Assessment of Serum Sclerostin Level in Children with Physical Disabilities

Background: Sclerostin, which is a protein that secreted by osteocytes, plays a role in bone remodeling and may reflect changes in bone metabolism in such populations. Objective: This study aimed to evaluate serum sclerostin levels as a potential bone turnover marker in children with physical disabilities and to examine its correlation with bone mineral density and biochemical bone markers. Patients and Methods: This is a case-control study, which we performed at the Children Hospital of Zagazig University, and it involved 96 participants. Group A: 32 children with cerebral palsy and motor disability; Group B: 32 children with osteoporosis from various causes, all on IV zoledronic acid. Group C: 32 healthy, age- and sex-matched controls. Clinical assessments, anthropometric measurements, serum sclerostin levels, and bone markers including calcium, phosphate, alkaline phosphatase (ALP), vitamin D, and parathyroid hormone (PTH) were measured. Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry (DEXA). Results: Children with physical disabilities had significantly higher serum sclerostin levels compared to controls (p < 0.001). A strong negative correlation was observed between sclerostin and BMD at the lumbar spine and femoral neck. Sclerostin levels were positively associated with ALP and PTH, but inversely correlated with vitamin D, calcium, phosphorus, body mass index (BMI), and hemoglobin. ROC curve analysis revealed that serum sclerostin could distinguish disabled children from controls with 68.75% sensitivity and 78.12% specificity at a cutoff value of 445 pg/mL. Conclusion: Serum sclerostin may serve as a non-invasive biomarker for assessing bone metabolism in children with physical disabilities and could help detect early changes in bone health.