Relevance of serum sclerostin concentrations in critically ill patients.
PURPOSE
Sclerostin is a negative regulator of bone metabolism and associated with chronic morbidities. We investigated circulating sclerostin in critically ill patients.


METHODS
A total of 264 patients (170 with sepsis) were studied prospectively upon admission to the medical intensive care unit (ICU) and on day 7. Patients' survival was followed for up to 3 years.


RESULTS
Sclerostin serum levels were significantly elevated in critically ill patients at ICU admission compared with 99 healthy controls. Unlike in healthy controls, sclerostin did not depend on sex or age of ICU patients. Sclerostin was associated with disease severity, independent of the presence of sepsis. Sclerostin levels increased during the first week of treatment at the ICU but were not a predictor of mortality. Sclerostin was elevated in patients with preexisting chronic kidney disease or liver cirrhosis, but was not related to diabetes, obesity, or cardiovascular disease. Circulating sclerostin in ICU patients correlated with biomarkers reflecting renal, hepatic and cardiac dysfunction, and biomarkers reflecting bone metabolism.


CONCLUSION
Serum sclerostin concentrations are significantly elevated in critically ill patients, linked to renal or hepatic organ failure, and associated with bone resorption markers, supporting its value as a potential tool for the assessment of ICU-related metabolic bone disease.
['Koch|Alexander|A|', 'Weiskirchen|Ralf|R|', 'Ludwig|Sebastian|S|', 'Buendgens|Lukas|L|', 'Bruensing|Jan|J|', 'Yagmur|Eray|E|', 'Baeck|Christer|C|', 'Herbers|Ulf|U|', 'Trautwein|Christian|C|', 'Tacke|Frank|F|']
D048868:Adaptor Proteins, Signal Transducing D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D015415:Biomarkers D001851:Bone Diseases, Metabolic D019485:Bone Morphogenetic Proteins D002318:Cardiovascular Diseases D016022:Case-Control Studies D003422:Critical Care D016638:Critical Illness D003920:Diabetes Mellitus D005260:Female D005819:Genetic Markers D006801:Humans D007362:Intensive Care Units D008103:Liver Cirrhosis D008297:Male D008875:Middle Aged D009026:Mortality D009765:Obesity D011379:Prognosis D011446:Prospective Studies D051436:Renal Insufficiency, Chronic D018805:Sepsis D055815:Young Adult
Sclerostin Bone metabolism Sepsis Cirrhosis Organ failure Prognosis