In our recent study involving 59 elderly men, increases in serum sclerostin levels following combined T and E deficiency were prevented by E treatment alone but not T treatment without E.(14) Thus, while our previous interventional data clearly demonstrate that E reduces serum sclerostin levels,(14) the correlation analyses in this study are not consistent with this observation, suggesting that there may be additional confounders in the relationship between E and sclerostin levels that we may not have accounted for in this analysis. This evidence concerns the gene SOST and hyperinsulinemic hypoglycemia, familial, 4.