Relationships between sclerostin and morphometric vertebral fractures, bone mineral density, and bone microarchitecture in postmenopausal women

Summary Higher sclerostin levels in postmenopausal women are associated with improved bone microarchitecture, areal and volumetric bone mineral density, and bone strength. However, the serum sclerostin level had no independent associations with the prevalence of morphometric vertebral fractures in this population after multivariable adjustment. Purpose We aim to investigate the associations between serum sclerostin levels and morphometric vertebral fractures (VFs) prevalence, bone mineral density (BMD), and bone microarchitecture in postmenopausal women. Methods A total of 274 community-dwelling postmenopausal women were randomized enrolled. We collected general information and measured the serum sclerostin level. Morphometric VFs were assessed on the lateral thoracic and lumbar spine X-rays. Areal BMD and calculated trabecular bone score (TBS) were detected by dual-energy X-ray absorptiometry, and volumetric BMD and bone microarchitecture data were acquired from high-resolution peripheral quantitative computed tomography. Results The prevalence of morphometric VFs was 18.6% in the cohort, and it was significantly higher in the lowest quartile of the sclerostin group than that in the highest quartile of the sclerostin group (27.9% vs. 11.8%, p <0.05). But the serum sclerostin had no independent association with the prevalence of morphometric VFs after adjusting by age, body mass index, BMD at the lumbar vertebrae 1–4, and fragility fracture history after 50 years old (odds ratio: 0.995, 95% confidence interval: 0.987–1.003, p =0.239). The serum sclerostin level positively correlated with the areal, volumetric BMDs, and TBS. It also had significant positive associations with Tb.BV/TV, Tb.N, Tb.Th, and Ct.Th, and negative associations with Tb.Sp and Tb.1/N.SD. Conclusion Chinese postmenopausal women with higher serum sclerostin levels had a lower prevalence of morphometric VFs, higher BMDs, and better bone microarchitecture. Nevertheless, the serum sclerostin level had no independent association with the prevalence of morphometric VFs.