ROLE OF SERUM SCLEROSTIN IN OSTEOPOROSIS IN RHEUMATOID ARTHRITIS PATIENTS

Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation leading to cartilage and local bone erosion. Three forms of bone loss have been described in rheumatoid arthritis. These include: periarticular osteopenia adjacent to inflamed joints; joints erosions and generalized osteoporosis involving the axial and appendicular skeleton. Joint erosions are the hallmark of RA. They are caused by an increased bone resorption. However, there is no increased bone formation to prevent or heal these erosions. The Wnt pathway is important in the control of bone formation through regulation of osteoblast activity. Sclerostin is an important regulator of the Wnt pathway by blocking Wnt binding to its receptor and thereby inhibiting bone formation. The aim of this study was to measure Clinical, Laboratory, and radiology study in patients with RA to assess Serum sclerostin level in order to: assess its relation to bone mineral density, assess its effect on disease activity. Twenty RA patients diagnosed according to The 2010 American College of Rheumatology / European League Against Rheumatism classification criteria for rheumatoid arthritis and 10 age and sex matched apparently healthy subjects were included in the present study. They were recruited from outpatient clinical of Physical Medicine, Rheumatology and Rehabilitation Department of Ain Shams University All patients were subjected to: 1. History taking and full clinical examination. 2. Routine laboratory investigations. 3. Dual-energy x-ray absorptiometry test. 4. Detection of serum level of sclerostin (for all RA patients and control subjects). Disease activity in the RA patients was assessed using the Disease Activity Score 28 (DAS 28). The results obtained were statistically analyzed and summarized as follows: • There was highly significant difference between serum sclerostin levelin studied RA patients and controls. • There waspositive significant correlation between serum sclerostin and age of the pateints. • There was negative significant correlationbetween serum sclerostin and BMI