Relevance of serum sclerostin concentrations in critically ill patients.
Sclerostin is a negative regulator of bone metabolism and associated with chronic morbidities. We investigated circulating sclerostin in critically ill patients.



A total of 264 patients (170 with sepsis) were studied prospectively upon admission to the medical intensive care unit (ICU) and on day 7. Patients' survival was followed for up to 3 years.



Sclerostin serum levels were significantly elevated in critically ill patients at ICU admission compared with 99 healthy controls. Unlike in healthy controls, sclerostin did not depend on sex or age of ICU patients. Sclerostin was associated with disease severity, independent of the presence of sepsis. Sclerostin levels increased during the first week of treatment at the ICU but were not a predictor of mortality. Sclerostin was elevated in patients with preexisting chronic kidney disease or liver cirrhosis, but was not related to diabetes, obesity, or cardiovascular disease. Circulating sclerostin in ICU patients correlated with biomarkers reflecting renal, hepatic and cardiac dysfunction, and biomarkers reflecting bone metabolism.



Serum sclerostin concentrations are significantly elevated in critically ill patients, linked to renal or hepatic organ failure, and associated with bone resorption markers, supporting its value as a potential tool for the assessment of ICU-related metabolic bone disease.
Department of Medicine III, RWTH-University Hospital Aachen, Aachen, Germany.
Alexander
A
Koch
Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry, RWTH-University Hospital Aachen, Aachen, Germany.
Ralf
R
Weiskirchen
Department of Medicine III, RWTH-University Hospital Aachen, Aachen, Germany.
Sebastian
S
Ludwig
Department of Medicine III, RWTH-University Hospital Aachen, Aachen, Germany.
Lukas
L
Buendgens
Department of Medicine III, RWTH-University Hospital Aachen, Aachen, Germany.
Jan
J
Bruensing
Medical Care Center, Dr Stein and Colleagues, Mönchengladbach, Germany.
Eray
E
Yagmur
Department of Medicine III, RWTH-University Hospital Aachen, Aachen, Germany.
Christer
C
Baeck
Department of Medicine III, RWTH-University Hospital Aachen, Aachen, Germany.
Ulf
U
Herbers
Department of Medicine III, RWTH-University Hospital Aachen, Aachen, Germany.
Christian
C
Trautwein
Department of Medicine III, RWTH-University Hospital Aachen, Aachen, Germany. Electronic address: frank.tacke@gmx.net.
Frank
F
Tacke
D048868:Adaptor Proteins, Signal Transducing; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000453:epidemiology; D019485:Bone Morphogenetic Proteins / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D016022:Case-Control Studies; D003422:Critical Care; D016638:Critical Illness / Q000401:mortality; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology; D005260:Female; D005819:Genetic Markers; D006801:Humans; D007362:Intensive Care Units; D008103:Liver Cirrhosis / Q000097:blood / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology; D018805:Sepsis / Q000097:blood* / Q000453:epidemiology / Q000401:mortality; D055815:Young Adult
D048868:Adaptor Proteins, Signal Transducing; D015415:Biomarkers; D019485:Bone Morphogenetic Proteins; D005819:Genetic Markers; C422903:SOST protein, human
Bone metabolism; Cirrhosis; Organ failure; Prognosis; Sclerostin; Sepsis