ENDOCRINOLOGY
Serum Sclerostin Level in Patients of Type 2 Diabetes Mellitus and Its Correlation with HbA1c and Bone Turnover Markers
November 04, 2018 | Ashish S Srivastava, Lubna Zafar, SS Siddiqui, Anjum Parvez
Aims and objectives: The aims were to observe the circulating level of sclerostin in type 2 diabetes mellitus patients and its
relationship with glycemic control and markers of bone turnover. Material and methods: The study was an observational
study conducted at JNMCH, Aligarh, Uttar Pradesh, with 50 male patients between 40 and 60 years of age, who were diabetic
as per the ADA criteria. It excluded patients having diseases affecting bone metabolism (Paget disease, liver dysfunction,
vitamin D deficiency, renal insufficiency, hematological disorder) or patients who had or were receiving treatment with drugs
altering bone metabolism (calcium, vitamin D, calcitonin, thiazide, steroids, anticonvulsant). After obtaining the approval
by Institutional Ethics Committee and the consent of patients, the subjects underwent investigations to assess for glycemic
control, along with estimation of the serum levels of calcium, phosphate, 25-hydroxyvitamin D [25(OH)D], bone-specific
alkaline phosphatase (BSAP) and sclerostin. Bone mineral density (BMD) was measured at L2-L4 by DEXA scan. Results: The
mean level of serum sclerostin in our study was 79.84 pmol/L. The mean values of serum calcium, serum phosphate, 25(OH)
D and BSAP were 8.75 mg/dL, 3.35 mg/dL, 24.66 pg/mL and 28.8 U/L, respectively. There was inverse correlation between
sclerostin and BSAP (r = -0.225, p < 0.004) and levels of vitamin D (r = -0.638, p < 0.001). The serum sclerostin levels were
negatively correlated with BMD (r = -0.701, p < 0.001) and positively with HbA1c (r = 0.846, p < 0.001). Conclusion: The
circulating sclerostin level is increased in poorly controlled diabetes and is correlated with BMD and BSAP. It may be
contributing to the deranged bone metabolism in diabetics. Additional studies are needed to evaluate the role of sclerostin
on bone metabolism in this population.