Frailty of the elderly in orthopaedic surgery and body composition changes: the musculoskeletal crosstalk through irisin


Article ID: 5658
Vol 34, Issue 4S3, 2020
DOI: https://doi.org/10.54517/jbrha5658
Received: 8 September 2020; Accepted: 8 September 2020; Available online: 8 September 2020; Issue release: 8 September 2020

Abstract

In recent years, scientific interest has been developed towards irisin, a novel molecule of the family of myokines, which is directly involved in body mass composition balance, chronic diseases susceptibility and physiologic resilience to stressful events, including surgery. In the context of musculoskeletal disease, the role of this molecule has been associated to the balance of lean and fatty mass, and the production of irisin is subordinated to a healthy lifestyle and exercise. The mechanism of action of irisin on tissues is complex, and several studies described the molecular pathways in animal model and human subjects. In particular, in adipose cells, the key-role of irisin is to stimulate the differentiation of white adipose tissue to brown adipose tissue, through the action on the uncoupling protein 1. Furthermore, in the bony tissue, irisin stimulates osteogenesis through expression of Sost and Opn genes. These features make irisin a suitable molecule to use as a biomarker of the overall musculoskeletal health of the elderly, before undergoing orthopaedic surgery. Further research on this topic should be carried out to highlight the possible clinical role and predictive value of irisin in a multidisciplinary approach to the elderly before musculoskeletal surgery.


Keywords

irisin;biomarkers;elderly;physical activity;sport;bone;muscle;adipose tissue


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