Sclerostin and bone in diabetes mellitus type 2
In the current number, García-Martín et al.1 from the working group of Dr. Muñoz of Granada report that blood levels of sclerostin – the protein coded for by the gene SOST, which inhibits the osteoblast Wnt pathway – depend on the sex, the age and the renal function of patients with diabetes mellitus type 2 (DM2). They also demonstrate, contrary to expectations, a negative relationship with the markers for bone remodelling, and a positive relationship with bone mineral density (BMD). Finally, they show that blood levels of sclerostin are lower in patients with DM2 and osteoporosis irrespective of the presence or absence of fractures.
DM2 is a disease of high prevalence – up to 12-15% of the adult population in our country2 – and with an enormous impact on morbi-mortality and quality of life. Its relationship with micro-vascular complications – retinopathy, nephropathy and diabetic neuropathy – and macro-vascular complications – coronary artery, peripheral arterial and cerebrovascular disease – is well known. Most recently, new complications have been recognised to be clearly related to diabetes, among which osteoporosis or diabetes-related metabolic bone disease is a notable example.