Sclerostin, periostin and microRNA as potential markers of osteoporosis

Abstract

In recent years, people have had high hopes for the possibility of using measurements of the so-called modern bone turnover markers in diagnosis, diagnostics of the course and the prediction of the occurrence of complications of bone metabolic diseases, especially osteoporosis. So far, several diagnostic markers of bone turnover have been identified, particular importance attached to PINP and CTx. However, many studies have highlighted that their use in the diagnosis of osteoporosis is rather limited due to their inter-individual and intra-individual variability, tissue non-specificity, the inability to evaluate individual bone tissue compartments, and the ability to assess metabolic activity of only osteoblasts and/or osteoclasts without osteocytes. The data presented in the thesis indicates the potential usefulness of sclerostin measurements, primarily associated with metabolic activity of osteocytes, periostin, as the indicator of metabolic activity of periosteum and microRNAs as the group of specific markers in the early detection of osteoporosis. All of the above-mentioned candidates could possibly become a predictor of osteoporotic fractures: sclerostin in patients with type 2 diabetes; periostin, especially in non-vertebral fractures in postmenopausal women and microRNA in early prediction of these fractures. However, many of the studies underline some of the limitations associated with their use in the diagnosis of osteoporosis. Ambiguous results of the presented studies may be primarily due to population selection, population size, type of fractures and duration of the observation itself. An objective judgement will be made when an adequate number of standardized and independent studies will allow for the exclusion or validation of each of them in clinical practice.