Association of Sclerostin with Bone Metabolism and Bone Mineral Density in Adults with Type 1 Diabetes Mellitus

Aims: Type 1 DM (T1DM) patients are shown having lower bone mineral density (BMD). Wnt signaling pathway is important in bone homestasis. Sclerostin is a major inhibitor of this pathway. The objectives of our study are to evaluate sclerostin levels of T1DM patients and to analyse its relationships with bone turnover markers.

Place and Duration of Study: Department of Endocrinology, Tekirdağ State Hospital, between January to December 2013.

Methodology: 48 T1DM patients and age, sex and BMI-matched 40 healthy control cases were included in this study. BMD measurements of T1DM patients were done by dual energy x ray absorptiometry. Serum samples were used to measure albumin, calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone, osteocalcin, pyrilinks-D, 25(OH) Vitamin D and sclerostin levels of all cases.

Results: Sclerostin levels of T1DM patients (803,9±92,01 pg/ml) were significantly higher than control cases (522,9±76,23 pg/ml) (P=0.000). Sclerostin has no correlation with age or gender. Sclerostin level was negatively correlated with lumbar vertebrae and femur neck BMD; however, positively correlated with alkaline phosphatase, intact parathyroid hormone, osteocalcin, pyrilinks-D. Lumbar vertebrae and femur neck BMD has negative correlation with HbA1c and duration of T1DM.

Conclusions: Sclerostin is increased in T1DM patients and this increment is associated with degradation of lumbar vertebrae and femur neck BMD.