Abstract
Background
Sclerostin, a regulator of bone metabolism and vascular calcification involved in regulating the Wnt/β-catenin signaling pathway, has been shown to be involved in the pathogenesis of rheumatoid arthritis (RA). However, current results regarding the circulating sclerostin level of RA patients are debatable. This study aimed to evaluate the circulating level of sclerostin in RA patients and briefly summarize its role.
Method
PubMed, EMBASE, and the Cochrane Library databases were systematically searched till May 27, 2021, for eligible articles. Useful data from all qualified papers were systematically extracted and analyzed using Stata 12.0 software (Stata Corp LP, College Station, TX, USA).
Results
Overall, 13 qualifying studies including 1030 cases and 561 normal controls were analyzed in this updated meta-analysis. Forest plot of this meta-analysis showed that RA patients had higher circulating sclerostin levels (P < 0.001, standardized mean difference [SMD] = 0.916, 95% CI: 0.235–1.597) compared to normal controls. Subgroup analyses implied that age, region, and assay method were associated with sclerostin level in RA patients.
Conclusion
RA patients have higher circulating sclerostin levels, and these was influenced by age, region, and assay method.
Zusammenfassung
Hintergrund
Für Sclerostin, ein Regulator des Knochenstoffwechsels und der Gefäßkalzifizierung, der an der Regulierung des Wnt/β-Catenin-Signalwegs beteiligt ist, wurde nachgewiesen, dass es auch in der Pathogenese der rheumatoiden Arthritis (RA) eine Rolle spielt. Jedoch sind die aktuellen Ergebnisse in Bezug auf die Werte für zirkulierendes Sclerostin bei RA-Patienten umstritten. Ziel der vorliegende Studie war es, die Werte für zirkulierendes Sclerostin bei RA-Patienten zu untersuchen und dessen Rolle kurz zusammenzufassen.
Methoden
Die Datenbanken PubMed, EMBASE und der Cochrane Library wurden systematisch bis 27. Mai 2021 auf infrage kommende Artikel hin durchsucht. Nützliche Daten aus allen geeigneten Arbeiten wurden systematisch erfasst und mittels der Software Stata 12.0 analysiert (Stata Corp LP, College Station, TX, USA).
Ergebnisse
In dieser aktualisierten Metaanalyse wurden 13 geeignete Studien mit 1030 Fällen und 561 normalen Kontrollen ausgewertet. Das Walddiagramm dieser Metaanalyse zeigte, dass RA-Patienten höhere Werte für Werte für zirkulierendes Sclerostin aufwiesen als die normalen Kontrollen (p < 0,001; standardisierte mittlere Differenz, SMD: 0,916; 95%-Konfidenzintervall, 95%-KI: 0,235–1,597). Untergruppenanalysen ergaben, dass Alter, Region und Bestimmungsmethode mit dem Sclerostinwert bei RA-Patienten in Zusammenhang standen.
Schlussfolgerung
Bei RA-Patienten fanden sich höhere Werte für zirkulierendes Sclerostin auf als bei normalen Kontrollen. Dieser Zusammenhang wurde durch die Faktoren Alter, Region und Bestimmungsmethode beeinflusst.
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Funding
This work was supported by grants from the National Natural Science Foundation of China (Grant Number 81872687; 82073652).
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Y.-M. Mao, T. Liao, Q.-L. Ye, G.-C. Wu, Q. Zhang, S.-S. Tao, C.-N. Zhao, Q. Wu, Y.‑L. Dan, H.-F. Pan, and D.-Q. Ye declare that they have no competing interests.
For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.
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Ulf Müller-Ladner, Bad Nauheim
Uwe Lange, Bad Nauheim
Yan-Mei Mao and Tao Liao contributed equally to this work and should be considered co-first authors.
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Mao, YM., Liao, T., Ye, QL. et al. Increased circulating sclerostin levels in rheumatoid arthritis patients: an updated meta-analysis. Z Rheumatol 82 (Suppl 1), 51–58 (2023). https://doi.org/10.1007/s00393-021-01091-3
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DOI: https://doi.org/10.1007/s00393-021-01091-3