Endocrine Abstracts

Introduction: Sclerostin, produced by osteocytes, is a potent inhibitor of Wnt signaling and bone formation. The usefulness of its determination in clinical practice is not well established.

Objectives: The aims of this study were to evaluate serum sclerostin levels in a cohort of Spanish posmenopausal women, and to analyze its relationship with bone metabolism.

Methods: We measured serum sclerostin in 97 posmenopausal women using ELISA and we also evaluated calciotropic hormones, bone turnover markers, bone mineral density (BMD), morphometric vertebral fractures, and prevalent fractures.

Results: Mean levels of sclerostin were 36.7±14.4 pmol/l. We did not found a significant relationship between serum sclerostin and calciotropic hormones, bone turnover markers or BMD. In contrast, sclerostin levels were significantly lower in osteoporotic women (n:34) compared with non-osteoporotic women (n:67): 31.4±11.02 pmol/l vs 39.57±15.27 pmol/l, P=0.007. In the ROC curve analysis to evaluate the usefulness of sclerostin as a marker for high risk of osteoporosis, the area under the curve was 0.678 (95% CI: 0.565–0.791, P=0.004). A concentration of 35.03 pmol/l or lower showed a sensitivity of 70.6% and a specificity of 54% to detect an increased risk of osteoporosis. However, we did not found differences in sclerostin levels according to the diagnosis of morphometric vertebral fractures or the history of prior fracture.

Conclusions: In summary, circulating sclerostin levels were decreased in Spanish women with postmenopausal osteoporosis but serum sclerostin had limited usefulness as a diagnostic marker of osteoporosis.