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Subject Area

Rheumatology and Rehabilitation

Article Type

Original Study

Abstract

Objective The aim was to measure serum levels of Dickkopf-1 (DKK1) in ankylosing spondylitis (AS) patients and to study its relation with vertebral fractures, bone mineral density (BMD), and disease activity. Background AS patients have an increased risk of bone loss and vertebral fractures, which might be related to the activity of the Wingless signaling pathway, and the serum levels of its circulating inhibitors, especially DKK1. Patients and methods This cross-sectional study included 80 participants, 40 patients diagnosed with AS and 40 healthy sex-matched and age-matched volunteers as controls, from 2018 to 2020. All patients and controls were evaluated for the presence of vertebral fractures using conventional radiography of the spine (lateral view), and lumbar spine BMD was assessed with dual X-ray absorptiometry. Serum levels of DKK1, erythrocyte sedimentation rate, and C-reactive protein were measured. Results Serum DKK1 levels of the AS patients were significantly higher than those of the healthy controls. Patients with vertebral fractures had significantly higher DKK1 levels. DKK1 serum levels were inversely correlated to lumbar spine Z-score BMD. A positive correlation was found between DKK1 serum levels and erythrocyte sedimentation rate, C-reactive protein, and disease activity scores. Conclusions Serum DKK1 levels were significantly higher in AS patients than in healthy controls and positively correlated with bone loss and vertebral fracture incidence.

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