Serum Sclerostin Correlates with ACPA Positivity in Post-Menopausal Women with Rheumatoid Arthritis: Data from a Cross-Sectional Case-Control Study in Greece.

INTRODUCTION

Rheumatoid arthritis (RA) is a chronic inflammatory disease marked by bone loss, partly due to impaired Wnt signalling. The role of sclerostin, an endogenous Wnt inhibitor, in RA remains unclear.

METHODS

This 9-month cross-sectional case-control study included post-menopausal women recruited at a tertiary hospital in Athens, Greece. Participants underwent clinical assessment, DXA, radiographs, and blood tests. The aim was to assess serum sclerostin levels and their associations in RA.

RESULTS

A total of 97 RA patients and 45 controls were included. Mean age was 67 ± 7 years; median RA duration was 8 years; 40% were seropositive; 65% received bDMARDs. Median sclerostin levels did not differ significantly between groups (p=0.645). In RA patients, sclerostin levels were positively associated with ACPA (p=0.043). Notably, 27% of RA patients had extremely high sclerostin levels versus 11% of controls (p=0.035). Within this subgroup, high sclerostin was inversely associated with sarcopenia (p=0.020).

DISCUSSION: Although overall sclerostin levels were similar between groups, higher levels in seropositive RA suggest a possible link with ACPA.