Elevated Sclerostin Levels Are Associated With Vertebral Fractures in Patients With Type 2 Diabetes Mellitus

Context: Patients with type 2 diabetes mellitus (T2DM) patients are at increased risk of vertebral fractures (VFs) compared with non-T2DM individuals, because of poor bone quality. Recent studies in nondiabetic subjects have shown that elevated sclerostin levels are associated with VFs independent of bone mineral density (BMD). Objective: We aimed to investigate the association between sclerostin levels and VFs in T2DM. Research Design and Methods: We conducted a cross-sectional observational study in 146 postmenopausal women and 175 men over 50 years old. Sclerostin levels were compared in the patients with and without VFs confirmed by spinal radiographs. Results: Sclerostin levels were significantly higher in men than in women (P < .01). Stepwise forward multiple regression analyses demonstrated that spine BMD was the strongest and independent positive determinant for sclerostin in both genders. When the participants were divided into 2 subgroups by the T score of spine BMD to eliminate the influence of BMD on sclerostin values, elevated sclerostin levels were associated with an increased risk of VFs in the male patients with BMD T scores ≥−1 (odds ratio = 1.85, 95% confidence interval = 1.12–3.07) and female with T scores