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J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Frailty is a multidimensional syndrome of reduced physiological reserve that is particularly prevalent in individuals with type 2 diabetes. Identifying objective biochemical markers to complement clinical screening tools, such as the FRAIL scale, is an increasingly important unmet need. Periostin, a matricellular protein involved in tissue remodeling, bone metabolism, and chronic complications of diabetes, has emerged as a potential candidate. In this cross-sectional study of 137 adults with type 2 diabetes (65 \u00b1 8 years), participants were classified as robust, pre-frail, or frail according to FRAIL scores. Frailty correlated positively with age (p &lt; 0.001), BMI (p = 0.006), waist circumference (p = 0.01), and diabetes duration (p = 0.040), and negatively with TBS (p = 0.001), HDL-c (p = 0.040), and eGFR (p = 0.009). A stronger positive correlation was observed with serum periostin (p &lt; 0.001). Frail individuals showed higher periostin levels than pre-frail (p = 0.006) and robust participants (p = 0.008), independent of age. Periostin demonstrated moderate discriminatory capacity for frailty status (AUC = 0.710; p &lt; 0.001), while adding periostin to clinical variables resulted in a numerical increase in overall model discrimination (AUC = 0.900 vs. 0.858). A threshold of &gt;1307 pmol\/L yielded 77.8% sensitivity and 66.7% specificity. These preliminary findings indicate that periostin is significantly associated with frailty in type 2 diabetes and may represent a complementary biochemical biomarker of frailty status, warranting further validation in longitudinal studies.<\/jats:p>","DOI":"10.3390\/ijms27167503","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T15:51:05Z","timestamp":1787327465000},"page":"7503","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum Periostin as a Complementary Biomarker of Frailty in Type 2 Diabetes: A Pilot Study Using the FRAIL Scale"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6413-7001","authenticated-orcid":false,"given":"Sheila","family":"Gonz\u00e1lez-Salvatierra","sequence":"first","affiliation":[{"name":"Endocrinology and Nutrition Unit, Hospital Universitario Cl\u00ednico San Cecilio, 18016 Granada, Spain"},{"name":"CIBER of Frailty and Healthy Aging (CIBERFES), Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4134-5561","authenticated-orcid":false,"given":"Beatriz","family":"Garc\u00eda-Fontana","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Unit, Hospital Universitario Cl\u00ednico San Cecilio, 18016 Granada, Spain"},{"name":"CIBER of Frailty and Healthy Aging (CIBERFES), Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain"},{"name":"Department of Cell Biology, University of Granada, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9328-6022","authenticated-orcid":false,"given":"Cristina","family":"Garc\u00eda-Fontana","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Unit, Hospital Universitario Cl\u00ednico San Cecilio, 18016 Granada, Spain"},{"name":"CIBER of Frailty and Healthy Aging (CIBERFES), Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9330-8108","authenticated-orcid":false,"given":"Luis","family":"Mart\u00ednez-Heredia","sequence":"additional","affiliation":[{"name":"CIBER of Frailty and Healthy Aging (CIBERFES), Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1393-9885","authenticated-orcid":false,"given":"Jos\u00e9 Francisco","family":"Rojas-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Diaverum M\u00e1laga, 29002 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7452-4387","authenticated-orcid":false,"given":"Mar\u00eda Carmen","family":"Andreo-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Unit, Hospital Universitario Cl\u00ednico San Cecilio, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5104-9942","authenticated-orcid":false,"given":"Antonia","family":"Garc\u00eda-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Unit, Hospital Universitario Cl\u00ednico San Cecilio, 18016 Granada, Spain"},{"name":"CIBER of Frailty and Healthy Aging (CIBERFES), Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Department of Medicine, University of Granada, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9645-3260","authenticated-orcid":false,"given":"Manuel","family":"Mu\u00f1oz-Torres","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Unit, Hospital Universitario Cl\u00ednico San Cecilio, 18016 Granada, Spain"},{"name":"CIBER of Frailty and Healthy Aging (CIBERFES), Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain"},{"name":"Department of Medicine, University of Granada, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Guevara, E., Sim\u00f3-Servat, A., Perea, V., Quir\u00f3s, C., Puig-Jov\u00e9, C., Formiga, F., and Barahona, M.-J. 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