Circulating Periostin Levels in Osteoporosis and Related Fractures

Abstract

Objective: Periostin, a protein involved in bone remodeling, is linked to osteoporosis. Elevated levels of periostin are associated with an increased risk of fractures due to its role in bone repair and turnover. This meta-analysis aims to investigate the usability of serum periostin levels as a potential biomarker in individuals with osteoporosis and patients at risk of osteoporotic fractures. Methods: This study was conducted in accordance with the PRISMA guideline. We identified studies reporting periostin levels associated with osteoporosis and osteoporotic fractures through a systematic search in PubMed, Cochrane Library, Web of Science, and Scopus databases. From a total of 175 studies, nine studies meeting the inclusion criteria were included for quantitative synthesis (meta-analysis). Meta-analysis was performed using Revman 5.4.1 software, and forest plots were generated using standardized mean differences (SMD). Results: When serum periostin levels (ng/mL) were compared between individuals with osteoporosis and healthy controls, periostin levels were found to be significantly higher in patients with osteoporosis (SMD: 1.29, 95% CI: 0.87-1.71). In addition, in the comparison between individuals with and without osteoporosis, periostin levels were found to be significantly higher in patients with fractures (SMD: 11.23, 95% CI: 5.64-16.82). However, significant heterogeneity was observed across studies (I²: 99% and 72%). Conclusions: This meta-analysis supports the use of serum periostin levels as a potential biomarker of osteoporosis and osteoporotic fracture risk. However, heterogeneity across studies suggests that caution should be exercised in interpreting these findings. In order for periostin to be more widely used in clinical practice, standardized measurement protocols should be developed and confirmatory studies should be conducted in different populations. periostin to be more widely used in clinical practice, standardized measurement protocols should be developed and confirmatory studies should be conducted in different populations.

Keywords

• Bone Mineral Density
• Osteoporotic Fractures
• Osteoporosis
• Periostin

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