The role of sclerostin in rheumatoid arthritis in a Syrian population: a potential indicator of disease activity in newly-diagnosed patients

Abstract Background: Rheumatoid arthritis (RA) is an autoimmune disease that can cause irreversible joint deformities and bone erosions. Criteria to diagnose RA includs many laboratory tests with variable sensitivity and specificity. Sclerostin, a Wnt inhibitor, could be associated with the reduced bone formation in RA. This study aims to measure sclerostin level and its association with RA and its activity.Materials and methods: This study contained fifty-eight RA cases and thirty controls who were age and sex matched. All laboratory tests were conducted on both groups, including sclerostin which was measured by enzyme-linked immunosorbent assay (ELISA). The disease activity was assessed using disease activity scores (DAS28).Results: Our results showed that sclerostin levels were significantly higher in RA patients compared to control (p<0.001) but were significantly lower than RA patients with joint deformities (0.026). Sclerostin levels also correlated with CRP (r=0.328, p=0.012), Anti-CCP (r=0.418, p=0.001), tender joint count (r=0.293, p=0.025), and DAS28 (r=0.26, p=0.047). There was not a significant association with other variables such as ESR, and rheumatoid factor. By using receiver operating characteristic (ROC) curve, the best cut-off value of sclerostin was 249.69 pg/ml which showed (AUC 0.910, sensitivity 87.9%; specificity 93.3%) and [Odd Ratio (OR) Value & P-value: 102, P< 0.0001].Conclusion: Sclerostin can be used in addition to other parameters to diagnose RA as it was associated with RA with good sensitivity and specificity. It was also associated in early joint destruction and tenderness.