High serum periostin influences cancer mortality but not cancer risk in older men

Among older home-dwelling men, high serum levels of periostin confer an increased cancer mortality risk but not cancer risk itself, according to long-term data from the STRAMBO study.

STRAMBO included 815 home-dwelling men (aged 60–87) who were followed-up for 8 years. All participants underwent baseline serum periostin measurements using immunoassay. During the follow-up, 168 deaths (20.6 percent) were recorded.

Compared with the survivors, men who died were older, shorter and had higher body mass index. The latter were also more likely to have lower leisure and professional physical activity, lower grip strength, and higher prevalence of ischaemic heart disease, diabetes mellitus and Parkinson's disease.

Multivariable Cox analysis revealed a positive association between serum periostin and all-cause mortality (hazard ratio [HR], 1.30 per standard deviation [SD], 95 percent confidence interval [CI], 1.13–1.50; p<0.001) and cancer mortality (n=69; HR, 1.44 per SD, 95 percent CI, 1.16–1.78; p<0.001) in the overall population. This relationship was not observed for cardiovascular mortality (n=55; p=0.28) and noncardiovascular/noncancer mortality (n=44; p=0.94).

In the subgroup of 107 men with prevalent cancer, the risks of all-cause mortality (HR, 1.93 per SD, 95 percent CI, 1.30–2.87; p<0.005) and cancer mortality (HR, 2.07 per SD, 95 percent CI, 1.23–3.47; p<0.01) heightened with increasing periostin concentrations.

In the subgroup of 613 men with incident cancer, higher periostin concentrations were likewise associated with elevated cancer mortality (HR, 1.40 per SD, 95 percent CI, 1.12–1.76; p<0.005) but not with the risk of cancer (HR, 1.16 per SD, 95 percent CI, 0.89–1.46; p=0.21).

The present data may have important clinical implications, as a high level of serum periostin—a protein that helps regulate multiple biological behaviours of tumour cells—could be recognized as a risk factor for aggressive cancer and guide the choice of a more effective treatment strategy, according to the researchers.