling pathway to exacerbate cardiac fibrosis and ag- gravate chronic heart failure [6]. Several inhibitors regulate the Wnt canonical pathway, among them Dickkopf-related protein-1 (Dkk-1) and scle- rostin (Scl) [7]. Sclerostin is a 190-residue glycoprotein, which is expected to contain a cysteine-knot motif and belongs to the DAN/Cerberus family of proteins [8]. Hindawi International Journal of Nephrology Volume 2021, Article ID 2439868, 11 pages https://doi.org/10.1155/2021/2439868