Plasma sclerostin level in multiple myeloma: Correlations with disease features and international staging system

Abstract

Background: Multiple myeloma (MM) is a heterogenous plasma cell malignancy with various complications. Sclerostin is a Wingless-type (Wnt) inhibitor specifically expressed by osteocytes; it acts as a negative regulator of bone formation. Objectives: To assess plasma sclerostin level in MM patients and find its correlations with clinical and laboratory data, including osteolytic bone disease and international staging system (ISS). Materials and Methods: This cross-sectional study included 80 individuals: 40 newly diagnosed MM patients and 40 healthy adults. Patients were divided according to the presence of bone disease and ISS stage and were investigated for complete blood count, blood film and bone marrow (BM). Plasma levels of β2-microglobulin and sclerostin were measured using competitive and sandwich enzyme immunoassay techniques, respectively. Results: Sclerostin level was significantly increased in MM patients than control group (P < 0.001) and was significantly higher in those with osteolytic bone disease and/or pathological fractures than those without bone lytic lesions (P < 0.001). Patients with ISS stage III showed significantly higher sclerostin level than stages I and II (P = 0.003). High sclerostin levels were positively correlated with blood urea, serum creatinine, uric acid, and β2-microglobulin (P-values 0.034, <0.001, <0.018 and <0.001, respectively) and negatively with glomerular filtration rate (P = 0.001). No significant correlation was found with age, gender, hematological and other biochemical parameters. Conclusions: In newly diagnosed MM patients, the plasma sclerostin was significantly correlated with renal impairment. High levels of plasma sclerostin were also found in advanced disease stage and with the presence of significant bone disease.

Keywords

• bone disease
• multiple myeloma
• sclerostin