International Journal of Multidisciplinary Research and Development

ISSN Online: 2349-4182
ISSN Print: 2349-5979

Vol. 2, Issue 10 (2015)

To study the level of sclerostin in type 2 diabetic patients and its correlation with other markers of bone turnover

Author(s): Ashish S. Shriwastava, Vinay Pandey, Nabeel Mushtaq
Abstract: Both osteoporosis and diabetes mellitus are the two greatest burden to the modern society and the incidence of both the diseases is increasing day by day. When present simultaneously causes their additive effect on outcome of patients morbidity and mortality [2]. By definition osteoporosis is defined as deviation of Z score beyond -2.5 of SD on DEXA. In T2DM bone quality is poor due to impaired blood glucose, poor glycemic control, decreased levels of insulin like growth factor impaired vit D and calcium metabolism, possible vascular abnormalities, associated neuropathy, acidosis, ketosis, associated abnormalities of sex harmone levels and history of repeated fall in patient of DM [3]. Previous experimental and histomorphometry observations often evidenced a condition of low bone turnover and decreased osteoblast activity in both DM1 and DM2 [4].rnSeveral indicators are available to monitor the exent of osteogenesis and bone remodelling in both normal subjects and cases of type 2 DM and its correlation with glycemic control indices can correlate bone quality and glycemic control in cases of DM. Harmonal factors which can alter the prevalence of apoptotic activities against osteoblasts/osteocytes have potential therapeutic value for the treatment of osteoporosis. BUT breakthrough discovery of role of marker such as Sclerostin (ten Dijke et al. 2008; Winkler et al. 2003) leads to the concept that these osteoblastic regulators secreted by osteocytes highlight the importance of the presence of osteocytes in bones. Measurement of bone turnover markers (BTMs) provides a noninvasive approach to assess the bone-remodeling process [5]rnSclerostin:- Mechanism by which sclerostin inhibits bone remodeling. The biological importance is underlined by both experimental studies in knockout animals and clinical observations in subjects with sclerosteosis and van Buchem disease, two genetic disorders with impaired sclerostin production and markedly increased bone mass [5]. Circulating sclerostin levels can be measured in peripheral blood, increase progressively with age [6], and are negatively regulated by estrogens and PTH in both women and men [7]. Remarkably, a recent study also demonstrated that changes in circulating sclerostin levels reflect changes of similar magnitude in bone marrow plasma sclerostin [8]. Moreover sclerostin levels are increased in long-term immobilized patients and negatively correlate with bone formation markers [9].rnNeutralizing monoclonal antibodies against sclerostin have been developed and are under investigation as potential novel anabolic therapy for osteoporosis [10].rn
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