title: P4 medicine and osteoporosis: a systematic review.
abstract: BACKGROUND
  Osteoporosis is the most frequent bone metabolic disease. In order to improve early detection, prediction, prevention, diagnosis, and treatment of the disease, a new model of P4 medicine (personalized, predictive, preventive, and participatory medicine) could be applied. The aim of this work was to systematically review the publications of four different types of "omics" studies related to osteoporosis, in order to discover novel predictive, preventive, diagnostic, and therapeutic targets for better management of the geriatric population.
  
  
  METHODS
  To systematically search the PubMed database, we created specific groups of criteria for four different types of "omics" information on osteoporosis: genomic, transcriptomic, proteomic, and metabolomic. We then analyzed the intersections between them in order to find correlations and common pathways or molecules with important roles in osteoporosis, and with a potential application in disease prediction, prevention, diagnosis, or treatment.
  
  
  RESULTS
  Altogether, 180 publications of "omics" studies in the field of osteoporosis were found and reviewed at first selection. After introducing the inclusion and exclusion criteria (the secondary selection), 46 papers were included in the systematic review.
  
  
  CONCLUSIONS
  The intersection of reviewed papers identified five genes (ESR1, IBSP, CTNNB1, SOX4, and IDUA) and processes like the Wnt pathway, JAK/STAT signaling, and ERK/MAPK, which should be further validated for their predictive, diagnostic, or other clinical value in osteoporosis. Such molecular insights will enable us to fit osteoporosis into the P4 strategy and could increase the effectiveness of disease prediction and prevention, with a decrease in morbidity in the geriatric population.
authors.affiliation: Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana, Askerceva cesta 7, 1000, Ljubljana, Slovenia.
authors.forename: Klemen
authors.initials: K
authors.lastname: Kodrič
authors.affiliation: Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana, Askerceva cesta 7, 1000, Ljubljana, Slovenia.
authors.forename: Klemen
authors.initials: K
authors.lastname: Čamernik
authors.affiliation: Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana, Askerceva cesta 7, 1000, Ljubljana, Slovenia.
authors.forename: Darko
authors.initials: D
authors.lastname: Černe
authors.affiliation: General and Teaching Hospital Celje, Celje, Slovenia.
authors.forename: Radko
authors.initials: R
authors.lastname: Komadina
authors.affiliation: Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana, Askerceva cesta 7, 1000, Ljubljana, Slovenia. janja.marc@ffa.uni-lj.si.
authors.forename: Janja
authors.initials: J
authors.lastname: Marc
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005819:Genetic Markers / Q000235:genetics*; D020022:Genetic Predisposition to Disease / Q000453:epidemiology* / Q000235:genetics*; D005820:Genetic Testing / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*; D057285:Precision Medicine; D015995:Prevalence; D012307:Risk Factors
chemical_list: D005819:Genetic Markers
keywords: Geriatrics; Omics; Osteoporosis biomarkers; Personalized medicine; Systems biology