The following is a summary of “Associations of serum sclerostin levels with body composition, pulmonary function, and exacerbations in COPD patients,” published in the November 2024 issue of Pulmonology by Amado et al. 

Chronic obstructive pulmonary disease (COPD) is characterized by a pathologically activated Wnt pathway in the bronchial epithelium, and sclerostin (SOST), a glycoprotein known to obstruct the Wnt pathway, plays a role in bone metabolism.   

Researchers conducted a retrospective study to analyze the individuals with low SOST levels linked to lung function and COPD exacerbations.  

They assessed 139 outpatients with stable COPD and normal kidney function with baseline assessments including SOST levels, bone metabolism parameters, body composition, clinical characteristics, and lung function. Participants were followed for 12 months after enrollment. Data on moderate exacerbations and hospital admissions were recorded during the follow-up period.  

The results showed the serum SOST levels as 23.98±7.6 pmol/l (men: 25.5±7.7 pmol/l, women: 20.3±5.9 pmol/l, P < 0.001) and was correlated with age (r = 0.36), fat-free mass index (FFMI) (r = 0.38), forced expiratory volume in first second (FEV1) (r = 0.27), diffusing capacity of the lung for carbon monoxide (DLCO) (r = 0.39), six-minute walking test distance (6MWD) (r = 0.19), and COPD Assessment Test (CAT) (r = -0.24). In multivariate linear regression, only age (beta=0.264) and FFMI (beta=1.241) remained significant, and SOST negatively correlated with serum phosphorus (r = -0.29). A Cox proportional risk analysis revealed that patients in the lower SOST tertile had a more increased risk of moderate COPD exacerbation (HR 2.015, CI95% 1.136–3.577, P = 0.017) and hospital admission due to COPD (HR 5.142, CI95% 1.380–19.158, P = 0.015) compared to other patients.  

Investigators concluded that lower SOST levels were associated with body composition and lung function in individuals with COPD and predicted a higher risk of exacerbations and hospitalization. 

Source: sciencedirect.com/science/article/pii/S2531043722001313