STUDY OF SERUM SCLEROSTIN LEVELS AND CORONARY ARTERY CALCIUM SCORE IN CORONARY ARTERY DISEASE
Coronary artery calcification is an emerging marker being used to evaluate the risk of CAD. Vascular calcification is an active and regulated process. Wnt signalling, required for osteoblast function, is also involved in SMC trans-differentiation in both vascular and bone calcification. Sclerostin is an endogenous antagonist of wnt/B catenin signaling pathway. Computed tomography coronary angiography (CTCA) is a non invasive, though expensive and high radiation exposure tool to detect coronary calcification which is expressed as calcium scores (CACS) and is widely used. Hence, there is a need to find innocuous marker such as sclerostin to evaluate CAC score.
Following were objectives of the study:
1. To estimate the serum levels of sclerostin, hs-CRP and lipid profile parameters in patients with CAD.
2. To correlate sclerostin level with the coronary artery calcium score (CACS) and other markers of atherosclerosis i.e. hs-CRP, ApoA1, ApoB100, lipid profile and carotid intima media thickness (CIMT) in CAD.
A hospital based cross sectional study recruiting 80 subjects was conducted. For comparison subjects were divided in 2 groups CACS=0(n=50) and CACS>0 (n=30) Serum sclerostin levels were estimated by using commercially available ELISA kit. Hs-CRP, ApoA1, ApoB100 and lipid profile parameters by immunoturbidimetry. CACS and CIMT measured by CT angiography and color Doppler.
Sclerostin levels were higher in males than females (p value<0.01) as well as higher in elderly. Sclerostin was significantly higher in subjects CACS>0 as compared to CACS=0 ( p <0.01) significant positive correlation was seen between hs-CRP, CIMT and sclerostin levels (r= 0.262, p=0.019; r=0.275, p=0.014 respectively).
In our study subjects having CACS>0 showed a significantly higher serum sclerostin levels also serum sclerostin levels significantly correlated with hs-CRP, ApoA1, ApoB100 and CIMT. Hence we conclude that serum sclerostin levels can act as a marker of coronary artery calcification in CAD.
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