Decreased Plasma Levels of Sclerostin But Not Dickkopf-1 are Associated with an Increased Prevalence of Osteoporotic Fracture and Lower Bone Mineral Density in Postmenopausal Korean Women.
Although sclerostin (SOST) and Dickkopf-related protein 1 (DKK1) are major regulators in bone metabolism, their associations with osteoporotic fracture (OF) in Asians are inconclusive. Furthermore, there have been no clinical studies separately considering non-vertebral and vertebral fractures in terms of the blood levels of SOST and DKK1. Among 513 consecutive postmenopausal Korean women, we identified 103 cases defined as subjects with OF (i.e., non-vertebral and/or vertebral fractures). The controls were randomly selected from the remaining 410 subjects and matched 1:1 to cases according to both age and body mass index. Non-vertebral and morphological vertebral fractures were identified by an interviewer-assisted questionnaire and lateral thoracolumbar radiographs, respectively. Bone mineral density (BMD) and plasma levels of SOST and DKK1 were measured. Plasma SOST levels were lower in subjects with OF than in the control group. Each standard deviation decrement of plasma SOST concentration was associated with a multivariable-adjusted odds ratio of 1.77 for any prevalent OF type. The odds for OF was 2.97-fold higher in subjects in the lowest SOST tertile compared with subjects in the highest SOST tertile. These associations remained significant when the non-vertebral and vertebral fractures were analyzed separately. However, prevalent OF was not associated with plasma DKK1 levels, regardless of the type of fracture and the adjustment model employed. Consistently, plasma SOST levels were positively related with BMD values at all measured skeletal sites, although this was not observed for DKK1. Circulating SOST but not DKK1 may be a potential biomarker for predicting bone health in Asians.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea.
Yejee
Y
Lim
Department of Internal Medicine, Sejong General Hospital, Bucheon, 422-711, Korea.
Chong Hwa
CH
Kim
Asan Institute for Life Sciences, Seoul, 138-736, Korea.
Sun-Young
SY
Lee
Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43 Gil, Songpa-Gu, Seoul, 138-736, Korea.
Hyeonmok
H
Kim
Department of Endocrinology, Inha University School of Medicine, Incheon, 22332, South Korea.
Seong Hee
SH
Ahn
Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43 Gil, Songpa-Gu, Seoul, 138-736, Korea.
Seung Hun
SH
Lee
Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43 Gil, Songpa-Gu, Seoul, 138-736, Korea.
Jung-Min
JM
Koh
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, 120-752, Korea.
Yumie
Y
Rhee
Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea.
Ki Hyun
KH
Baek
Division of Endocrinology and Metabolism, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, 135-710, Korea.
Yong-Ki
YK
Min
Department of Nuclear Medicine, Kyunghee University School of Medicine, Seoul, 130-872, Korea.
Deog-Yoon
DY
Kim
Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43 Gil, Songpa-Gu, Seoul, 138-736, Korea. umkbj@naver.com.
Beom-Jun
BJ
Kim
Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea. mikang@catholic.ac.kr.
Moo-Il
MI
Kang
D048868:Adaptor Proteins, Signal Transducing; D000328:Adult; D000368:Aged; D044466:Asian People; D015992:Body Mass Index; D015519:Bone Density; D019485:Bone Morphogenetic Proteins / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D005786:Gene Expression Regulation; D005819:Genetic Markers; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015663:Osteoporosis, Postmenopausal / Q000097:blood* / Q000453:epidemiology; D017698:Postmenopause; D015995:Prevalence; D015203:Reproducibility of Results; D056910:Republic of Korea; D011795:Surveys and Questionnaires
D048868:Adaptor Proteins, Signal Transducing; D019485:Bone Morphogenetic Proteins; C501126:DKK1 protein, human; D005819:Genetic Markers; D036341:Intercellular Signaling Peptides and Proteins; C422903:SOST protein, human
Asian; Bone mineral density; Dickkopf-1; Osteoporotic fracture; Sclerostin