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Open access

Anouar Aznou, Rick I. Meijer, Dani�l H van Raalte, Martin den Heijer, Annemieke C Heijboer, and Renate T De Jongh


The mechanisms underlying the development of peripheral insulin resistance are complex.

Several studies have linked sclerostin, an osteocyte-derived inhibitor of the Wnt/β-catenin pathway, to obesity and insulin resistance. The aim of this study was to investigate 1) whether serum sclerostin is associated with insulin sensitivity in lean and/or obese women; and 2) whether hyperinsulinemia affects serum sclerostin concentrations.


A cross-sectional study.


Insulin sensitivity was measured in lean (BMI<25 kg·m-2) and obese (BMI > 30 kg·m-2) women using a hyperinsulinemic-euglycemic clamp. Serum sclerostin was measured at baseline and during the clamp procedure.


We studied 21 lean and 22 obese women with a median age of 40 and 43

years and a median BMI of 22.4 and 33.5 kg·m-2, respectively. Obese women had higher

serum sclerostin than lean women (122±33 vs 93±33 nmol/L, p<0.01). Higher serum

sclerostin was associated with lower insulin sensitivity in obese, but not in lean individuals

(difference in M value between highest and lowest quartile: -7.02 mg⋅kg−1⋅min−1, p =

0.03 and 1.59 mg⋅kg−1⋅min−1, p = 0.50, respectively). Hyperinsulinemia did not affect serum

sclerostin in lean nor obese women (p>0.5).


Serum sclerostin is negatively associated with insulin sensitivity as measured

with the hyperinsulinemic euglycemic clamp in obese, but not lean women. This indicates a potential role of the Wnt/β-catenin pathway in regulating insulin sensitivity particularly in obese individuals. Our findings remain hypothesis-generating and should be confirmed by additional studies.

Open access

Miranda Scharff, Chantal Maria Wiepjes, Maartje Klaver, Thomas Schreiner, Guy T’Sjoen, and Martin den Heijer


Gender-affirming hormonal treatment (HT) in trans people changes physical appearance. Muscle mass and strength are important aspects of physical appearance, but few data exist on the effect of HT on grip strength and muscle mass. This study aimed to investigate the change in grip strength in trans people during the first year of HT and to study the possible determinants of this change and the associations between changes in grip strength, lean body mass and bone mineral density (BMD).

Design and methods

A multicenter, prospective study was performed, including 249 transwomen and 278 transmen. Grip strength, lean body mass and BMD were measured at baseline and after 1 year.


After 1 year of HT, grip strength decreased with −1.8 kg (95% CI −2.6; −1.0) in transwomen and increased with +6.1 kg (95% CI +5.5; +6.7) in transmen. No differences in grip strength change was found between age groups, BMI groups, hormonal administration routes or hormone concentrations. In transmen, increase in grip strength was associated with increase in lean body mass (per kg increase in grip strength: +0.010 kg, 95% CI +0.003; +0.017), while this was not found in transwomen (per kg increase in grip strength: +0.004 kg, 95% CI −0.000; +0.009). Change in grip strength was not associated with change in BMD in transwomen and transmen.


After 1 year of HT, grip strength decreased in transwomen, and increased in transmen. In transmen only, change in grip strength was associated with change in lean body mass.