Relationship between serum levels of sclerostin and metabolic risk factors in patients with gestational diabetes mellitus

Objective: Sclerostin, an inhibitor of Wnt/β-catenin pathway, is associated with facets of the metabolic syndrome, as well as with atherosclerotic lesions in patients with type 2 diabetes mellitus. However, regulation of this osteocyte-derived factor in women with gestational diabetes mellitus (GDM) has not been investigated so far.

Methods: Circulating sclerostin was quantified in 72 women with GDM and 72 healthy, pregnant, age-, body mass index-, and gestational age-matched controls by enzyme-linked immunosorbent assay. Furthermore, sclerostin serum levels were correlated to biochemical and anthropometric markers of glucose and lipid metabolism, renal function, and inflammation.

Results: Median [interquartile range] sclerostin serum levels did not differ between GDM (16.7 [5.8] ng/l) and control patients (16.5 [6.0] ng/l) during pregnancy (p = 0.879). In univariate analysis, circulating sclerostin was positively correlated with maternal age and total cholesterol, whereas there was a negative association between sclerostin and estimated glomerular filtration rate, as well as high sensitivity C reactive protein (p < 0.05). However, all of these associations were lost in multivariate linear regression analysis.

Conclusions: Circulating sclerostin is not independently associated with facets of the metabolic syndrome, as well as renal function, in pregnancy in contrast to data obtained in non-pregnant humans. Future studies are needed to elucidate the discrepancies seen in pregnant and non-pregnant subjects around the sclerostin system.