Sclerostin (Scl) is an osteoblast inhibiting glycoprotein secreted mainly by osteocytes which is regulated by hormonal changes and skeletal loading. Decreased physical function and high serum Scl concentrations have been reported in chronic renal failure patients but little is known about the differences among diabetic and nondiabetic patients on hemodyalisis who are susceptible to both sarcopenia and bone fragility.

Objective: To determine the prevalence of sarcopenia and its association with serum sclerostin concentrations and metabolic parameters in 92 patients on hemodyalisis. Anthropometric data and physical performance were evaluated. Blood sample were collected for sclerostin, glucose, cholesterol, triglycerides, calcium, phosphate, PTH e 25OH-vitamin D measurements. Lean mass was evaluated using multifrequency electro-bioimpedance at a “dry weight” time (after dialysis session).

Results: Mean age was 63.3±13.6 years, 63% were male and 44.6% had diabetes. Mean BMI was higher in diabetics (26.6±5.2 vs. 24.1±3.7; p=0.01) and there were no differences in gait speed and hand grip strength between diabetic and nondiabetic subjects. A low skeletal muscle mass index (SMI) was identified in 65.2% of the participants, and among them 76.7% were men and 36.7% diabetics. Mean serum sclerostin was 86.9 ± 39.0 pmol/L, which was higher in men (94.6 ± 41.7; p = 0.017), in individuals with low SMI (94.9 ± 40.7; p < 0.001) and in diabetics (97.2 ± 46.6; p < 0.003). After multivariate analysis and adjustments for potential confounders, high serum sclerostin was independently associated with low SMI and with the presence of diabetes. The following variables correlated positively with diabetes: blood pressure, body mass index (BMI) waist circumference, waist/hip ratio, plasma glucose, serum sclerostin and fat mass.

Conclusions: We found higher serum sclerostin concentrations in hemodialysis patients with diabetes which were inversely related to muscle mass.


F. Bandeira: None. M.W. Medeiros: None. M.H. Junior: None. N.R. Silva: None. M. Bandeira Farias: None. L. Farias: None.


Arab Society for Paediatric Endocrinology and Diabetes

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