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Circulating Periostin Levels in Osteoporosis and Related Fractures

Year 2024, Volume: 4 Issue: 4, 107 - 115, 10.10.2024
https://doi.org/10.5281/zenodo.13880257

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.

References

  • 1. Nih Consensus Panel. Development Panel on Osteoporosis Prevention D, Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285(6):785-795.
  • 2. Anam AK, Insogna K. Update on Osteoporosis Screening and Management. Med Clin North Am. 2021;105(6):1117-1134.
  • 3. Zhu R, Zheng Y, Dirks NL, et al. Model-based clinical pharmacology profiling and exposure-response relationships of the efficacy and biomarker of lebrikizumab in patients with moderate-to-severe asthma. Pulm Pharmacol Ther. 2017;46:88-98.
  • 4. Yuan C, Li J. Research progress of periostin and osteoporosis. Front Endocrinol (Lausanne). 2024;15:1356297.
  • 5. Hakuno D, Kimura N, Yoshioka M, et al. Periostin advances atherosclerotic and rheumatic cardiac valve degeneration by inducing angiogenesis and MMP production in humans and rodents. J Clin Invest. 2010;120(7):2292-2306.
  • 6. Bonnet N, Garnero P, Ferrari S. Periostin action in bone. Mol Cell Endocrinol. 2016;432:75-82.
  • 7. Yan J, Wang Z, Xian L, et al. Periostin Promotes the Proliferation, Differentiation and Mineralization of Osteoblasts from Ovariectomized Rats. Horm Metab Res. 2024.
  • 8. Yan J, Liu HJ, Li H, et al. Circulating periostin levels increase in association with bone density loss and healing progression during the early phase of hip fracture in Chinese older women. Osteoporos Int. 2017;28(8):2335-2341.
  • 9. Anastasilakis AD, Polyzos SA, Makras P, et al. Circulating periostin levels do not differ between postmenopausal women with normal and low bone mass and are not affected by zoledronic acid treatment. Horm Metab Res. 2014;46(2):145-149.
  • 10. Li J, Niu X, Si Q, et al. Plasma periostin as a biomarker of osteoporosis in postmenopausal women with type 2 diabetes. J Bone Miner Metab. 2021;39(4):631-638.
  • 11. Mahmood H, Abass EAA. Association between periostin and bone minerals in osteoporosis and osteopenia Iraqi patients. Int. J. Health Sci., 2022:9633-9644.
  • 12. Maïmoun L, Ben Bouallègue F, Gelis A, et al. Periostin and sclerostin levels in individuals with spinal cord injury and their relationship with bone mass, bone turnover, fracture and osteoporosis status. Bone. 2019;127:612-619.
  • 13. Mohamed AS, Khalifa AI, Abotaleb AA-M, Eldesoky NA-R. Comparative Study between Periostin and Osteocalcin as Biomarkers for Osteoporosis and Fracture Risk in Egyptian Postmenopausal Women. Int J Pharm Pharm Sci. 2020:17-22.
  • 14. Yigitdol I, Gulumsek E, Ozturk HA, et al. Serum Periostin Levels are Significantly Higher in Patients with Primary Hyperparathyroidism and Closely Related to Osteoporosis. Exp Clin Endocrinol Diabetes. 2023;131(9):449-455.
  • 15. Walsh JS, Gossiel F, Scott JR, Paggiosi MA, Eastell R. Effect of age and gender on serum periostin: Relationship to cortical measures, bone turnover and hormones. Bone. 2017;99:8-13. [CrossRef] 16. Garnero P. New developments in biological markers of bone metabolism in osteoporosis. Bone. 2014;66:46-55.
  • 17. Kim BJ, Lee SH, Koh JM. Potential Biomarkers to Improve the Prediction of Osteoporotic Fractures. Endocrinol Metab (Seoul). 2020;35(1):55-63.
  • 18. Guo YM, Cheng JH, Zhang H, et al. Serum Periostin Level and Genetic Polymorphisms Are Associated with Vertebral Fracture in Chinese Postmenopausal Women. Genes (Basel). 2022;13(3).
  • 19. Bonnet N, Biver E, Chevalley T, Rizzoli R, Garnero P, Ferrari SL. Serum Levels of a Cathepsin-K Generated Periostin Fragment Predict Incident Low-Trauma Fractures in Postmenopausal Women Independently of BMD and FRAX. J Bone Miner Res. 2017;32(11):2232-2238.
  • 20. Pepe J, Bonnet N, Cipriani C, et al. Higher serum levels of a cathepsin K-generated periostin fragment are associated with fractures in postmenopausal women with primary hyperparathyroidism: a pilot study. Osteoporos Int. 2021;32(11):2365-2369.
  • 21. Li R, Zhu X, Zhang M, Zong G, Zhang K. Association of Serum Periostin Level with Classical Bone Turnover Markers and Bone Mineral Density in Shanghai Chinese Postmenopausal Women with Osteoporosis. Int J Gen Med. 2021;14:7639-7646.
  • 22. Garnero P. The Utility of Biomarkers in Osteoporosis Management. Mol Diagn Ther. 2017;21(4):401-418.
  • 23. Xiao SM, Gao Y, Cheung CL, et al. Association of CDX1 binding site of periostin gene with bone mineral density and vertebral fracture risk. Osteoporos Int. 2012;23(7):1877-1887.
  • 24. Rousseau JC, Sornay-Rendu E, Bertholon C, Chapurlat R, Garnero P. Serum periostin is associated with fracture risk in postmenopausal women: a 7-year prospective analysis of the OFELY study. J Clin Endocrinol Metab. 2014;99(7):2533-2539.
  • 25. Pickering ME, Oris C, Chapurlat R. Periostin in Osteoporosis and Cardiovascular Disease. J Endocr Soc. 2023;7(7):bvad081.
  • 26. Kudo A. Periostin in Bone Biology. Adv Exp Med Biol. 2019;1132:43-47.
  • 27. Li C, Li X, Wang X, et al. Periostin Mediates Oestrogen-Induced Osteogenic Differentiation of Bone Marrow Stromal Cells in Ovariectomised Rats. Biomed Res Int. 2020;2020:9405909.
  • 28. Farrokhi M, Arjaki D, Peykanpour F. Circulating periostin levels increase in association with bone density loss and healing progression during the early phase of hip fracture in Chinese older women. Osteoporos Int. 2020;31(10):2061.
  • 29. Luo J, Deng W. Serum Periostin Level is not a Predictor of Early Stage Bone Loss in Chinese Postmenopausal Women. Clin Lab. 2019;65(11).
  • 30. Kerschan-Schindl K, Tiefenböck TM, Föger-Samwald U, et al. Circulating Myostatin Levels Decrease Transiently after Implantation of a Hip Hemi-Arthroplasty. Gerontology. 2020;66(4):393-400.

Circulating Periostin Levels in Osteoporosis and Related Fractures

Year 2024, Volume: 4 Issue: 4, 107 - 115, 10.10.2024
https://doi.org/10.5281/zenodo.13880257

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.

References

  • 1. Nih Consensus Panel. Development Panel on Osteoporosis Prevention D, Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285(6):785-795.
  • 2. Anam AK, Insogna K. Update on Osteoporosis Screening and Management. Med Clin North Am. 2021;105(6):1117-1134.
  • 3. Zhu R, Zheng Y, Dirks NL, et al. Model-based clinical pharmacology profiling and exposure-response relationships of the efficacy and biomarker of lebrikizumab in patients with moderate-to-severe asthma. Pulm Pharmacol Ther. 2017;46:88-98.
  • 4. Yuan C, Li J. Research progress of periostin and osteoporosis. Front Endocrinol (Lausanne). 2024;15:1356297.
  • 5. Hakuno D, Kimura N, Yoshioka M, et al. Periostin advances atherosclerotic and rheumatic cardiac valve degeneration by inducing angiogenesis and MMP production in humans and rodents. J Clin Invest. 2010;120(7):2292-2306.
  • 6. Bonnet N, Garnero P, Ferrari S. Periostin action in bone. Mol Cell Endocrinol. 2016;432:75-82.
  • 7. Yan J, Wang Z, Xian L, et al. Periostin Promotes the Proliferation, Differentiation and Mineralization of Osteoblasts from Ovariectomized Rats. Horm Metab Res. 2024.
  • 8. Yan J, Liu HJ, Li H, et al. Circulating periostin levels increase in association with bone density loss and healing progression during the early phase of hip fracture in Chinese older women. Osteoporos Int. 2017;28(8):2335-2341.
  • 9. Anastasilakis AD, Polyzos SA, Makras P, et al. Circulating periostin levels do not differ between postmenopausal women with normal and low bone mass and are not affected by zoledronic acid treatment. Horm Metab Res. 2014;46(2):145-149.
  • 10. Li J, Niu X, Si Q, et al. Plasma periostin as a biomarker of osteoporosis in postmenopausal women with type 2 diabetes. J Bone Miner Metab. 2021;39(4):631-638.
  • 11. Mahmood H, Abass EAA. Association between periostin and bone minerals in osteoporosis and osteopenia Iraqi patients. Int. J. Health Sci., 2022:9633-9644.
  • 12. Maïmoun L, Ben Bouallègue F, Gelis A, et al. Periostin and sclerostin levels in individuals with spinal cord injury and their relationship with bone mass, bone turnover, fracture and osteoporosis status. Bone. 2019;127:612-619.
  • 13. Mohamed AS, Khalifa AI, Abotaleb AA-M, Eldesoky NA-R. Comparative Study between Periostin and Osteocalcin as Biomarkers for Osteoporosis and Fracture Risk in Egyptian Postmenopausal Women. Int J Pharm Pharm Sci. 2020:17-22.
  • 14. Yigitdol I, Gulumsek E, Ozturk HA, et al. Serum Periostin Levels are Significantly Higher in Patients with Primary Hyperparathyroidism and Closely Related to Osteoporosis. Exp Clin Endocrinol Diabetes. 2023;131(9):449-455.
  • 15. Walsh JS, Gossiel F, Scott JR, Paggiosi MA, Eastell R. Effect of age and gender on serum periostin: Relationship to cortical measures, bone turnover and hormones. Bone. 2017;99:8-13. [CrossRef] 16. Garnero P. New developments in biological markers of bone metabolism in osteoporosis. Bone. 2014;66:46-55.
  • 17. Kim BJ, Lee SH, Koh JM. Potential Biomarkers to Improve the Prediction of Osteoporotic Fractures. Endocrinol Metab (Seoul). 2020;35(1):55-63.
  • 18. Guo YM, Cheng JH, Zhang H, et al. Serum Periostin Level and Genetic Polymorphisms Are Associated with Vertebral Fracture in Chinese Postmenopausal Women. Genes (Basel). 2022;13(3).
  • 19. Bonnet N, Biver E, Chevalley T, Rizzoli R, Garnero P, Ferrari SL. Serum Levels of a Cathepsin-K Generated Periostin Fragment Predict Incident Low-Trauma Fractures in Postmenopausal Women Independently of BMD and FRAX. J Bone Miner Res. 2017;32(11):2232-2238.
  • 20. Pepe J, Bonnet N, Cipriani C, et al. Higher serum levels of a cathepsin K-generated periostin fragment are associated with fractures in postmenopausal women with primary hyperparathyroidism: a pilot study. Osteoporos Int. 2021;32(11):2365-2369.
  • 21. Li R, Zhu X, Zhang M, Zong G, Zhang K. Association of Serum Periostin Level with Classical Bone Turnover Markers and Bone Mineral Density in Shanghai Chinese Postmenopausal Women with Osteoporosis. Int J Gen Med. 2021;14:7639-7646.
  • 22. Garnero P. The Utility of Biomarkers in Osteoporosis Management. Mol Diagn Ther. 2017;21(4):401-418.
  • 23. Xiao SM, Gao Y, Cheung CL, et al. Association of CDX1 binding site of periostin gene with bone mineral density and vertebral fracture risk. Osteoporos Int. 2012;23(7):1877-1887.
  • 24. Rousseau JC, Sornay-Rendu E, Bertholon C, Chapurlat R, Garnero P. Serum periostin is associated with fracture risk in postmenopausal women: a 7-year prospective analysis of the OFELY study. J Clin Endocrinol Metab. 2014;99(7):2533-2539.
  • 25. Pickering ME, Oris C, Chapurlat R. Periostin in Osteoporosis and Cardiovascular Disease. J Endocr Soc. 2023;7(7):bvad081.
  • 26. Kudo A. Periostin in Bone Biology. Adv Exp Med Biol. 2019;1132:43-47.
  • 27. Li C, Li X, Wang X, et al. Periostin Mediates Oestrogen-Induced Osteogenic Differentiation of Bone Marrow Stromal Cells in Ovariectomised Rats. Biomed Res Int. 2020;2020:9405909.
  • 28. Farrokhi M, Arjaki D, Peykanpour F. Circulating periostin levels increase in association with bone density loss and healing progression during the early phase of hip fracture in Chinese older women. Osteoporos Int. 2020;31(10):2061.
  • 29. Luo J, Deng W. Serum Periostin Level is not a Predictor of Early Stage Bone Loss in Chinese Postmenopausal Women. Clin Lab. 2019;65(11).
  • 30. Kerschan-Schindl K, Tiefenböck TM, Föger-Samwald U, et al. Circulating Myostatin Levels Decrease Transiently after Implantation of a Hip Hemi-Arthroplasty. Gerontology. 2020;66(4):393-400.
There are 29 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Research Articles
Authors

Halil İbrahim Akbay 0000-0002-4303-7837

Hamit Hakan Alp

Publication Date October 10, 2024
Submission Date September 7, 2024
Acceptance Date October 9, 2024
Published in Issue Year 2024 Volume: 4 Issue: 4

Cite

EndNote Akbay Hİ, Alp HH (October 1, 2024) Circulating Periostin Levels in Osteoporosis and Related Fractures. Pharmata 4 4 107–115.

Content of this journal is licensed under a Creative Commons Attribution NonCommercial 4.0 International License

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