{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:37:22Z","timestamp":1777869442578,"version":"3.51.4"},"reference-count":27,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Background: Thyroid hormones influence bone metabolism, and autoimmune thyroid diseases may further impact skeletal homeostasis. Wnt signaling inhibitors, including Dickkopf-1 (DKK-1) and sclerostin (SOST), as well as osteoprotegerin (OPG), play key roles in regulating bone formation and resorption. This study aimed to evaluate circulating DKK-1, SOST, and OPG in women with newly diagnosed overt thyroid dysfunction. Methods: This cross-sectional study included 62 women with newly diagnosed, untreated overt thyroid dysfunction (35 hypothyroid and 27 hyperthyroid) and 33 age- and BMI-matched healthy controls. Serum levels of DKK-1, sclerostin, and OPG were measured using ELISA. Thyroid function and autoantibodies were assessed using automated immunoassays. Correlation analysis was performed to evaluate associations between variables. Results: Serum DKK-1 levels were significantly elevated in both hypothyroid and hyperthyroid women compared with controls (p &lt; 0.001). Sclerostin levels showed a non-significant trend toward higher values. OPG levels were significantly increased in hyperthyroid patients and moderately elevated in hypothyroid patients. Significant positive correlations were observed between OPG and FT3 (r = 0.42, p = 0.001) and FT4 (r = 0.43, p = 0.001). In hypothyroid patients, OPG correlated positively with TgAb (r = 0.46, p = 0.007). A strong positive correlation was found between DKK-1 and SOST (p &lt; 0.001), while DKK-1 was negatively associated with age (p &lt; 0.05). Conclusions: Overt thyroid dysfunction is associated with significant alterations in circulating Wnt signaling inhibitors and OPG. These findings suggest a potential role of Wnt signaling and immune\u2013bone interactions in thyroid-related changes in bone metabolism.<\/jats:p>","DOI":"10.3390\/metabo16050308","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:32:21Z","timestamp":1777555941000},"page":"308","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Circulating Wnt Signaling Inhibitors and Osteoprotegerin in Women with Newly Diagnosed Overt Thyroid Dysfunction"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6566-1542","authenticated-orcid":false,"given":"Mariya Zhivkova","family":"Miteva","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Clinic of Endocrinology and Metabolic Diseases, \u201cSt. George\u201d University Hospital, 4000 Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Mitkova","family":"Orbetzova","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Clinic of Endocrinology and Metabolic Diseases, \u201cSt. George\u201d University Hospital, 4000 Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2931-3804","authenticated-orcid":false,"given":"Boyan Ivanov","family":"Nonchev","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Clinic of Endocrinology and Metabolic Diseases, \u201cKaspela\u201d University Hospital, 4001 Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delyana Miteva","family":"Davcheva","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Faculty of Medicine, \u201cSt. George\u201d University Hospital, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kostadin","family":"Gigov","sequence":"additional","affiliation":[{"name":"Section of Plastic Reconstructive and Aesthetic Surgery and Thermal Trauma, Department of Propedeutics of Surgical Diseases, Faculty of Medicine, \u201cSt. George\u201d University Hospital Plovdiv, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1210\/er.2015-1106","article-title":"Role of Thyroid Hormones in Skeletal Development and Bone Maintenance","volume":"37","author":"Bassett","year":"2016","journal-title":"Endocr. 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