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Circulating periostin levels increase in association with bone density loss and healing progression during the early phase of hip fracture in Chinese older women

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Abstract

Summary

The present study shows that hip fracture women had higher serum periostin (sPostn) levels. The elevation of sPostn is associated with bone density loss, yet fracture itself may even increase sPostn levels during early healing phase.

Introduction

The study aims to quantify the associations of sPostn levels with bone density loss and the possible effect on the fracture healing.

Methods

This study enrolled 261 older women with osteoporotic hip fracture and 106 age-matched women without fracture serving as controls. Clinical features, bone mineral density (BMD), and bone turnover markers including sPostn level were measured after fracture within 2 days. Follow-up sPostn levels during 1 year after 2 days were available for 128 patients.

Results

Initial levels of sPostn after fracture were significantly higher in patients than controls. sPostn was correlated with BMD of femoral neck (r = −0.529, P < 0.001), β-isomerized C-terminal crosslinking of type I collagen (β-CTX) (r = 0.403, P = 0.008), and N-terminal procollagen of type I collagen (PINP) (r = 0.236, P = 0.042) in the entire cohort. After multivariate analysis, sPostn remained as an independent risk factor for femoral neck BMD, which explained 19.1% of the variance in BMD. sPostn sampled within 7 days after fracture were acutely increasing from day 2 and then decreased and maintained at slightly high levels at 360 days. The percentage changes of sPostn positively correlated with the variation in β-CTX (r = 0.396, P = 0.002) and PINP (r = 0.180, P = 0.033) at day 7 after fracture.

Conclusions

High sPostn levels were an independent predictor of femoral neck BMD in older women presenting with an acute hip fracture. Increased sPostn levels during early healing phase may imply that Postn play a role in bone repair.

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Acknowledgments

This study was supported by the National Natural Science Foundation of China (No. 81601892), the Natural Science Foundation of Shandong province (No. ZR2016HP11), and the Natural Science Foundation of Shandong province (No. ZR2014HP038).

Author information

Author notes

  1. J. Yan and H. J. Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Liaocheng People’s Hospital, Liaocheng, Shandong, China

    J. Yan, H. Li, L. Chen, Y. Q. Bian, B. Zhao, S. Z. Han, L. R. Han, D. W. Wang & X. F. Yang

  2. Department of Endocrinology, Liaocheng People’s Hospital, Liaocheng, Shandong, China

    H. J. Liu

  3. Second Department of Clinical Medicine, Medical University of Anhui, Hefei, Anhui, China

    H. X. Han

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  1. J. Yan
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  4. L. Chen
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  9. L. R. Han
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Corresponding authors

Correspondence to L. R. Han or D. W. Wang.

Ethics declarations

The study was performed at the Liaocheng People’s Hospital, China, and approved by the local ethics committee. All patients signed a written informed consent document prior to any study-related procedures.

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Yan, J., Liu, H.J., 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 28, 2335–2341 (2017). https://doi.org/10.1007/s00198-017-4034-z

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  • DOI: https://doi.org/10.1007/s00198-017-4034-z

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