Exploring the Role of Sclerostin as a Biomarker of Cardiovascular Disease and Mortality: A Scoping Review

Int J Environ Res Public Health. 2022 Nov 30;19(23):15981. doi: 10.3390/ijerph192315981.

Abstract

Sclerostin is most recognized for its role in controlling bone formation; however, it is also expressed in the heart, aorta, coronary, and peripheral arteries. Human studies have associated high circulating sclerostin levels with the presence of different cardiovascular diseases (CVD), surrogate CVD markers, and a high risk of cardiovascular events in some populations. However, this is still a matter of scientific debate, as the results have been very heterogeneous among studies. In the present review, the association between serum sclerostin levels and CVD and/or cardiovascular mortality was analyzed. For this purpose, a scoping review was performed in which articles measuring serum sclerostin levels and cardiovascular risk in patients were selected. Eleven articles answered the research question; of these articles, 8/11 evaluated the association between sclerostin and CVD, of which 4/8 found a positive association, 2/8 found a negative association, and 2/8 found no association between variables. Five (5/11) of the articles included in the study evaluated cardiovascular mortality, of which 3/5 found a positive association, 1/5 found a negative association, and 1/5 found no association between variables. In conclusion, we did not find sufficient results to be able to demonstrate an association between elevated sclerostin levels and the development of CVD and/or cardiovascular mortality in the general population due to heterogeneity in the results. However, there seems to be a tendency to consider increased sclerostin levels as a risk factor for both the development of cardiovascular events and cardiovascular mortality in specific populations. Further studies in this field will help to solve some of the inconsistencies found during this scoping review and allow for the future use of sclerostin measurement as a strategy in the prevention and diagnosis of CVD and/or cardiovascular mortality.

Keywords: biomarkers; cardiovascular disease; cardiovascular mortality; cardiovascular risk; sclerostin.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Bone Morphogenetic Proteins
  • Cardiovascular Diseases* / epidemiology
  • Genetic Markers
  • Humans
  • Risk Factors

Substances

  • Bone Morphogenetic Proteins
  • Genetic Markers
  • Biomarkers

Grants and funding

This research was funded by Instituto de Salud Carlos III grants (PI18-00803, PI21/01069 and PI18-01235), co-funded by the European Regional Development Fund (FEDER) and by Junta de Andalucía grant (PI-0268-2019). In addition, C.G.-F. and B.R.-G. are funded by postdoctoral fellowships from Instituto de Salud Carlos III and Junta de Andalucía (CD20/00022 and RH-0069-2021, respectively) and S.G.-S. and R.S.-d.l.T. are funded by a predoctoral fellowship from Carlos III Health Institute and funded by the University of Granada grant with co-funding by FEDER, (FI19/00118 and 8110 respectively).