{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T10:47:46Z","timestamp":1781606866804,"version":"3.54.5"},"reference-count":39,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002649","name":"Yeungnam University","doi-asserted-by":"publisher","award":["2024"],"award-info":[{"award-number":["2024"]}],"id":[{"id":"10.13039\/501100002649","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Sclerostin, an osteocyte-derived glycoprotein, plays a key role in bone metabolism by inhibiting the Wnt\/\u03b2-catenin signaling pathway. While it is a recognized therapeutic target in osteoporosis, its relationship with sarcopenia remains unclear. This study aimed to investigate the associations between serum sclerostin levels, sarcopenia, and osteoporosis in older women. Methods: We conducted a cross-sectional study of 79 postmenopausal women aged \u226565 years. Sarcopenia was defined based on grip strength and appendicular skeletal muscle mass (ASM), osteoporosis was diagnosed according to femoral T-scores, and serum sclerostin levels were measured using ELISA. Associations with clinical variables and bone mineral density (BMD) were evaluated using correlation and logistic regression analyses. Results: Sclerostin levels were significantly higher in women with sarcopenia (p = 0.036) and exhibited a negative correlation with grip strength (r = \u22120.298, p = 0.008) but not with ASM. Positive correlations were found between sclerostin and multiple femoral BMD parameters. In a logistic regression analysis, sclerostin was modestly associated with sarcopenia (p = 0.045); however, no significant association was observed with osteoporosis (p = 0.257). Conclusions: Elevated sclerostin levels are associated with reduced muscle strength and sarcopenia in older women, independent of muscle mass, indicating that sclerostin may reflect a functional decline in musculoskeletal health. Muscle strength should therefore be considered when interpreting sclerostin\u2019s clinical implications in aging populations.<\/jats:p>","DOI":"10.3390\/diagnostics16020272","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T15:12:04Z","timestamp":1768403524000},"page":"272","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Sclerostin and Sarcopenia-Related Functional Decline in Older Women"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4787-4448","authenticated-orcid":false,"given":"Dong Gyu","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6837-838X","authenticated-orcid":false,"given":"Jong Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunjung","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.bone.2015.04.016","article-title":"Osteoporosis and sarcopenia in older age","volume":"80","author":"Edwards","year":"2015","journal-title":"Bone"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1301\/nr.2003.may.157-167","article-title":"Sarcopenia and aging","volume":"61","author":"Kamel","year":"2003","journal-title":"Nutr. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/01.blo.0000200248.34876.fe","article-title":"Burden of osteoporosis","volume":"443","author":"Atik","year":"2006","journal-title":"Clin. Orthop. Relat. Res. (1976\u20132007)"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s40520-013-0097-7","article-title":"Osteoporosis and sarcopenia: The connections","volume":"25","author":"Tarantino","year":"2013","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"253","DOI":"10.12968\/hmed.2018.79.5.253","article-title":"Osteosarcopenia","volume":"79","author":"Paintin","year":"2018","journal-title":"Br. J. Hosp. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s12020-013-0026-8","article-title":"Muscle\u2013bone interactions: Basic and clinical aspects","volume":"45","author":"Cianferotti","year":"2014","journal-title":"Endocrine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.bone.2015.02.010","article-title":"Bone and muscle: Interactions beyond mechanical","volume":"80","author":"Brotto","year":"2015","journal-title":"Bone"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.bone.2016.11.024","article-title":"Sclerostin expression and functions beyond the osteocyte","volume":"96","author":"Weivoda","year":"2017","journal-title":"Bone"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1842","DOI":"10.1096\/fj.05-4221fje","article-title":"Sclerostin is a delayed secreted product of osteocytes that inhibits bone formation","volume":"19","author":"Poole","year":"2005","journal-title":"FASEB J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1138\/20060233","article-title":"Mechanosensation and transduction in osteocytes","volume":"3","author":"Bonewald","year":"2006","journal-title":"BoneKEy Osteovision"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1007\/s00198-011-1656-4","article-title":"Mechanical loading-related changes in osteocyte sclerostin expression in mice are more closely associated with the subsequent osteogenic response than the peak strains engendered","volume":"23","author":"Moustafa","year":"2012","journal-title":"Osteoporos. Int."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Nguyen, J., Tang, S.Y., Nguyen, D., and Alliston, T. (2013). Load regulates bone formation and Sclerostin expression through a TGF\u03b2-dependent mechanism. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0053813"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1002\/jbmr.546","article-title":"Association between sclerostin and bone density in chronic spinal cord injury","volume":"27","author":"Morse","year":"2012","journal-title":"J. Bone Miner. Res."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Lee, J.H., Cho, J.H., and Lee, D.G. (2022). Sclerostin concentration and bone biomarker trends in patients with spinal cord injury: A prospective study. Healthcare, 10.","DOI":"10.3390\/healthcare10060983"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Oniszczuk, A., Kaczmarek, A., Kaczmarek, M., Cia\u0142owicz, M., Arslan, E., Silva, A.F., Clemente, F.M., and Murawska-Cia\u0142owicz, E. (2022). Sclerostin as a biomarker of physical exercise in osteoporosis: A narrative review. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.954895"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1002\/jbmr.217","article-title":"Relation of age, gender, and bone mass to circulating sclerostin levels in women and men","volume":"26","author":"Hoey","year":"2011","journal-title":"J. Bone Miner. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.afos.2018.03.002","article-title":"Romosozumab for the treatment of osteoporosis","volume":"4","author":"McClung","year":"2018","journal-title":"Osteoporos. Sarcopenia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.cger.2011.03.009","article-title":"Physical activity and sarcopenia","volume":"27","author":"Pillard","year":"2011","journal-title":"Clin. Geriatr. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"115053","DOI":"10.1016\/j.bone.2019.115053","article-title":"Association of serum sclerostin levels with low skeletal muscle mass: The Korean Sarcopenic Obesity Study (KSOS)","volume":"128","author":"Kim","year":"2019","journal-title":"Bone"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"41","DOI":"10.2165\/11319760-000000000-00000","article-title":"The influence of estrogen on skeletal muscle: Sex matters","volume":"40","author":"Enns","year":"2010","journal-title":"Sports Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"104972","DOI":"10.1016\/j.archger.2023.104972","article-title":"Anthropometric equations to estimate appendicular muscle mass from dual-energy X-ray absorptiometry (DXA): A scoping review","volume":"110","author":"Abdalla","year":"2023","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4235\/agmr.23.0009","article-title":"Korean Working Group on Sarcopenia guideline: Expert consensus on sarcopenia screening and diagnosis by the Korean Society of Sarcopenia, the Korean Society for Bone and Mineral Research, and the Korean Geriatrics Society","volume":"27","author":"Baek","year":"2023","journal-title":"Ann. Geriatr. Med. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"85","DOI":"10.11005\/jbm.2020.27.2.85","article-title":"Measurement and interpretation of handgrip strength for research on sarcopenia and osteoporosis","volume":"27","author":"Lee","year":"2020","journal-title":"J. Bone Metab."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s11154-006-9006-0","article-title":"Guidelines for the diagnosis of osteoporosis: T-scores vs fractures","volume":"7","author":"Miller","year":"2006","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1359\/jbmr.090411","article-title":"Sclerostin mediates bone response to mechanical unloading through antagonizing Wnt\/\u03b2-catenin signaling","volume":"24","author":"Lin","year":"2009","journal-title":"J. Bone Miner. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"6741","DOI":"10.1210\/jc.2005-2370","article-title":"Sclerostin and Wnt signaling\u2014The pathway to bone strength","volume":"90","author":"Ott","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"19883","DOI":"10.1074\/jbc.M413274200","article-title":"Sclerostin binds to LRP5\/6 and antagonizes canonical Wnt signaling","volume":"280","author":"Li","year":"2005","journal-title":"J. Biol. Chem."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5866","DOI":"10.1074\/jbc.M705092200","article-title":"Mechanical stimulation of bone in vivo reduces osteocyte expression of Sost\/sclerostin","volume":"283","author":"Robling","year":"2008","journal-title":"J. Biol. Chem."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1038\/s41413-020-0099-y","article-title":"Molecular mechanosensors in osteocytes","volume":"8","author":"Qin","year":"2020","journal-title":"Bone Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/j.bbrc.2011.12.048","article-title":"The sclerostin-bone protein interactome","volume":"417","author":"Craig","year":"2012","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1210\/jc.2011-2152","article-title":"Sclerostin and its association with physical activity, age, gender, body composition, and bone mineral content in healthy adults","volume":"97","author":"Amrein","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2685","DOI":"10.1007\/s00198-014-2808-0","article-title":"Osteocyte control of bone remodeling: Is sclerostin a key molecular coordinator of the balanced bone resorption\u2013formation cycles?","volume":"25","author":"Livshits","year":"2014","journal-title":"Osteoporos. Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s12603-013-0357-4","article-title":"A path model of sarcopenia on bone mass loss in elderly subjects","volume":"18","author":"Rondanelli","year":"2014","journal-title":"J. Nutr. Health Aging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4857","DOI":"10.1007\/s00068-022-02017-7","article-title":"Serum sclerostin levels in osteoporotic fracture patients","volume":"48","author":"Gorter","year":"2022","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4030","DOI":"10.1210\/jc.2013-2143","article-title":"Elevated sclerostin levels are associated with vertebral fractures in patients with type 2 diabetes mellitus","volume":"98","author":"Yamamoto","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Ueland, T., Stilgren, L., and Bollerslev, J. (2019). Bone matrix levels of dickkopf and sclerostin are positively correlated with bone mass and strength in postmenopausal osteoporosis. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20122896"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e220209","DOI":"10.1530\/JOE-22-0209","article-title":"Novel insights on the effect of sclerostin on bone and other organs","volume":"257","author":"Dreyer","year":"2023","journal-title":"J. Endocrinol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Maccarone, M.C., Coraci, D., Bernini, A., Sarandria, N., Valente, M.R., Frigo, A.C., Dionyssiotis, Y., and Masiero, S. (2023). Sarcopenia prevalence and association with nutritional status in cohort of elderly patients affected by musculoskeletal concerns: A real-life analysis. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1194676"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/2\/272\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T15:21:24Z","timestamp":1768404084000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/2\/272"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":39,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["diagnostics16020272"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16020272","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]}}}