Factors associated with sclerostin levels – A calcification inhibitor – In individuals with type 2 diabetes mellitus; Is autonomic neuropathy the missing link?

Sclerostin inhibits bone formation and its expression is upregulated in the vasculature during the arterial calcification process as a counterregulatory mechanism preventing further calcification. Lower extremity arterial calcification (LEAC) is common in neuropathic patients with type 2 diabetes (T...

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Published in:Journal of diabetes and its complications 2020-10, Vol.34 (10), p.107677-107677, Article 107677
Main Authors: Eleftheriadou, Ioanna, Tentolouris, Anastasios, Anastasiou, Ioanna A., Mourouzis, Iordanis, Tsilingiris, Dimitrios, Kosta, Ourania, Grigoropoulou, Pinelopi, Tentolouris, Nikolaos
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Language:English
Subjects:
Angina pectoris
Ankle
Arterial calcification
Blood pressure
Calcification
Cardiac autonomic neuropathy
Cardiovascular disease
Coronary vessels
Creatinine
Diabetes
Diabetic neuropathy
Heart rate
Homeostasis
Peripheral neuropathy
Plasma
Regression analysis
Sclerostin
Statistical analysis
Type 2 diabetes mellitus
X-rays
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container_issue 10
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container_title Journal of diabetes and its complications
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creator Eleftheriadou, Ioanna
Tentolouris, Anastasios
Anastasiou, Ioanna A.
Mourouzis, Iordanis
Tsilingiris, Dimitrios
Kosta, Ourania
Grigoropoulou, Pinelopi
Tentolouris, Nikolaos
description Sclerostin inhibits bone formation and its expression is upregulated in the vasculature during the arterial calcification process as a counterregulatory mechanism preventing further calcification. Lower extremity arterial calcification (LEAC) is common in neuropathic patients with type 2 diabetes (T2DM). Herein, we investigated for associations between plasma sclerostin levels and diabetic neuropathy as well as LEAC in subjects with T2DM. A total of 74 individuals with and 76 without T2DMwere recruited. Plasma sclerostin levels were measured by ELISA. Diagnosis of cardiac autonomic neuropathy (CAN) was based on the battery of the four autonomic tests, while of somatosensory peripheral neuropathy (DPN) on neuropathy symptom score and neuropathy disability score. LEAC was assessed with conventional ankle and foot x-rays. Plasma sclerostin levels were higher in participants with LEAC vs. those without LEAC in both diabetes and non-diabetes cohorts (p = 0.035 and p = 0.003, respectively). In the diabetes cohort, patients with CAN, but not with DPN, had higher sclerostin levels when compared with those without CAN (p 
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Lower extremity arterial calcification (LEAC) is common in neuropathic patients with type 2 diabetes (T2DM). Herein, we investigated for associations between plasma sclerostin levels and diabetic neuropathy as well as LEAC in subjects with T2DM. A total of 74 individuals with and 76 without T2DMwere recruited. Plasma sclerostin levels were measured by ELISA. Diagnosis of cardiac autonomic neuropathy (CAN) was based on the battery of the four autonomic tests, while of somatosensory peripheral neuropathy (DPN) on neuropathy symptom score and neuropathy disability score. LEAC was assessed with conventional ankle and foot x-rays. Plasma sclerostin levels were higher in participants with LEAC vs. those without LEAC in both diabetes and non-diabetes cohorts (p = 0.035 and p = 0.003, respectively). In the diabetes cohort, patients with CAN, but not with DPN, had higher sclerostin levels when compared with those without CAN (p &lt; 0.001). Multivariate analysis in the diabetes cohort demonstrated that sclerostin levels were associated positively with CAN and LEAC, while in the non-diabetes cohort there was a trend for a positive association with male gender and presence of LEAC. Plasma sclerostin levels are increased in individuals with LEAC irrespectively of diabetes status. In addition, plasma sclerostin concentrations are associated independently with LEAC and CAN in people with T2DM. •Individuals with diabetes and lower extremity arterial calcification (LEAC) had increased sclerostin concentrations.•Sclerostin levels were associated independently with both autonomic dysfunction and LEAC.•The increased sclerostin levels in subjects with LEAC can be a mechanism to prevent further arterial calcification•More research is needed to examine if therapeutic interventions targeting sclerostin effects can reduce arterial calcification.</description><identifier>ISSN: 1056-8727</identifier><identifier>EISSN: 1873-460X</identifier><identifier>DOI: 10.1016/j.jdiacomp.2020.107677</identifier><identifier>PMID: 32713708</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Angina pectoris ; Ankle ; Arterial calcification ; Blood pressure ; Calcification ; Cardiac autonomic neuropathy ; Cardiovascular disease ; Coronary vessels ; Creatinine ; Diabetes ; Diabetic neuropathy ; Heart rate ; Homeostasis ; Peripheral neuropathy ; Plasma ; Regression analysis ; Sclerostin ; Statistical analysis ; Type 2 diabetes mellitus ; X-rays</subject><ispartof>Journal of diabetes and its complications, 2020-10, Vol.34 (10), p.107677-107677, Article 107677</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. 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Lower extremity arterial calcification (LEAC) is common in neuropathic patients with type 2 diabetes (T2DM). Herein, we investigated for associations between plasma sclerostin levels and diabetic neuropathy as well as LEAC in subjects with T2DM. A total of 74 individuals with and 76 without T2DMwere recruited. Plasma sclerostin levels were measured by ELISA. Diagnosis of cardiac autonomic neuropathy (CAN) was based on the battery of the four autonomic tests, while of somatosensory peripheral neuropathy (DPN) on neuropathy symptom score and neuropathy disability score. LEAC was assessed with conventional ankle and foot x-rays. Plasma sclerostin levels were higher in participants with LEAC vs. those without LEAC in both diabetes and non-diabetes cohorts (p = 0.035 and p = 0.003, respectively). In the diabetes cohort, patients with CAN, but not with DPN, had higher sclerostin levels when compared with those without CAN (p &lt; 0.001). Multivariate analysis in the diabetes cohort demonstrated that sclerostin levels were associated positively with CAN and LEAC, while in the non-diabetes cohort there was a trend for a positive association with male gender and presence of LEAC. Plasma sclerostin levels are increased in individuals with LEAC irrespectively of diabetes status. 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Is autonomic neuropathy the missing link?</atitle><jtitle>Journal of diabetes and its complications</jtitle><addtitle>J Diabetes Complications</addtitle><date>2020-10</date><risdate>2020</risdate><volume>34</volume><issue>10</issue><spage>107677</spage><epage>107677</epage><pages>107677-107677</pages><artnum>107677</artnum><issn>1056-8727</issn><eissn>1873-460X</eissn><abstract>Sclerostin inhibits bone formation and its expression is upregulated in the vasculature during the arterial calcification process as a counterregulatory mechanism preventing further calcification. Lower extremity arterial calcification (LEAC) is common in neuropathic patients with type 2 diabetes (T2DM). Herein, we investigated for associations between plasma sclerostin levels and diabetic neuropathy as well as LEAC in subjects with T2DM. A total of 74 individuals with and 76 without T2DMwere recruited. Plasma sclerostin levels were measured by ELISA. Diagnosis of cardiac autonomic neuropathy (CAN) was based on the battery of the four autonomic tests, while of somatosensory peripheral neuropathy (DPN) on neuropathy symptom score and neuropathy disability score. LEAC was assessed with conventional ankle and foot x-rays. Plasma sclerostin levels were higher in participants with LEAC vs. those without LEAC in both diabetes and non-diabetes cohorts (p = 0.035 and p = 0.003, respectively). In the diabetes cohort, patients with CAN, but not with DPN, had higher sclerostin levels when compared with those without CAN (p &lt; 0.001). Multivariate analysis in the diabetes cohort demonstrated that sclerostin levels were associated positively with CAN and LEAC, while in the non-diabetes cohort there was a trend for a positive association with male gender and presence of LEAC. Plasma sclerostin levels are increased in individuals with LEAC irrespectively of diabetes status. In addition, plasma sclerostin concentrations are associated independently with LEAC and CAN in people with T2DM. •Individuals with diabetes and lower extremity arterial calcification (LEAC) had increased sclerostin concentrations.•Sclerostin levels were associated independently with both autonomic dysfunction and LEAC.•The increased sclerostin levels in subjects with LEAC can be a mechanism to prevent further arterial calcification•More research is needed to examine if therapeutic interventions targeting sclerostin effects can reduce arterial calcification.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32713708</pmid><doi>10.1016/j.jdiacomp.2020.107677</doi><tpages>1</tpages></addata></record>
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subjects Angina pectoris
Ankle
Arterial calcification
Blood pressure
Calcification
Cardiac autonomic neuropathy
Cardiovascular disease
Coronary vessels
Creatinine
Diabetes
Diabetic neuropathy
Heart rate
Homeostasis
Peripheral neuropathy
Plasma
Regression analysis
Sclerostin
Statistical analysis
Type 2 diabetes mellitus
X-rays
title Factors associated with sclerostin levels – A calcification inhibitor – In individuals with type 2 diabetes mellitus; Is autonomic neuropathy the missing link?
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