ECTS2013 Poster Presentations Osteoporosis: pathophysiology and epidemiology (49 abstracts)
Role of Wnt antagonists (sclerostin and Dkk-1) on bone turnover markers and bone mass, in patients with complete spinal cord injury: preliminary results
Laia Gifre 1 , Joan Vidal 2 , Silvia Ruiz-Gaspà 3 , Enric Portell 2 , Ana Monegal 1 , Africa Muxi 4 , Núria Guañabens 1, & Pilar Peris 1,
1Metabolic Bone Diseases Unit, Rheumatology Department, Hospital Clínic, Barcelona, Spain; 2Spinal Cord Unit, Neurorehabilitation Institute Guttmann, Badalona, Spain; 3CIBERehd, Hospital Clínic, Barcelona, Spain; 4Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain.
Spinal cord injury (SCI) has been associated with a marked increase in bone loss. This study analysed the effect of Wnt signalling antagonists (sclerostin and DKK-1) and their relationship with bone turnover markers and BMD evolution in patients with a recent SCI.
Methods: Patients with a recent complete motor SCI (AIS A or B); (<6 months) were prospectively included. Bone turnover markers (bone formation: P1NP, bone AP; bone resorption: sCTx), Wnt antagonists (serum sclerostin and Dkk-1, determined by ELISA, Biomedica Gruppe, Austria) and bone mineral density (BMD) were assessed in all patients at baseline and at 6 months. The results were compared with 23 healthy individuals of similar age and sex.
Results: 25 men with a mean age of 37±15 years were included at 101±33 days of SCI onset (AIS 24A; 1B). 56% had paraplegia. Thirteen patients were assessed at 6 months of follow-up. Patients with SCI showed a significant increase in bone turnover markers compared to controls (P1NP 194±87 vs 49±15 ng/ml, P<0.001; sCTx 1.39±0.47 vs 0.48±0.21 ng/ml, P<0.001) and decreased levels of Dkk-1 (63.5±32.8 vs 39.9±15.7 pmol/l, P=0.003). No differences in sclerostin levels were observed vs controls (39.7±15.4 vs 35.9±20.5 pmol/l, P=ns). 60% had a low BMD. At 6 months, sclerostin levels increased significantly (40%, P=0.013), bone turnover markers decreased (P1NP −37%, P=0.003 and sCTx −32%, P=0.007) and BMD decreased about 11% at total femur (P=0.002) compared to baseline. Dkk-1 levels also significantly decreased (−35%, P=0.041). Changes in Dkk-1 levels were positively correlated with changes in total femur BMD (r=0.6, P=0.05), while changes in sclerostin were negatively correlated with bone AP change (r=−0.668, P=0.025).
Conclusions: Patients with complete SCI have a marked increase in bone turnover markers and early bone loss over 10% at femur. Wnt signalling antagonists seem to be related to bone loss in acute SCI.
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Bone Abstracts
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