This result is in accordance with data that high serum periostin levels are independently associated with increased fracture risk in postmenopausal women.7, 8 Moreover, periostin is elevated in the serum of patients with different subtypes of hemoglobinopathies, disorders that also correlate with bone loss.18 It is of interest that NDMM patients with fractures had markedly elevated bone marrow plasma periostin even compared with patients with high number of osteolytic lesions. Here, POSTN is linked to hemoglobinopathy.