Therefore, the lower levels seen in whole group analysis may suggest impaired bone formation, and a reduced adaptive response to mechanical stress is associated with low bone mass, fragility and poor bone quality, even when bone mineral density is not markedly reduced, and is seen in conditions of osteoporosis or reduced bone turnover states [23,24]; however, with linear regression, periostin did not significantly differ but rather may have shown a trend. The gene discussed is POSTN; the disease is osteoporosis.