Irisin and Its Role in Postmenopausal Osteoporosis and Sarcopenia

Abstract

Menopause, an extremely delicate phase in a woman's life, is characterized by a drop in estrogen levels. This decrease has been associated with the onset of several diseases, including postmenopausal osteoporosis and sarcopenia, which often coexist in the same person, leading to an increased risk of fractures, morbidity, and mortality. To date, there are no approved pharmacological treatments for sarcopenia, while not all of those approved for postmenopausal osteoporosis are beneficial to muscles. In recent years, research has focused on the field of myokines, cytokines, or peptides secreted by skeletal muscle fibers following exercise. Among these, irisin has attracted great interest as it possesses myogenic properties but at the same time exerts anabolic effects on bone and could therefore represent the link between muscle and bone. Therefore, irisin could represent a new therapeutic strategy for the treatment of osteoporosis and also serve as a new biomarker of sarcopenia, thus facilitating diagnosis and pharmacological intervention. The purpose of this review is to provide an updated summary of what we know about the role of irisin in postmenopausal osteoporosis and sarcopenia.

Keywords: irisin; postmenopausal osteoporosis; sarcopenia.

Figure 1

Effects of decreased estrogen levels on bone and muscle. This image was created with BioRender software (https://www.biorender.com/).

Figure 2

Crosstalk between bone and muscle through cytokine and myokine synthesis, with a focus on the role of irisin in muscle, bone, and adipose tissue. OCN: osteocalcin; OPG: osteoprotegerin; FGF: fibroblast growth factor; SOST: sclerostin; RANKL: receptor activator of nuclear factor κB ligand; IL-7: interleukin-7; IGF: insulin-like growth factor 1; LIF: leukemia inhibitory factor; BDNF: brain-derived neurotropic factor. This image was created with BioRender software (https://www.biorender.com/).