Serum sclerostin as a marker of microvascular and macrovascular complications among children and adolescents with type 1 diabetes mellitus.

Abstract

Background: Uncontrolled diabetes mellitus (DM) accelerates atherosclerosis and vascular diseases, leading to micro- and macrovascular complications. Early cardiac and kidney involvement necessitates an early biomarker. Sclerostin is a Wnt-signaling inhibitor, having a pathophysiological role in vasculopathy, and could be used as a vasculopathy marker. Nevertheless, few data are available in pediatric patients with type 1 diabetes mellitus (T1DM). We aimed at assessing its serum level, and relation to diabetic microvascular and macrovascular complications.

Methods: This is a case control study on patients with T1DM, and healthy controls. Patients were divided into non-diabetic nephropathy (DN), and DN groups according to proteinuria. Patients' clinicodemographic and anthropometrics were obtained, with withdrawal of fasting serum lipid profile, kidney function test, and serum sclerostin. Carotid intimal media thickness (CIMT), a marker of subclinical atherosclerosis, was measured.

Results: We had 75 comparable subjects, where median (IQR) serum sclerostin levels were significantly higher in DN, compared to non-DN and controls [90.83 (82.32 - 115.1), vs. 33.29 (28.37 - 38.53), vs. 13.5 (10.32 - 15.72) ng/mL,respectively, p, < 0.001]. Similarly, median (IQR) CIMT was significantly higher in DN, than in non-DN and controls [1.1 (0.8 - 1.3), vs. 0.11 (0.1 - 0.2), vs. 0.11 (0.1 - 0.2) mm, respectively, p < 0.001]. Serum sclerostin level correlated positively with disease duration, higher HgbA1c%, albuminuria level, and CIMT in all patients. The cut-off values of serum sclerostin > 60.0 ng/mL and CIMT > 0.3 mm were able to detect DN.

Conclusions: Serum sclerostin levels may serve as a potential biomarker for microvascular and macrovascular complications in pediatric patients with T1DM.