Lower circulating irisin in middle-aged and older adults with osteoporosis: a systematic review and meta-analysis

Osteoporosis has imposed a heavy socioeconomic burden worldwide, especially in postmenopausal women. As a newly found protein, irisin has an important physiological role in bone metabolism. This meta-analysis intends to identify the association between circulating irisin levels and osteoporosis.

This meta-analysis was conducted following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guideline. A comprehensive search of five databases was performed from inception to January 2019. Studies with original date on middle-aged and older participants were included. Data were analyzed according to study characteristics and heterogeneity between studies. The quality of each study and the presence of publication bias were assessed by Newcastle-Ottawa score (NOS) and normal quantile plot.

Seven studies, with a total of 1,018 participants, conducted in four countries, were included. Six of them were identified as high-quality research. Five studies included postmenopausal women, and two studies included both men and women. Possible publication bias was found in the analysis of irisin and osteoporosis. Pooled analysis indicated decreased irisin levels in osteoporotic participants (mean difference -87.91, 95% CI, -92.56 to -83.25). Subgroup analysis revealed an even lower level of irisin in postmenopausal women and in participants with a history of fractures. Analysis on associations between irisin and femoral neck or lumbar spine bone mineral density showed a weak positive correlation.

The findings of this analysis suggested that circulating irisin levels were decreased in middle-aged and older participants with osteoporosis. Irisin was positively correlated with bone mineral density.