Journal of Osteopathic Medicine, 2024/03, 124(3):121–125. doi: 10.1515/jom-2023-0174, type of study: ,cos,,,,,,,,,,,,,,,,,,,,,,

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Keywords:

biomarkers [21]
cohort study [90]
diagnosis [412]
fractures [13]
fragility [2]
geriatrics [141]
microRNA [1]
osteoporosis [27]
risk assessment [16]

Abstract:

Context As a common disease in the elderly, osteoporosis clearly increases the risk of fractures, leading to higher mortality, but the current markers to estimate the risk of fractures are limited. MicroRNA-21 (miR-21) may play an important role in osteoporosis, but the link of this biomarker with fractures was undetermined. Objectives We aimed to investigate the association between miR-21 levels and the presence of fragility fractures. Methods A total of 200 patients were recruited and miR-21 was collected from baseline serum. The correlation between miR-21 and the fracture risk assessment tool (FRAX) score was analyzed. The incidence of fragility fractures was presented by Kaplan-Meier analysis, and Cox regression analysis was utilized to evaluate risk factors. The diagnostic value of miR-21 was conducted by the area under curve (AUC). Results The FRAX score was significantly associated with miR-21 level (p<0.001). According to the 50th percentile of miR-21 content in the overall distribution, the cumulative incidence of fragility fractures was significantly higher in patients with higher miR-21 levels than those with lower levels (75.4, 95 % CI: 69.0–81.8 vs. 59.2, 95 % CI: 42.1–76.3, p<0.001). The results of the Cox regression analysis showed that the miR-21 level was an independent risk factor linked to the incidence of fracture (p=0.005). The optimal cut-off value of the miR-21 was 6.08, and the AUC for predicting fracture was 0.718 (95 % CI, 0.645–0.790). Conclusions This study showed that miR-21 has optimal diagnostic performance in the discrimination of fragility fracture, and the circulating miR-21 level in predicting the risk of fragility fracture may have a certain value.