Abstract

Objective: To study serum sclerostin levels in COPD and to evaluate the relationship and correlation between serum sclerostin levels and exacerbation frequency in COPD patients.

Methods: 59 male patients diagnosed with COPD according to GOLD 2024 guidelines and 74 healthy men visited the Department of Internal Medicine - Endocrinology - Rheumatology and Internal Medicine Clinic, Hue University of Medicine and Pharmacy Hospital, from August 2024 to February 2026.

Results: Age and smoking status of the disease group were similar to those of the control group. In our study, serum sclerostin concentration in patients with COPD was significantly lower than that in the control group. In addition, there was an inverse correlation between serum sclerostin concentration and the number of exacerbations and hospitalizations for exacerbations of COPD in the past year. The area under the ROC curve (AUC) of serum sclerostin concentration to discriminate the risk of exacerbations was 0.824 (p < 0.001). With a cut-off point ≤ 6.70 pmol/L, serum sclerostin concentration was able to discriminate patients with high exacerbation risk with a sensitivity of 74.3% and a specificity of 83.3% (95%CI: 0.713 – 0.936). When performing multivariate regression analysis of factors differentiating high exacerbation risk, high exacerbation risk was associated with low FEV1 (OR 0.097; 95% CI 0.014–0.685; p = 0.019) and low serum sclerostin levels (OR 0.971; 95% CI 0.953–0.990; p = 0.002).

Conclusion: Patients with COPD have lower serum sclerostin concentration than the control group. Low sclerostin levels were associated with a higher risk of exacerbations and hospitalizations.