Distinct Metabolites in Osteopenia and Osteoporosis: A Systematic Review and Meta-Analysis.

Yuhe Wang, Xu Han, Jingru Shi, Zeqi Liao, Yuanyue Zhang, Yuanyuan Li, Miao Jiang, Meijie Liu

Journal: Nutrients 2023;15(23):4895

PMID: 38068753

Plain Language Summary

Osteopenia (ON) and Osteoporosis (OP) are conditions characterised by reduced bone mineral density (BMD), which increases the risk of fractures. The identification of distinct metabolites associated with these conditions can enhance understanding and prediction of disease progression. The aim of this study was to investigate the distinct metabolites present in patients with ON and OP, providing insights into the metabolic changes associated with these bone diseases. This study was a systematic review and meta-analysis of 21 articles. Results showed that three metabolites increased, four decreased, and five had conflicting directions in OP/ON patients. Specifically, gly-gly (glycylglycine) and cystine levels were significantly lower, while lysophosphatidylcholine (LPC) levels were higher in the OP group compared to healthy controls. Authors concluded that distinct metabolites are associated with ON and OP, suggesting their potential as predictors for these conditions. However, further research is necessary to standardise these findings and fully understand their clinical implications.

Abstract

Multiple studies have indicated that distinct metabolites are involved in the occurrence and development of osteopenia (ON) and osteoporosis (OP); however, these metabolites in OP and ON have not yet been classified and standardized. This systematic review and meta-analysis included 21 articles aiming to investigate the distinct metabolites in patients with ON and OP. The quality of the included articles was generally high; seventeen studies had >7 stars, and the remaining four received 6 stars. This systematic review showed that three metabolites (phosphatidylcholine (PC) (lipid metabolites), galactose (carbohydrate metabolites), and succinic acid (other metabolites)) increased, four (glycylglycine (gly-gly), cystine (amino acids), sphingomyelin (SM) (lipid metabolites) and glucose (carbohydrate metabolites)) decreased, and five (glutamine, hydroxyproline, taurine (amino acids), lysophosphatidylcholine (LPC) (lipid metabolites), and lactate (other metabolites)) had conflicting directions in OP/ON. The results of the meta-analysis show that gly-gly (MD = -0.77, 95%CI -1.43 to -0.11, = 0.02) and cystine (MD = -5.52, 95%CI -7.35 to -3.68, < 0.00001) decreased in the OP group compared with the healthy control group. Moreover, LPC (MD = 1.48, 95%CI 0.11 to 2.86, = 0.03) increased in the OP group compared with the healthy control group. These results indicate that distinct metabolites were associated with ON and OP, which could be considered a predictor for OP.

Address: Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700, China.; Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.

DOI: 10.3390/nu15234895