Published in IJCP November 2018
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.