Increased serum sclerostin and decreased serum IGF-1 are associated with vertebral fractures among postmenopausal women with type-2 diabetes

Insulin-like growth factor 1 (IGF-1) is a determinant of bone mass and is inversely associated with vertebral fractures (VFs). Sclerostin regulates bone formation by inhibiting Wnt/beta-catenin signaling. Currently, there is little information on circulating sclerostin levels among postmenopausal women with type-2 diabetes mellitus (T2DM) with VFs in relation to serum IGF-1 (s-IGF-1). We investigated the relationships between serum sclerostin, s-IGF-1, and VFs in postmenopausal women with T2DM. We assessed cross-sectionally 482 postmenopausal women with T2DM and 482 age-matched postmenopausal women without T2DM who were recruited at diabetic clinics and primary health care centers for inclusion in a bone health survey. The main outcome measures were serum sclerostin, s-IGF-1, bone mineral density (BMD), and bone turnover markers. Lateral X-rays of the thoracic and lumbar spine were taken to diagnose VFs. Serum sclerostin levels were increased, whereas s-IGF-1 levels were decreased when,T2DM women were stratified by the number of VFs (P < 0.0001). Multiple logistic regression analysis showed that serum sclerostin levels were positively associated with 1 VF (odds ratio [OR] = 1.27, (95%CI:1.01-2.03), P = 0.016), 2 VFs (OR = 1.41, (95%CI:1.03-236), P = 0.006), and >= 3 VFs (OR = 1.54, (95%CI:1.12-2.44) P = 0.005). s-IGF-1 level S were inversely associated with 1 VF (OR = 0.58, (95%CI:0.39-0.88), P = 0.041), 2 VFs (OR = 0.42, (95%CI:0.21-0.90), P = 0.012), and >= 3 VFs (OR = 0.19, (95%CI: 0.14-0.27), P < 0.001). Increased serum sclerostin and decreased s-IGF-1 were associated with VFs among postmenopausal women with T2DM, suggesting that sclerostin and/or IGF-1 may be involved in increased bone fragility in T2DM and could be potential markers of VF severity. (C) 2013 Elsevier Inc. All rights reserved.