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Increased sclerostin levels after further ablation of remnant estrogen by aromatase inhibitors.

Kim W, Chung Y, Kim SH, Park S, Bae JH, Kim G, Lee SJ, Kim JE, Park BW, Lim SK, Rhee Y - Endocrinol Metab (Seoul) (2014)

Bottom Line: Postmenopausal women with breast cancer had significantly higher sclerostin levels compared to those in premenopausal women (27.8±13.6 pmol/L vs. 23.1±4.8 pmol/L, P<0.05).Baseline sclerostin levels positively correlated with either lumbar spine or total hip bone mineral density only in postmenopausal women (r=0.218 and r=0.233; P<0.05, respectively).Serum sclerostin levels increased by 39.9%±10.2% 6 months after AI use in postmenopausal women; however, no difference was observed between the alendronate and placebo groups (39.9%±10.2% vs. 55.9%±9.13%, P>0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Sclerostin is a secreted Wnt inhibitor produced almost exclusively by osteocytes, which inhibits bone formation. Aromatase inhibitors (AIs), which reduce the conversion of steroids to estrogen, are used to treat endocrine-responsive breast cancer. As AIs lower estrogen levels, they increase bone turnover and lower bone mass. We analyzed changes in serum sclerostin levels in Korean women with breast cancer who were treated with an AI.

Methods: We included postmenopausal women with endocrine-responsive breast cancer (n=90; mean age, 57.7 years) treated with an AI, and compared them to healthy premenopausal women (n=36; mean age, 28.0 years). The subjects were randomly assigned to take either 5 mg alendronate with 0.5 μg calcitriol (n=46), or placebo (n=44) for 6 months.

Results: Postmenopausal women with breast cancer had significantly higher sclerostin levels compared to those in premenopausal women (27.8±13.6 pmol/L vs. 23.1±4.8 pmol/L, P<0.05). Baseline sclerostin levels positively correlated with either lumbar spine or total hip bone mineral density only in postmenopausal women (r=0.218 and r=0.233; P<0.05, respectively). Serum sclerostin levels increased by 39.9%±10.2% 6 months after AI use in postmenopausal women; however, no difference was observed between the alendronate and placebo groups (39.9%±10.2% vs. 55.9%±9.13%, P>0.05).

Conclusion: Serum sclerostin levels increased with absolute deficiency of residual estrogens in postmenopausal women with endocrine-responsive breast cancer who underwent AI therapy with concurrent bone loss.

No MeSH data available.


Related in: MedlinePlus

Partial correlations between sclerostin, lumbar spine bone mineral density (BMD), and total hip BMD after adjusting for body mass index. (A, B) Premenopausal women. (C, D) Postmenopausal women. Circulating sclerostin positively correlated with lumbar spine and total hip BMD only in postmenopausal women (C, r=0.439, P<0.001; D, r=0.454, P<0.001, respectively). The age-adjusted correlation between BMD and sclerostin remained positive (data not shown). NS, not significant.
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Figure 1: Partial correlations between sclerostin, lumbar spine bone mineral density (BMD), and total hip BMD after adjusting for body mass index. (A, B) Premenopausal women. (C, D) Postmenopausal women. Circulating sclerostin positively correlated with lumbar spine and total hip BMD only in postmenopausal women (C, r=0.439, P<0.001; D, r=0.454, P<0.001, respectively). The age-adjusted correlation between BMD and sclerostin remained positive (data not shown). NS, not significant.

Mentions: Table 2, Fig. 1 show the relationships between sclerostin and various parameters according to Pearson correlation analysis. Serum baseline sclerostin level positively correlated with lumbar spine and total hip BMD (r=0.218 and r=0.233; P<0.05, respectively) (Fig. 1), but only in the postmenopausal group. No significant correlations were observed between bone turnover markers such as CTx and OCN and serum sclerostin (Table 2). A negative correlation was observed between PTH and sclerostin in postmenopausal women (r=-0.074), but was not significant. Serum calcium, phosphorus, and 25(OH)D had no relevant relationships with sclerostin levels.


Increased sclerostin levels after further ablation of remnant estrogen by aromatase inhibitors.

Kim W, Chung Y, Kim SH, Park S, Bae JH, Kim G, Lee SJ, Kim JE, Park BW, Lim SK, Rhee Y - Endocrinol Metab (Seoul) (2014)

Partial correlations between sclerostin, lumbar spine bone mineral density (BMD), and total hip BMD after adjusting for body mass index. (A, B) Premenopausal women. (C, D) Postmenopausal women. Circulating sclerostin positively correlated with lumbar spine and total hip BMD only in postmenopausal women (C, r=0.439, P<0.001; D, r=0.454, P<0.001, respectively). The age-adjusted correlation between BMD and sclerostin remained positive (data not shown). NS, not significant.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384667&req=5

Figure 1: Partial correlations between sclerostin, lumbar spine bone mineral density (BMD), and total hip BMD after adjusting for body mass index. (A, B) Premenopausal women. (C, D) Postmenopausal women. Circulating sclerostin positively correlated with lumbar spine and total hip BMD only in postmenopausal women (C, r=0.439, P<0.001; D, r=0.454, P<0.001, respectively). The age-adjusted correlation between BMD and sclerostin remained positive (data not shown). NS, not significant.
Mentions: Table 2, Fig. 1 show the relationships between sclerostin and various parameters according to Pearson correlation analysis. Serum baseline sclerostin level positively correlated with lumbar spine and total hip BMD (r=0.218 and r=0.233; P<0.05, respectively) (Fig. 1), but only in the postmenopausal group. No significant correlations were observed between bone turnover markers such as CTx and OCN and serum sclerostin (Table 2). A negative correlation was observed between PTH and sclerostin in postmenopausal women (r=-0.074), but was not significant. Serum calcium, phosphorus, and 25(OH)D had no relevant relationships with sclerostin levels.

Bottom Line: Postmenopausal women with breast cancer had significantly higher sclerostin levels compared to those in premenopausal women (27.8±13.6 pmol/L vs. 23.1±4.8 pmol/L, P<0.05).Baseline sclerostin levels positively correlated with either lumbar spine or total hip bone mineral density only in postmenopausal women (r=0.218 and r=0.233; P<0.05, respectively).Serum sclerostin levels increased by 39.9%±10.2% 6 months after AI use in postmenopausal women; however, no difference was observed between the alendronate and placebo groups (39.9%±10.2% vs. 55.9%±9.13%, P>0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Sclerostin is a secreted Wnt inhibitor produced almost exclusively by osteocytes, which inhibits bone formation. Aromatase inhibitors (AIs), which reduce the conversion of steroids to estrogen, are used to treat endocrine-responsive breast cancer. As AIs lower estrogen levels, they increase bone turnover and lower bone mass. We analyzed changes in serum sclerostin levels in Korean women with breast cancer who were treated with an AI.

Methods: We included postmenopausal women with endocrine-responsive breast cancer (n=90; mean age, 57.7 years) treated with an AI, and compared them to healthy premenopausal women (n=36; mean age, 28.0 years). The subjects were randomly assigned to take either 5 mg alendronate with 0.5 μg calcitriol (n=46), or placebo (n=44) for 6 months.

Results: Postmenopausal women with breast cancer had significantly higher sclerostin levels compared to those in premenopausal women (27.8±13.6 pmol/L vs. 23.1±4.8 pmol/L, P<0.05). Baseline sclerostin levels positively correlated with either lumbar spine or total hip bone mineral density only in postmenopausal women (r=0.218 and r=0.233; P<0.05, respectively). Serum sclerostin levels increased by 39.9%±10.2% 6 months after AI use in postmenopausal women; however, no difference was observed between the alendronate and placebo groups (39.9%±10.2% vs. 55.9%±9.13%, P>0.05).

Conclusion: Serum sclerostin levels increased with absolute deficiency of residual estrogens in postmenopausal women with endocrine-responsive breast cancer who underwent AI therapy with concurrent bone loss.

No MeSH data available.


Related in: MedlinePlus