Clinical Rheumatology

, Volume 37, Issue 11, pp 3093–3098 | Cite as

Parathyroid hormone is a determinant of serum Dickkopf-1 levels in ankylosing spondylitis

  • Giovanni OrsoliniEmail author
  • Giovanni Adami
  • Maurizio Rossini
  • Francesco Ghellere
  • Cristian Caimmi
  • Angelo Fassio
  • Luca Idolazzi
  • Davide Gatti
  • Ombretta Viapiana
Original Article


Available studies reported contradictory results about serum levels Dickkopf-1 (DKK1), an inhibitor of Wnt signaling in patients with ankylosing spondylitis (AS). In previous studies, we observed in other conditions that parathyroid hormone (PTH) serum levels were an important determinant of DKK1 serum levels. The aim of the present study was to investigate it in patients with AS. We recruited 71 patients diagnosed with AS. Levels of C-reactive protein (CRP), DKK1, PTH, 25OH-vitamin D, and bone turnover markers (intact N-propeptide of type I collagen, P1NP, and C-terminal telopeptide of type I collagen, CTX) were measured and compared to healthy controls (HC). Dual X-ray absorptiometry at lumbar spine and proximal femoral site was used for bone mineral density (BMD) assessment and spine X-rays were also performed. PTH serum levels were found to be significantly higher in AS patients than in HC (33.8 ± 14.11 vs 24.8 ± 13 pg/ml, p = 0.002), while mean DKK1 serum levels were lower than in HC (23.3 ± 13.1 vs 29.8 ± 15.9 pmol/l, p = 0.009). A positive correlation between DKK1 and PTH (correlation coefficient + 0.25, p = 0.03) was observed; it remained significant in a multivariate analysis. In patients with longer disease duration, DKK1 was also positively correlated with CTX (coefficient 0.42, p = 0.01), and PTH was higher in those patients with low BMD (Z-score ≤ − 1) at any site (p = 0.04). Also in AS, PTH is an important determinant of DKK1 serum levels and should be evaluated in studies on DKK1. PTH might have a role in bone involvement in AS, also through the Wnt pathway.


Ankylosing spondylitis Dickkopf-1 Osteoporosis Parathyroid hormone Wnt 


Compliance with ethical standards

The study protocol was in line with the Declaration of Helsinki. The study obtained a positive opinion and approval from the Ethical Committee of our institution.




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  • Giovanni Orsolini
    • 1
    Email author
  • Giovanni Adami
    • 1
  • Maurizio Rossini
    • 1
  • Francesco Ghellere
    • 1
  • Cristian Caimmi
    • 1
  • Angelo Fassio
    • 1
  • Luca Idolazzi
    • 1
  • Davide Gatti
    • 1
  • Ombretta Viapiana
    • 1
  1. 1.University of Verona, Rheumatology UnitVeronaItaly

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