Exploratory analysis of mitochondrial transcription factor A as a putative biomarker for osteoporosis: a...

Numerous studies have linked mitochondrial dysfunction to osteoporosis; however, the roles of mitochondrial transcription factor A (TFAM) and oxidative stress in osteoporosis are unclear. This exploratory cross-sectional study examined the relationship between TFAM, oxidative stress markers, and osteoporosis.

This study included 48 participants aged 50-75, including 12 non-osteoporosis patients and 36 osteoporosis patients. Bone mineral density was assessed, and serum and bone samples were analyzed for TFAM, RANKL, OPG, BMP, SOD2, and MDA levels.

No significant differences in age, height, weight, or BMI were observed between groups. The osteoporosis group had higher serum MDA levels and lower SOD2 levels than the control group. Bone tissue analysis in the OP group revealed decreased TFAM and OPG expression and increased RANKL expression, with no consistent change in BMP across protein and mRNA levels. BMD was positively correlated with SOD2, TFAM, and OPG and negatively correlated with MDA and RANKL. In multiple regression, TFAM showed a significant association with BMD (β = 0.326, P = 0.005), but the model was limited by small sample size and risk of overfitting. The AUC for TFAM was 0.706 (95% CI: 0.52-0.86).

TFAM may represent a candidate biomarker for osteoporosis, pending validation in larger, prospective cohorts. Causal and therapeutic potential should be addressed by interventional and functional studies.