Endocrine Abstracts

Objective: Sclerostin, a circulating Wnt antagonist and a main negative regulator of bone formation, is increased in type 2 diabetes (T2DM). No data are available on latent autoimmune diabetes in adults (LADA) and whether sclerostin is affected by metabolic syndrome (MS) associated with T2DM or LADA. We evaluated serum sclerostin and bone turnover markers in LADA and T2DM in relation with MS.

Research design and methods: This cross-sectional study included 98 T2DM and 89 LADA recruited by the ACTION LADA and NIRAD cohorts, and further divided according to diagnosis of MS (NCEP criteria). Serum sclerostin, bone formation (P1NP) and bone resorption (serum beta-CTx) markers were analyzed by ELISA.

Results: Sclerostin was unrelated with age, but increased significantly with BMI (ρ=0.29; P<0.0001) and diabetes duration (r=0.32, P<0.0001), this parameter (β=1.77; P=0.008) and to a lesser extent triglycerides (β=0.03; P=0.022) were independent predictor of sclerostin levels in the overall population. T2DM subjects had higher serum sclerostin than LADA overall (median with range 30.7, 1.98–98.8, vs 21.9, 1–74.54 pmol/l, P<0.0001) and also when further subdivided according to the presence of MS (31.6, 1.98–98.8, vs 22.2, 1–74.5 pmol/l, P=0.02). In both T2DM and LADA groups, the presence of MS did not influence significantly serum sclerostin (P>0.15). Patients with T2DM had lower P1NP compared to LADA (57.3±16.6 vs 64.2±59.2 pg/ml; P=0.038) but similar beta-CTx.

Conclusion: T2DM patients present higher levels of sclerostin than LADA, this could result in low bone formation. MS or BMI may not play a crucial role.