Background and Objectives: Inflammatory bowel disease (IBD) is associated with chronic inflammation and an increased risk of impaired bone metabolism. Wnt-pathway regula-tors -including sclerostin (sclerostin), dickkopf-1 (DKK-1), and periostin (periostin)- are key mediators of osteoblast and osteocyte function, yet data on their role in IBD-related bone alterations remain limited. This study aimed to evaluate serum levels of DKK-1, scle-rostin, and periostin in IBD patients. Materials and Methods: In this observational case–control study, 89 adults with IBD (58 CD, 31 UC) and 73 age- and sex-matched healthy controls were evaluated. Fasting serum levels of sclerostin, DKK-1, periostin, calcium, phosphorus, magnesium, and 25(OH)D were measured. BMD at the lumbar spine and femoral regions was assessed by DXA. Results: Patients with IBD showed elevated in-flammation, reflected by higher CRP and ESR compared with controls. Sclerostin levels were significantly lower in IBD and independently associated with disease status, age, corticosteroid use, vitamin D supplementation, and disease activity. DKK-1 levels were significantly increased in IBD and were independently associated with ESR, with addi-tional correlations to inflammatory markers and disease activity in subtype analyses. Per-iostin levels were reduced in IBD and independently associated by IBD status, sex, and BMI, with gender remaining a consistent determinant across analyses. Conclusions: IBD patients show distinct alterations in Wnt-pathway biomarkers, indicating increased bone turnover and disrupted osteoblast/osteocyte activity despite preserved DXA measure-ments. These findings suggest that biochemical markers may detect early bone impairment before measurable declines in BMD and highlight the utility of Wnt-related proteins as early indicators of skeletal risk in IBD.