Background Periostin is an emerging biomarker that plays a role in bone metabolism and may be associated with bone mineral density (BMD). This study is aimed to investigate serum periostin levels in patients with primary hyperparathyroidism (PHPT) and its correlation with BMD in these patients.

Methods Forty patients with newly diagnosed PHPT without co-morbidities and 30 healthy controls were included. Laboratory tests for the diagnosis of PHPT and serum levels of periostin were measured for all patients. BMD was measured on lumbar spines L1 and L4 by dual-energy X-ray absorptiometry (DEXA). Serum periostin levels were detected using an enzyme-linked immunosorbent assay (ELISA).

Results Serum periostin levels were significantly higher in patients with PHPT than in healthy controls (p<0.001). Serum periostin levels were also significantly higher (mean 59.7±11.0 ng/mL) in PHPT patients with osteoporosis than those without osteoporosis (p=0.004). In logistic regression analysis, only serum periostin levels independently predicted the patients with osteoporosis. According to this analysis, every 1 ng/mL increase in serum periostin increased the risk of having osteoporosis by 20.6%. When the cut-off for serum periostin level was 49.75 ng/mL, the patients with osteoporosis were predicted with 71.4% sensitivity and 69.2% specificity. Multivariate regression analysis revealed a negative correlation between serum periostin levels and L1-L4 T scores on DEXA.

Conclusion This is the first study to determine that serum periostin levels are higher in PHPT patients than those without PHPT and to demonstrate a significant association between serum periostin levels and T scores on DEXA in patients with PHPT. These findings will aid in detecting osteoporosis in patients with PHPT and making the decision for surgery in PHPT patients with no need for DEXA imaging that involves radiation.

背景骨膜素是一种新兴的生物标志物，在骨代谢中发挥作用，并可能与骨矿物质密度 (BMD) 相关。本研究旨在探讨原发性甲状旁腺功能亢进症（PHPT）患者血清骨膜素水平及其与患者骨密度的相关性。

方法纳入40例新诊断无合并症的PHPT患者和30例健康对照者。对所有患者进行了诊断 PHPT 的实验室检查和血清骨膜素水平的测量。通过双能 X 射线骨密度仪 (DEXA) 测量腰椎 L1 和 L4 的 BMD。使用酶联免疫吸附测定（ELISA）检测血清骨膜素水平。

结果PHPT 患者的血清骨膜素水平显着高于健康对照者 (p<0.001)。患有骨质疏松症的 PHPT 患者的血清骨膜素水平也显着高于未患有骨质疏松症的患者（平均 59.7±11.0 ng/mL）（p=0.004）。在逻辑回归分析中，只有血清骨膜素水平独立预测骨质疏松症患者。根据这项分析，血清骨膜素每增加 1 ng/mL，患骨质疏松症的风险就会增加 20.6%。当血清骨膜素水平的临界值为49.75 ng/mL时，预测骨质疏松症患者的敏感性为71.4%，特异性为69.2%。多变量回归分析显示血清骨膜素水平与 DEXA 的 L1-L4 T 评分呈负相关。

结论这是第一项确定 PHPT 患者血清骨膜素水平高于未患 PHPT 患者的研究，并证明 PHPT 患者血清骨膜素水平与 DEXA T 评分之间存在显着相关性。这些发现将有助于检测 PHPT 患者的骨质疏松症，并为 PHPT 患者做出手术决定，而无需进行涉及放射的 DEXA 成像。