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October 02, 2021
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Sclerostin biomarker signature effectively predicts women will develop osteoporosis

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An effective way to predict a woman aged 25 to 31 years will develop osteoporosis is to do a check of sclerostin and possibly other blood serum markers for bone turnover at key timepoints in the woman’s life, according to a presenter.

Scott M. Tintle, MD, and colleagues analyzed levels of sclerostin and other biomarkers for bone turnover at four timepoints — age 25 to 31 years, age 32 to 38 years, age 39 to 45 years and age 46 to 60 years — during the lives of 85 osteoporotic women and 85 non-osteoporotic women after age 46.

At the American Society for Surgery of the Hand Annual Meeting, Tintle presented the results of the study that compared the two groups of women.

Scott M. Tintle
Scott M. Tintle

“There are a number of markers that showed significant group differences at multiple different timepoints. So, some of them are important at multiple timepoints. Again, sclerostin appears to be the most significant,” he said.

In addition to sclerostin, serum levels of the other bone metabolism biomarkers that researchers measured and analyzed included leptin, tumor necrosis factor-alpha, parathyroid hormone, procollagen 1 intact N-terminal propeptide and 25(OH)-vitamin D. They also used multiplex immunoassays, according to the abstract.

A comparison of the biomarker levels between the two groups showed the most pronounced between-group difference was with sclerostin, the levels of which were significantly lower in the osteoporotic group at all time points, results showed.

Results with the gradient boost model the researchers developed, which was one of the machine-learning predictive models they used, showed sclerostin performed best of the biomarkers to predict osteoporosis in the subjects.

“At age 25 to 31 [years], we have a 0.87 area under the curve – so again, good performance of this model with a single serum blood draw from age 25 to 31 [years],” Tintle said.

Tintle, who worked with Sean Slaven, MD, and the Walter Reed Bone Health Research Team on this research, told Healio Orthopedics, “Novel strategies are necessary to help predict and prevent osteoporosis and associated fragility fractures. Bone turnover biomarkers represent one promising candidate to facilitate an earlier osteoporosis diagnosis when a difference might more reliably be made. The objective of this study was to analyze changes in serum markers of bone turnover across multiple decades in osteoporotic women compared with non-osteoporotic women, in order to determine the utility of the markers as potential predictors for osteoporosis (age 25 to 31 years, 32 to 38 years, 39 to 45 years, and 46 years and older). Multiple markers of bone turnover were found to be independent predictors of osteoporosis. Our models using these bone markers were able to estimate the likelihood of osteoporosis development in individuals over time, even as early as the third decade of life. While continued study is necessary, the screening potential of a blood test in women in their 20s could potentially revolutionize bone health.” 

References:

Slaven SE, et al. J Hand Surg Am. 2021;doi:10.1016/j.jhsa.2021.02.019.