Increased Sclerostin Levels after Further Ablation of Remnant Estrogen by Aromatase Inhibitors.
- Author:
Wonjin KIM
1
;
Yoonjung CHUNG
;
Se Hwa KIM
;
Sehee PARK
;
Jae Hyun BAE
;
Gyuri KIM
;
Su Jin LEE
;
Jo Eun KIM
;
Byeong Woo PARK
;
Sung Kil LIM
;
Yumie RHEE
Author Information
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords: Sclerostin; Breast neoplasms; Aromatase inhibitors; Osteoporosis
- MeSH: Alendronate; Aromatase Inhibitors*; Bone Density; Breast Neoplasms; Calcitriol; Estrogens*; Female; Hip; Humans; Osteocytes; Osteogenesis; Osteoporosis; Spine; Steroids
- From:Endocrinology and Metabolism 2015;30(1):58-64
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Sclerostin is a secreted Wnt inhibitor produced almost exclusively by osteocytes, which inhibits bone formation. Aromatase inhibitors (AIs), which reduce the conversion of steroids to estrogen, are used to treat endocrine-responsive breast cancer. As AIs lower estrogen levels, they increase bone turnover and lower bone mass. We analyzed changes in serum sclerostin levels in Korean women with breast cancer who were treated with an AI. METHODS: We included postmenopausal women with endocrine-responsive breast cancer (n=90; mean age, 57.7 years) treated with an AI, and compared them to healthy premenopausal women (n=36; mean age, 28.0 years). The subjects were randomly assigned to take either 5 mg alendronate with 0.5 microg calcitriol (n=46), or placebo (n=44) for 6 months. RESULTS: Postmenopausal women with breast cancer had significantly higher sclerostin levels compared to those in premenopausal women (27.8+/-13.6 pmol/L vs. 23.1+/-4.8 pmol/L, P<0.05). Baseline sclerostin levels positively correlated with either lumbar spine or total hip bone mineral density only in postmenopausal women (r=0.218 and r=0.233; P<0.05, respectively). Serum sclerostin levels increased by 39.9%+/-10.2% 6 months after AI use in postmenopausal women; however, no difference was observed between the alendronate and placebo groups (39.9%+/-10.2% vs. 55.9%+/-9.13%, P>0.05). CONCLUSION: Serum sclerostin levels increased with absolute deficiency of residual estrogens in postmenopausal women with endocrine-responsive breast cancer who underwent AI therapy with concurrent bone loss.
