Sclerostin: a candidate biomarker of SCI-induced osteoporosis

Osteoporos Int, 2013 · DOI: 10.1007/s00198-012-2072-0 · Published: March 1, 2013

Endocrinology Rehabilitation Musculoskeletal Medicine

Simple Explanation

Spinal cord injury leads to rapid bone loss and increases fracture risk. Identifying a biomarker could improve diagnosis and treatment of SCI-induced osteoporosis. This study assessed several circulating proteins as potential biomarkers for bone status in men with chronic SCI, finding sclerostin significantly associated with bone mineral content and density. Sclerostin, a protein produced within the bone microenvironment, may be useful for estimating bone density or lower extremity bone mineral content in the absence of DXA testing.

Study Duration

Not specified

Participants

39 men with chronic SCI and 10 men with no SCI

Evidence Level

Not specified

Key Findings

1
Lower sclerostin levels were significantly associated with lower bone mineral content and bone density at all skeletal sites tested.
2
No other circulating protein, including DKK-1, soluble RANKL, osteoprotegerin, osteocalcin, and c-telopeptide, was associated with bone mineral content or bone mineral density.
3
Age-adjusted sclerostin levels were positively associated with leg BMC and to a lesser extent arm BMC.

Research Summary

This study assessed circulating proteins as biomarkers of bone status in men with chronic SCI, finding sclerostin significantly associated with bone mineral content and density at all sites tested. The study suggests circulating sclerostin reflects the severity of bone loss and is a candidate biomarker of osteoporosis severity in chronic SCI. The study proposes that sclerostin may have utility in the development of SCI-specific clinical guidelines for the detection of bone loss.

Practical Implications

Diagnostic Potential

Sclerostin could serve as a biomarker to detect significant bone loss in individuals with SCI, potentially improving osteoporosis diagnosis.

Fracture Risk Assessment

Measuring sclerostin levels might aid in assessing fracture risk in SCI patients, especially when DXA scans are not readily available or compromised.

Treatment Monitoring

Sclerostin levels could be used to monitor the effectiveness of antiresorptive therapies in SCI-induced osteoporosis.

Study Limitations

1
Small sample size limited to men.
2
Larger, longitudinal studies that include women are needed to confirm these findings.
3
Limited information exists on the impact of medications on the relationship between sclerostin and bone.

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