Value of Serum Sclerostin in Osteopenia and Osteoporosis Associated with Liver Cirrhosis and Post Liver Transplantation

Background: Osteodystrophy is one of the signs of liver cirrhosis. In general, maintenance of bone over time requires balance between the formation of new bone tissue and breakdown and removal of old bone tissue. This balance is maintained by a variety of hormones. One of them is sclerostin.Sclerostin is an osteocyte-derived negative regulator of bone formation. It inhibits osteoblastic proliferation and differentiation and promotes osteoblast apoptosis. Aim of the work: Evaluation of serum sclerostin level in relation to osteopenia o serum sclerostine level, calcium phosphorus,parathyroid hormone levels were measured, in addition to Dexa scan. Results: Serum sclerostin level was present in highest concentration in group II (33.99 ± 13.8 ng/ml) compared to group I (15.01 ± 1.87 ng/ml) & group III patients (9.98 ± 1.12 ng/ml).Osteoporosis and osteopenia were significantly most frequent in Child B and C patients (59.4%) compared to Child A (25.1%)and patients post liver transplantation (12.5%).Serum sclerostin level was highest in osteoporotic patients (36.24 ± 11.9 ng/ml), followed by osteopenic patients (30.17± 11.7 ng/ml). Patients with normal Dexa scan had the lowest serum sclerostin level (14.91± 10.7 ng/ml). Conclusion: sclerostin is a good predictor for presence of bone diseases in patients with liver cirrhosis.It has sensitivity of 80.8% at serum level ≥17.7 ng/ml