title: Circulating periostin levels increase in association with bone density loss and healing progression during the early phase of hip fracture in Chinese older women.
abstract: 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.
  
  
  
  The study aims to quantify the associations of sPostn levels with bone density loss and the possible effect on the fracture healing.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Orthopaedic Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: J
authors.initials: J
authors.lastname: Yan
authors.affiliation: Department of Endocrinology, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: H J
authors.initials: HJ
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: Y Q
authors.initials: YQ
authors.lastname: Bian
authors.affiliation: Department of Orthopaedic Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: B
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Second Department of Clinical Medicine, Medical University of Anhui, Hefei, Anhui, China.
authors.forename: H X
authors.initials: HX
authors.lastname: Han
authors.affiliation: Department of Orthopaedic Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: S Z
authors.initials: SZ
authors.lastname: Han
authors.affiliation: Department of Orthopaedic Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China. fuleco@126.com.
authors.forename: L R
authors.initials: LR
authors.lastname: Han
authors.affiliation: Department of Orthopaedic Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China. wdw62@sohu.com.
authors.forename: D W
authors.initials: DW
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China.
authors.forename: X F
authors.initials: XF
authors.lastname: Yang
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000097:blood* / Q000502:physiology; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D017102:Fracture Healing / Q000502:physiology; D006620:Hip Fractures / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D015663:Osteoporosis, Postmenopausal / Q000097:blood* / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000097:blood* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; C512835:POSTN protein, human
keywords: Elderly; Fracture repair; Hip fracture; Osteoporosis; Periostin