The association of sclerostin with osteoporosis and vertebral fractures in patients with type 2 diabetes mellitus.

INTRODUCTION

Type 2 diabetes (T2D) is characterised by low bone turnover. Diabetes is considered to be a risk factor for osteoporosis and vertebral fractures (VF). Sclerostin, a molecule found at high levels in diabetic patients, inhibits osteoblastogenesis and bone formation. Our study aims to investigate the relationship between sclerostin, osteoporosis and VFs in patients with T2D.

METHODS

The study included 101 postmenopausal women with T2D and 30 nondiabetic, postmenopausal controls. The levels of parathyroid hormone (PTH), C-terminal telopeptide (CTX), 25-hydroxyvitamin D and sclerostin were measured in all participants. Dual-energy X-ray absorptiometry (DXA) and thoracolumbar radiography were performed on all patients, with the results being evaluated separately by two clinicians using the Genant method to assess VF in a blinded manner. The FRAX scoring system was used to calculate the patients' risk of fracture.

RESULTS

Postmenopausal diabetic patients were divided into three groups according to their T-scores: osteoporotic, osteopenic and normal. The group of diabetics with normal T-scores had the highest levels of sclerostin. Sclerostin was an independent factor associated with osteoporosis (p = 0.003, OR = 1.24, CI = 1.15-1.3). The prevalence of VF was similar in both diabetic and non-diabetic groups, and no relationship was found between VF and sclerostin levels.

CONCLUSION

Sclerostin may be a potential marker for osteoporosis in diabetic patients, but further research is needed for VF. Anti-sclerostin therapies could be a treatment option for diabetic osteoporosis.