Sclerostin in ankylosing spondylitis: A meta-analysis

Abstract

Objective: This study aims to assess circulating sclerostin levels in patients with ankylosing spondylitis (AS).

Methods: The databases of PubMed, Embase, Medline, Web of Science, The Cochrane Library, China National Knowledge Infrastructure Database (CNKI), China Biomedical Literature Database (CBM), Wanfang Med Online Database (Wanfang), China Science and Technology Journal Database (VIP) were used to collect all relevant published articles (up to 26 August 2024). The pooled standardized mean difference (SMD) with 95% confidence interval (CI) was calculated by the random-effect model.

Results: A total of 22 studies were included, including 1354 AS patients and 871 normal controls. There was no significant difference in the circulating sclerostin levels between AS patients and normal controls (SMD = -0.03, 95%CI = -0.51 to 0.46, P = 0.92). Subgroup analysis showed that the South America group, the Africa group, cohort study group, bath ankylosing spondylitis disease activity index (BASDAI) score < 4 group, bath ankylosing spondylitis functional index (BASFI) score < 4 group, C-reactive protein (CRP) ≤ 10 mg/L group, modified stoke ankylosing spondylitis spinal score (mSASSS) ≥ 30 group, TECO medical group and other enzyme-linked immunosorbent assay (ELISA) kits group had lower levels of the circulating sclerostin. Egger's linear regression test indicated that there was no significant publication bias. Sensitivity analysis showed that the results were stable.

Conclusion: There was no significant difference in circulating sclerostin levels between AS patients and normal controls. However, the circulating sclerostin levels in AS patients were influenced by region, type of study, BASDAI score, BASFI score, CRP, mSASSS, and ELISA kits. Therefore, it may serve as an indicator to evaluate disease activity, functional status, inflammation and imaging progression in AS patients.

Keywords: Ankylosing spondylitis; Disease activity; Meta-analysis; Sclerostin; Wnt/β-catenin signaling pathway.