Sclerostin in ankylosing spondylitis: A meta-analysis

Area of Science:

• Rheumatology
• Biochemistry
• Medical Research

Background:

• Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting the spine.
• Sclerostin is a protein involved in bone metabolism, and its role in AS is under investigation.

Purpose of the Study:

• To assess circulating sclerostin levels in patients with ankylosing spondylitis (AS).
• To explore potential correlations between sclerostin levels and disease characteristics.

Main Methods:

• A systematic literature search was conducted across multiple databases (PubMed, Embase, etc.) up to August 2024.
• A random-effect model was used to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for circulating sclerostin levels.
• Publication bias was assessed using Egger's linear regression test, and sensitivity analysis was performed.

Main Results:

• Twenty-two studies involving 1354 AS patients and 871 controls were analyzed.
• No significant difference in circulating sclerostin levels was found between AS patients and normal controls (SMD = -0.03, P = 0.92).
• Subgroup analyses indicated lower sclerostin levels in specific regions, study types, and patient groups with lower disease activity scores (BASDAI, BASFI), lower CRP, and specific imaging scores (mSASSS).

Conclusions:

• Circulating sclerostin levels do not significantly differ between AS patients and healthy controls.
• Factors such as geographic region, study design, disease activity (BASDAI, BASFI), inflammation (CRP), and imaging scores (mSASSS) influence sclerostin levels in AS.
• Sclerostin may hold potential as a biomarker for evaluating disease activity, functional status, inflammation, and radiographic progression in AS.