Increased Serum Levels of Dickkopf‐1 and Sclerostin as WNT Signaling Pathway Inhibitors in Celiac Disease Patients

BACKGROUND: Celiac disease (CD) is an autoimmune enteropathy. The WNT signaling pathway acts in adult intestinal epithelium maintenance. AIM: To evaluate the level of two WNT antagonists, including dikkopf-1 (Dkk-1) and sclerostin, in CD patients compared to controls. METHODS: A total of 43 cases and 45 controls were enrolled in this case-control study. The serum levels of Dkk-1, sclerostin, citrulline, and parathyroid hormone (PTH) were measured using the ELISA method. Moreover, the levels of vitamin D3 were measured using the HPLC method. RESULT: Our findings illustrated an elevation of both WNT antagonists (Dkk-1, p < 0.0001 and sclerostin, p = 0.002) in CD patients compared to controls. Moreover, the levels of PTH (p < 0.0001) and Ca (p = 0.009) were higher in CD patients. The level of citrullin was directly correlated with sclerostin (R = 0.71), PTH (R = 0.53), and Dkk-1 (R = 0.29). ROC curve analysis indicated that serum levels of Dkk-1 (AUC = 0.83), sclerostin (AUC = 0.7) and, PTH (AUC = 0.91) can differentiate CD from control. CONCLUSION: Celiac patients have increased levels of the Dkk-1 and sclerostin, together with PTH as bone modulators, correlated with citrulline level, known as a potential marker for enterocyte mass. These results collectively indicate the significance of Dkk-1 and sclerostin in the development of celiac disease; however, further research is needed to explore their possible diagnostic and therapeutic uses in the future.