Serum Sclerostin Is Associated With Central Fat Distribution in Patients With Type 2 Diabetes and Peripheral Neuropathy

Background: Peripheral neuropathy (PN) is the most common chronic diabetic complication occurring in both type 1 and type 2 (T2DM) patients as well as in prediabetes states. Metabolic syndrome seems to be as important as glycemic control in determining the onset and course of DPN, but the mechanisms underlying this association is far from conclusive. Sclerostin (SCL) is a glycoprotein secreted by osteocytes that has an antagonistic effect on the Wnt/beta-catenin pathway which is related to bone formation as well as to increased ectopic fat including marrow fat. Besides to its well-documented role in bone metabolism, the relationship between SCL and adiposity and metabolic syndrome is poorly understood. Objective: To determine SCL levels in patients with T2DM and DPN and evaluate their relationship with metabolic and body composition parameters. Design: Cross-sectional study including 56 patients with T2DM and DPN. Serum SCL levels, glycemic and lipid profile, anthropometric measurements, and percent body fat (PBF) were determined. Results: Mean age was 61.80 ± 10.67 years, duration of T2DM 13.30 ± 8.13 years, 57.1% men, 78.6% hypertensive, body mass index 28.74 ± 5.04 kg/m(2), abdominal circumference 99.86 ± 13.37 cm, waist-to-hip ratio (WHR) 0.97 ± 0.08, fasting plasma glucose 169.73 ± 83.13 mg/dL, HbA1c 8.88 ± 2.09%, Triglycerides (TG) 163.54 ± 75.93 mg/dL, SCL 207.41 ± 215.13 pg/mL, and PBF 34.45 ± 8.42%. There were significant correlations between SCL and TG (r=0.407, p=0.003) and significant differences in TG according to quartiles (< p25 vs >p75) of SCL: 125.15 ± 47.45 mg/dL vs 223.50 ± 88.77 mg/dL, p = 0.002; and in WHR: 0.97 ± 0.07 vs 1.01 ± 0.07, p = 0.027. Conclusion: We found that increased levels of SCL were associated with WHR and TG in T2DM patients with DPN.