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Decreased serum sclerostin levels in patients with primary hyperparathyroidism: a cross-sectional and a longitudinal study

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Abstract

Summary

Decreased serum sclerostin was evident in patients with primary hyperparathyroidism and was inversely related to parathyroid hormone (PTH). Sclerostin normalized earlier than biochemical bone turnover markers (BTMs) following parathyroidectomy.

Introduction

There is limited information on the changes of serum sclerostin in conditions with chronic PTH excess in humans. The main objectives of the present study were to: (1) examine cross-sectionally the changes of serum sclerostin levels in patients with primary hyperparathyroidism (PHPT), (2) study the time course changes in serum sclerostin in PHPT patients following parathyroidectomy (PTX) followed up longitudinally for 12 months, and (3) compare the changes in serum sclerostin to that of BTMs.

Methods

We studied 60 PHPT patients and compared them with 74 PTX patients together with 268 age- and sex-matched healthy controls. Also, we followed 27 PTX patients longitudinally at 2, 4, 6, 10, 30, 60, 180, and 360 days postoperatively. Serum sclerostin, BTMs, and minerals were measured. Also, bone mineral density was determined by dual energy X-ray absorptiometry.

Results

Patients with PHPT exhibited significantly lower mean serum sclerostin [mean, in picomoles per liter; 95% confidence interval (CI)] (28.98; 27.94–30.03) than that obtained for PTX patients (37.01; 35.75–38.27) and healthy controls (46.22; 45.13–47.31) (P < 0.0001, for each case), respectively. Serum PTH inversely correlated with serum sclerostin (r = −0.651, P < 0.0001). Serum sclerostin was normalized in PTX patients by the tenth day postoperatively and remained within the expected reference range thereafter.

Conclusions

Significantly decreased serum sclerostin was evidenced in PHPT patients as compared with PTX and euparathyroid controls. The inverse PTH and sclerostin relationship suggests that sclerostin is downregulated by PTH in humans. Serum sclerostin normalized earlier than BTMs following parathyroidectomy.

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Acknowledgments

We are grateful to the Ministry of Higher Education for financial support to the Center of Excellence for Osteoporosis Research (CEOR) at King Abdulaziz University (grant #s CEOR/001-08 and CEOR/004-08), Jeddah, Saudi Arabia. We thank Dr. M. Bellal and Dr. A.A. Yousif at the Department of Surgery of the New Jeddah Clinic Hospital for their help in the longitudinal study of the present work. We thank all the subjects who participated in the present study, and we thank all the staff and colleagues at CEOR, King Abdulaziz University Hospital, New Jeddah Clinic Hospital, Al-Khandara Clinic Hospital, and the Primary Care Health Centers for their invaluable assistance during the execution of the present study. Special thanks are due to Ms. Veronica Orbacedo for her excellent secretarial help.

Conflicts of interest

None.

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Authors and Affiliations

  1. Center of Excellence for Osteoporosis Research, and Faculty of Medicine, King Abdulaziz University, P.O. Box No. 20724, Jeddah, 21465, Saudi Arabia

    M.-S. M. Ardawi, A. M. Al-Sibiany, T. M. Bakhsh, A. A. Rouzi & M. H. Qari

  2. Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia

    M.-S. M. Ardawi

  3. Department of General Surgery, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia

    A. M. Al-Sibiany & T. M. Bakhsh

  4. Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia

    A. A. Rouzi

  5. Department of Haematology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia

    M. H. Qari

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  1. M.-S. M. Ardawi
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Correspondence to M.-S. M. Ardawi.

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Ardawi, MS.M., Al-Sibiany, A.M., Bakhsh, T.M. et al. Decreased serum sclerostin levels in patients with primary hyperparathyroidism: a cross-sectional and a longitudinal study. Osteoporos Int 23, 1789–1797 (2012). https://doi.org/10.1007/s00198-011-1806-8

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  • DOI: https://doi.org/10.1007/s00198-011-1806-8

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