Introduction-Aims-Materials-Methods: Increased sclerostin and dickkopf-1
levels, which are inhibitors of the Wnt/b-catenin bone metabolic pathway, have
been documented in adult patients with Diabetes Mellitus (DM), predominantly in
those with T2DM. No relevant data exist on childhood T1DM. Our aim was to study
plasma sclerostin, dickkopf-1, Osteoprotegerin (OPG), Receptor Activator of
Nuclear factor-KappaB Ligand(s-RANKL), s-RANKL metabolic bone markers and Bone
Mineral Density(total body and lumbar spine BMD) in children and adolescents
with T1DM and controls. We evaluated 40 children and adolescents with T1DM
(mean±SD age 13.04±3.53 years, mean±SD T1DM duration 5.15±3.33years) and 40
healthy age- and gender-matched controls (mean±SD age 12.99±3.3years).
Results: Patients had significantly lower BMD, higher levels of
dickkopf-1(13.56±5.34 vs 11.35±3.76pmol/L, p=0.0194), OPG(6.15±1.56 vs 5.01±1.
5pmol/L, p<0.001), s-RANKL(logS-RANKL 5.97±0.63 vs 5.51±0.84, p=0.004) and ALP
and lower levels of osteocalcin, CTX, PTH and magnesium than controls.
Sclerostin levels in patients and controls were comparable.
Conclusions: RANKL/OPG axis seems to be significantly activated in patients
with T1DM, indicating abnormal osteoclast function, while lower bone turnover
could indicate abnormal osteoblast function and both could be associated with
the lower BMD in T1DM patients. T1DM children and adolescents had similar
sclerostin but higher dickkopf-1 levels, indicating a downregulated
Wnt/b-catenin bone metabolic pathway
Sclerostin, Dickkopf-1, Type 1 diabetes mellitus, Bone metabolism, RANK/RANKL/OPG system