Assessment of Dickkopf Related Protein1 Levels in Iraqi Women Patients with Osteoporosis

Abstract

     Osteopenia and osteoporosis are systemic skeletal disorders characterized by low bone mass and microarchitectural deterioration of bone tissue. Osteoporosis is a silent disease characterized by rapid bone loss, often without noticeable symptoms. A key regulator of this process is Dickkopf-related protein 1 (DKK1), a secreted glycoprotein encoded by the DKK1 gene in humans. It plays a crucial role as an antagonist of the Wnt/β-catenin signaling pathway. DKK1 is a critical regulator in osteoporosis, primarily by inhibiting Wnt signaling, which is essential for osteoblast function and bone formation. This study aims to evaluate DKK1 levels and other biochemical parameters in Iraqi patients with osteoporosis and to investigate whether there is a correlation between these parameters. This study was conducted at Baghdad Teaching Hospital and Al Kadhimain Teaching Hospital, involving 37 participants with osteopenia, 42 with osteoporosis, and 42 healthy controls. Serum concentrations of DKK1, vitamin D3, calcium, magnesium, phosphorus, and lipid profile were measured for all participants. Dkk1 and vitamin D3 were evaluated utilizing an enzyme-linked immunoassay. The results demonstrated that both osteopenic and osteoporotic groups had elevated DKK1 levels compared to controls; however, no significant correlation was observed between Dkk1 levels and bone mineral density (BMD) within these groups (p > 0.05). Despite significant differences in bone density markers at (p<0.01), no notable differences were found in Mg and Ph levels among control, OP, and OS groups, indicating minimal impact on these groups’ bone mineral density (BMD). Regarding other biochemical markers, the study observed lower levels of vitamin D3 and Ca in patients with OP and OS. In addition, the study analyzed lipid profiles, revealing that there was an increase in the values of TG, LDL and VLDL (p-value <0.001) in the OS group than in the control group. Lastly, the receiver operating characteristic (ROC) analysis of Dkk1 for diagnosing osteopenia and osteoporosis yielded an area under the curve (AUC) of 1.000. In conclusion, this study supports DKK1 as a highly promising biomarker for osteopenia and osteoporosis.