Center of Excellence for Osteoporosis Research, and Faculty of Medicine, King Abdulaziz University, P.O. Box No. 20724, Jeddah, 21465, Saudi Arabia.
Osteoporos Int. 2012 Jun;23(6):1789-97. doi: 10.1007/s00198-011-1806-8. Epub 2011 Oct 28.
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.
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.
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.
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.
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.
研究原发性甲状旁腺功能亢进症（PHPT）患者血清中骨硬化蛋白（sclerostin）的变化，并与甲状旁腺切除术（PTX）后的变化进行比较。
我们研究了 60 例 PHPT 患者，并将其与 74 例 PTX 患者和 268 例年龄和性别匹配的健康对照组进行了比较。此外，我们对 27 例 PTX 患者进行了纵向随访，分别在术后 2、4、6、10、30、60、180 和 360 天进行检测。检测血清 sclerostin、骨代谢生化标志物和矿物质水平，并通过双能 X 线吸收法测量骨密度。
PHPT 患者的血清 sclerostin 水平明显低于 PTX 患者（28.98；27.94-30.03）和健康对照组（46.22；45.13-47.31）（均 P < 0.0001）。血清甲状旁腺激素与血清 sclerostin 呈负相关（r = -0.651，P < 0.0001）。PTX 患者术后第 10 天血清 sclerostin 恢复正常，此后一直处于预期参考范围内。
PHPT 患者的血清 sclerostin 水平明显低于 PTX 患者和甲状旁腺功能正常的对照组。甲状旁腺激素与 sclerostin 之间的负相关关系提示 sclerostin 在人体内受甲状旁腺激素的下调。PTX 术后，血清 sclerostin 比骨代谢生化标志物更早恢复正常。
