Salamanna Francesca, Contartese Deyanira, Ruffilli Alberto, Barile Francesca, Bellavia Daniele, Marchese Laura, Manzetti Marco, Viroli Giovanni, Faldini Cesare, Giavaresi Gianluca
Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Life (Basel). 2023 Feb 21;13(3):602. doi: 10.3390/life13030602.
Osteosarcopenia, a combination of osteopenia/osteoporosis and sarcopenia, is a common condition among older adults. While numerous studies and meta-analyses have been conducted on osteoporosis biomarkers, biomarker utility in osteosarcopenia still lacks evidence. Here, we carried out a systematic review to explore and analyze the potential clinical of circulating microRNAs (miRs) shared between osteoporosis/osteopenia and sarcopenia.
We performed a systematic review on PubMed, Scopus, and Embase for differentially expressed miRs (-value < 0.05) in (i) osteoporosis and (ii) sarcopenia. Following screening for title and abstract and deduplication, 83 studies on osteoporosis and 11 on sarcopenia were identified for full-text screening. Full-text screening identified 54 studies on osteoporosis, 4 on sarcopenia, and 1 on both osteoporosis and sarcopenia.
A total of 69 miRs were identified for osteoporosis and 14 for sarcopenia. There were 9 shared miRs, with evidence of dysregulation (up- or down-regulation), in both osteoporosis and sarcopenia: miR-23a-3p, miR-29a, miR-93, miR-133a and b, miR-155, miR-206, miR-208, miR-222, and miR-328, with functions and targets implicated in the pathogenesis of osteosarcopenia. However, there was little agreement in the results across studies and insufficient data for miRs in sarcopenia, and only three miRs, miR-155, miR-206, and miR-328, showed the same direction of dysregulation (down-regulation) in both osteoporosis and sarcopenia. Additionally, for most identified miRs there has been no replication by more than one study, and this is particularly true for all miRs analyzed in sarcopenia. The study quality was typically rated intermediate/high risk of bias. The large heterogeneity of the studies made it impossible to perform a meta-analysis.
The findings of this review are particularly novel, as miRs have not yet been explored in the context of osteosarcopenia. The dysregulation of miRs identified in this review may provide important clues to better understand the pathogenesis of osteosarcopenia, while also laying the foundations for further studies to lead to effective screening, monitoring, or treatment strategies.
骨少肌少症是骨质减少/骨质疏松与肌少症的结合，在老年人中很常见。虽然已经对骨质疏松症生物标志物进行了大量研究和荟萃分析，但骨少肌少症中生物标志物的效用仍缺乏证据。在此，我们进行了一项系统评价，以探索和分析骨质疏松症/骨质减少症和肌少症之间共享的循环微小RNA（miR）的潜在临床意义。
我们在PubMed、Scopus和Embase上进行了一项系统评价，以查找（i）骨质疏松症和（ii）肌少症中差异表达的miR（-值<0.05）。在对标题和摘要进行筛选并去除重复项后，确定了83项关于骨质疏松症的研究和11项关于肌少症的研究进行全文筛选。全文筛选确定了54项关于骨质疏松症的研究、4项关于肌少症的研究以及1项关于骨质疏松症和肌少症两者的研究。
共确定了69种与骨质疏松症相关的miR和14种与肌少症相关的miR。在骨质疏松症和肌少症中均有9种共享的miR存在失调（上调或下调）证据：miR-23a-3p、miR-29a、miR-93、miR-133a和b、miR-155、miR-206、miR-208、miR-222和miR-328，其功能和靶点与骨少肌少症的发病机制有关。然而，各研究结果之间几乎没有一致性，且肌少症方面miR的数据不足，只有三种miR，即miR-155、miR-206和miR-328，在骨质疏松症和肌少症中显示出相同的失调方向（下调）。此外，对于大多数已鉴定的miR，没有一项以上的研究进行过重复验证，肌少症中分析的所有miR尤其如此。研究质量通常被评为中等/高偏倚风险。研究的巨大异质性使得无法进行荟萃分析。
本综述的结果特别新颖，因为尚未在骨少肌少症的背景下对miR进行探索。本综述中鉴定出的miR失调可能为更好地理解骨少肌少症的发病机制提供重要线索，同时也为进一步研究制定有效的筛查、监测或治疗策略奠定基础。
