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AB0614 Role of wnt antagonists (sclerostin and dkk-1) on bone turnover markers and bone mass, in patients with complete spinal cord injury. preliminary results
  1. L. Gifre1,
  2. J. Vidal2,
  3. S. Ruiz-Gaspà3,
  4. E. Portell2,
  5. A. Monegal1,
  6. A. Muxi4,
  7. N. Guañabens1,
  8. P. Peris1
  1. 1Metabolic Bone Diseases Unit. Rheumatology Department, Hospital Clinic, Barcelona
  2. 2Spinal Cord Unit., Neurorehabilitation Institute Guttmann, Badalona
  3. 3CIBERehd
  4. 4Nuclear Medicine Department, Hospital Clinic, Barcelona, Spain

Abstract

Background Spinal cord injury (SCI) has been associated with a marked increase in bone loss.

Objectives To analyse the effect of Wnt signalling antagonists (sclerostin and DKK-1) and their relationship with bone turnover markers and BMD evolution in patients with a recent SCI.

Methods Patients with a recent complete motor SCI (AIS A or B)(<6 months) were prospectively included. Bone turnover markers (Bone formation: P1NP, bone AP; Bone resorption: sCTx), Wnt antagonists (serum sclerostin and Dkk-1, determined by ELISA, Biomedica Gruppe, Austria) and bone mineral density (BMD) were assessed in all patients at baseline and at 6 months. The results were compared with 23 healthy individuals of similar age and sex.

Results 25 men with a mean age of 37±15 years were included at 101±33 days of SCI onset (AIS 24A;1B). 56% had paraplegia. 13 patients were assessed at 6 months of follow-up. Patients with SCI showed a significant increase in bone turnover markers compared to controls (P1NP 194±87 ng/ml vs. 49±15, p<0.001; sCTx 1.39 ± 0.47 ng/ml vs. 0.48±0.21, p<0.001) and decreased levels of Dkk-1 (63.5±32.8 vs. 39.9±15.7 pmol/L, p=0.003). No differences in sclerostin levels were observed versus controls (39.7±15.4 vs. 35.9±20.5 pmol/L, p=ns). 60% had a low BMD. At 6 months, sclerostin levels increased significantly (40%, p=0.013), bone turnover markers decreased (P1NP -37%, p=0.003 and sCTx -32%, p=0.007) and BMD decreased about 11% at total femur (p=0.002) compared to baseline. Dkk-1 levels also significantly decreased (-35%, p=0.041). Changes in Dkk-1 levels were positively correlated with changes in total femur BMD (r=0.6, p=0.05), while changes in sclerostin were negatively correlated with bone AP change (r=-0.668, p=0.025).

Conclusions Patients with complete SCI have a marked increase in bone turnover markers and early bone loss over 10% at femur. Wnt signalling antagonists seem to be related to bone loss in acute SCI.

Acknowledgements Work funded by a grant from Fundació La Marató de TV3.

Disclosure of Interest None Declared

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