{"title":"Impact of mechanotransduction on gene expression changes in periodontal ligament during orthodontic tooth movement.","authors":"Suzu Chida, Tomoki Chiba, Yutaro Uchida, Takahide Matsushima, Ryota Kurimoto, Takayuki Miyazaki, Lisa Yagasaki, Satoshi Nakamura, Emiko Mihara, Junichi Takagi, Keiji Moriyama, Hiroshi Asahara","doi":"10.1007/s00774-025-01581-3","DOIUrl":"https://doi.org/10.1007/s00774-025-01581-3","url":null,"abstract":"<p><strong>Introduction: </strong>The periodontal ligament (PDL) is a structure between the alveolar bone and cementum, essential for tooth stability and composed of diverse cell types. Mohawk homeobox (Mkx) is a master transcription factor that regulates tendon and ligament homeostasis. However, the specific cell populations expressing Mkx and its role in mechanotransduction during orthodontic tooth movement (OTM) remain unclear.</p><p><strong>Materials and methods: </strong>We conducted single-cell RNA sequencing on wild-type rat PDL at 0 day, 1 week, and 2 weeks of post-OTM using coil springs to elucidate Mkx's function and the changes in cell populations under continuous mechanical stimulation. In addition, RT-qPCR was performed to assess the relationship between tenogenic gene expression and Mkx expression in human PDL cells.</p><p><strong>Results: </strong>The rat PDL was identified to consist of 14 clusters, with Mkx and Scleraxis (Scx) expressed in distinct cell populations. Collagen and ECM production increased throughout the OTM period, while the sterile inflammatory response was initially heightened and later diminished, indicating that bone remodeling occurs later in the inflammatory response. Overexpression of MKX in human PDL cells enhanced COL1A1 and DECORIN expression.</p><p><strong>Conclusion: </strong>Mechanical stimulation of the PDL appears to trigger an aseptic inflammatory response that disrupts PDL homeostasis and promotes bone remodeling. Mkx may exert a protective effect on the PDL during mechanical stimulation.</p>","PeriodicalId":15116,"journal":{"name":"Journal of Bone and Mineral Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Merve Yoldaş Çelik, Ebru Canda, Havva Yazıcı, Fehime Erdem, Ayşe Yüksel Yanbolu, Ayca Aykut, Asude Durmaz, Sema Kalkan Uçar, Eser Yıldırım Sözmen, Mahmut Çoker
{"title":"Insights into skeletal involvement in adult Gaucher disease: a single-center experience.","authors":"Merve Yoldaş Çelik, Ebru Canda, Havva Yazıcı, Fehime Erdem, Ayşe Yüksel Yanbolu, Ayca Aykut, Asude Durmaz, Sema Kalkan Uçar, Eser Yıldırım Sözmen, Mahmut Çoker","doi":"10.1007/s00774-024-01573-9","DOIUrl":"https://doi.org/10.1007/s00774-024-01573-9","url":null,"abstract":"<p><strong>Introduction: </strong>Gaucher disease (GD) is a lysosomal storage disorder causing systemic and skeletal complications. This study evaluates bone health in adult GD type 1 patients, focusing on skeletal complications, bone mineral density (BMD), and biochemical markers.</p><p><strong>Material and methods: </strong>A cohort of adult GD type 1 patients followed up at Ege University Pediatric Metabolism Department were retrospectively examined.</p><p><strong>Results: </strong>This study included 32 patients with GD type 1, comprising 11 males (34.4%) and 21 females (65.6%). The median age at diagnosis was 20.5 years (min: 3-max:65), and at enrolment, it was 35 years (min:18-max:71). Most patients (93.8%) had organomegaly, and 93.8% had cytopenia. Common genetic variants were p.Asn409Ser (60.9%), p.Leu483Pro (7.8%), and p.Asp448His(4.7%). All patients were on enzyme replacement therapy (ERT) for a median of 11 years (min:2-max:18). Bone complications included pathologic fractures in six patients (19%) and avascular necrosis in 12 patients (37.5%). Bone pain was reported by 93.7% of patients at admission and persisted in 59.4% during follow-up. DXA scans showed abnormal bone mineral density (BMD) in 62.5% of patients initially, with a significantly low bone density in 3.1% and reduced bone density in 59.3%. BMD improved with treatment, as evidenced by a significant increase in Z scores (p < 0.05). Elevated chitotriosidase (75%), ferritin (50%), and immunoglobulin G (21.9%) levels were noted but did not correlate with BMD. Seven patients (22%) were splenectomized, all with bone issues.</p><p><strong>Discussion: </strong>Bone health in GD involves multiple factors beyond biochemical markers. While ERT improves BMD, bone pain and fractures remain significant issues. Comprehensive management, including regular BMD monitoring and better vitamin D supplementation adherence, is crucial. Further research is needed to improve treatments for bone complications in GD.</p>","PeriodicalId":15116,"journal":{"name":"Journal of Bone and Mineral Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pamela Rufus-Membere, Kara B Anderson, Kara L Holloway-Kew, Mark A Kotowicz, Adolfo Diez-Perez, Julie A Pasco
{"title":"Associations between bone material strength index and FRAX scores.","authors":"Pamela Rufus-Membere, Kara B Anderson, Kara L Holloway-Kew, Mark A Kotowicz, Adolfo Diez-Perez, Julie A Pasco","doi":"10.1007/s00774-024-01575-7","DOIUrl":"https://doi.org/10.1007/s00774-024-01575-7","url":null,"abstract":"<p><strong>Introduction: </strong>Impact microindentation (IMI) measures bone material strength index (BMSi) in vivo. However, its ability to predict fractures is still uncertain. This study aimed to determine the association between BMSi and 10 year fracture probability, as calculated by the FRAX algorithm.</p><p><strong>Materials and methods: </strong>BMSi was measured using the OsteoProbe in 388 men (ages 40-90 yr) from the Geelong Osteoporosis Study. The probabilities for a major osteoporotic fracture (MOF) and hip fracture (HF) were calculated using the Australian FRAX tool. Hip (HF) and major osteoporotic (MOF) fracture probabilities were computed with and without the inclusion of femoral neck bone mineral density (BMD). For each participant, four 10 year probability scores were therefore generated: (i) HF-FRAXnoBMD; (ii) HF-FRAXBMD; (iii) MOF-FRAXnoBMD; (iv) MOF-FRAXBMD.</p><p><strong>Results: </strong>BMSi was negatively correlated with age (r = - 0.114, p = 0.025), no associations were detected between BMSi and femoral neck BMD (r = + 0.035, p = 0.507). BMSi was negatively correlated with HF-FRAXnoBMD (r = - 0.135, p = 0.008) and MOF-FRAXnoBMD (r = - 0.153, p = 0.003). These trends held true for HF-FRAXBMD (r = - 0.087, p = 0.094) and MOF-FRAXBMD (r = - 0.111, p = 0.034), but only the latter reached significance.</p><p><strong>Conclusion: </strong>BMSi captures the cumulative effect of clinical risk factors in the FRAX algorithm, suggesting that it could provide additional information that may be useful in predicting risk of fractures. Further studies are warranted to establish its efficacy in predicting fracture risk.</p>","PeriodicalId":15116,"journal":{"name":"Journal of Bone and Mineral Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiovascular safety of osteoanabolic agents.","authors":"Yasuhiro Takeuchi","doi":"10.1007/s00774-025-01580-4","DOIUrl":"https://doi.org/10.1007/s00774-025-01580-4","url":null,"abstract":"<p><strong>Purpose: </strong>Several osteoanabolic agents have been developed to build new bone more efficiently than anti-resorptive drugs. Among them, romosozumab, an anti-sclerostin antibody, is a potent pharmacological tool to prevent fractures in osteoporosis patients. The efficacy of romosozumab in preventing osteoporotic fractures is robust. However, there remains a concern about increased cardiovascular (CV) adverse events related to romosozumab. Available data have been reviewed to address this concern.</p><p><strong>Methods: </strong>Published articles on romosozumab of which pivotal randomized controlled trials (RCTs), meta-analyses of RCTs, pharmacovigilance investigations, and retrospective observational clinical studies using real-world data were collected through PubMed and other available tools.</p><p><strong>Results: </strong>Meta-analyses of RCTs of romosozumab compared to placebo and other anti-osteoporosis drugs have left room for controversy in the CV safety of romosozumab. Investigations of the real-world data also provide no conclusive evidence in this issue.</p><p><strong>Conclusion: </strong>We need more robust evidence to establish an appropriate and reasonable guide to prescribe romosozumab in our clinical practice.</p>","PeriodicalId":15116,"journal":{"name":"Journal of Bone and Mineral Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miaomiao An, Chunyan Wu, Shaohui Feng, Lingyan Zhu, Wanli Yang, Limei Ran, Lin Yang, Laigang Zhao
{"title":"Correlation between serum high-density lipoprotein cholesterol and bone mineral density in vitamin D-deficient populations.","authors":"Miaomiao An, Chunyan Wu, Shaohui Feng, Lingyan Zhu, Wanli Yang, Limei Ran, Lin Yang, Laigang Zhao","doi":"10.1007/s00774-024-01572-w","DOIUrl":"https://doi.org/10.1007/s00774-024-01572-w","url":null,"abstract":"<p><strong>Introduction: </strong>To investigate the relationship between serum high-density lipoprotein (HDL) cholesterol and bone mineral density (BMD) in vitamin D-deficient population.</p><p><strong>Materials and methods: </strong>This study was a cross-sectional study. From January to December 2020, 2583 middle-aged and older adult aged 40 and above were randomly selected in the Health Management Center of the Affiliated Hospital of Guizhou Medical University for health examination and questionnaire survey. The correlation was determined by Pearson correlation method, and the independent correlation was analyzed by multiple linear regression. The receiver Operating characteristic (ROC) curve estimates HDL-C cutoff levels for predicting osteoporosis risk.</p><p><strong>Results: </strong>The prevalence of osteoporosis in the study population was 11.4%, the overall prevalence of 25 (OH) D deficiency was 78.2%. There was no correlation between HDL-C and BMD of lumbar spine, femoral neck and total hip in normal vitamin D group (P > 0.05). HDL-C in the deficient group was negatively correlated with BMD of lumbar spine and femoral neck (P < 0.05), but not with BMD of total hip. Serum HDL-C concentration increased with the progression of osteoporosis. When serum 25 (OH) D level was lower than normal level, HDL-C ≥ 1.215 mmol/L was an independent predictor of osteoporosis (sensitivity = 75%, specificity = 53%, Area = 0.625).</p><p><strong>Conclusions: </strong>HDL-C was inversely associated with BMD in the lumbar spine and femoral neck in people aged 40 years and older with vitamin D deficiency. When serum HDL-C concentration ≥ 1.215 mmol/L, it can better predict the occurrence of osteoporosis.</p>","PeriodicalId":15116,"journal":{"name":"Journal of Bone and Mineral Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence of vertebral fractures at death.","authors":"Noriko Ogawa, Masahiro Yamamoto, Rie Kobayashi, Atsuko Kawamura, Akihiro Matsumoto, Hiroki Otani, Keizo Kanasaki","doi":"10.1007/s00774-025-01577-z","DOIUrl":"https://doi.org/10.1007/s00774-025-01577-z","url":null,"abstract":"<p><strong>Introduction: </strong>Despite many studies on the prevalence of vertebral fractures (VFs), the VF prevalence at death in the Japanese population remains unclear.</p><p><strong>Materials and methods: </strong>We evaluated the VF prevalence at death in a Japanese cohort using autopsy imaging computed tomography (AiCT). We enrolled 365 cadavers (188 men, 177 women, mean age of 84.6 years) donated for anatomical dissection at Shimane University School of Medicine. The VFs were diagnosed using the semiquantitative technique of Genant from the first cervical vertebra to the fifth lumbar vertebra.</p><p><strong>Results: </strong>The overall VF prevalence was 69.6% (58.5%/81.4% in men/women), of which 46.0% (29.8%/63.3% in men/women) had thoracic VFs, and 58.1% (50.5%/66.1% in men/women) had lumbar VFs. The most frequent fracture site was lumbar spine 1 (L1) with 31.5% (22.9%/40.7% in men/women), followed by thoracic spine 12 (T12) with 31.0% (20.7%/41.8% in men/women). In terms of severity, 3.8% (4.8%/2.8% in men/women), 23.8% (27.1%/20.3% in men/women), and 41.9% (26.6%/58.2% in men/women) were Grades 1, 2, and 3. The VFs from T3 to L5 and of Grade 3 severity were significantly higher in women. VF and Grade 3 fractures were associated with a history of surgical intervention for femoral neck fractures. VFs were not associated with the following underlying causes of death: cancer, heart disease, senile death, cerebrovascular disease, pneumonia, and aspiration pneumonia.</p><p><strong>Conclusion: </strong>The VF prevalence at death, assessed by AiCT in cadavers donated for anatomical dissection, was higher in both men and women compared with previous studies conducted on individuals aged ≥ 80 years in Japan.</p>","PeriodicalId":15116,"journal":{"name":"Journal of Bone and Mineral Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Challenges to implementing artificial intelligence-enabled Chest X-ray in opportunistic screening for osteoporosis.","authors":"Hongnan Ye","doi":"10.1007/s00774-025-01578-y","DOIUrl":"https://doi.org/10.1007/s00774-025-01578-y","url":null,"abstract":"","PeriodicalId":15116,"journal":{"name":"Journal of Bone and Mineral Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Osteoporosis and stroke: a bidirectional mendelian randomization study.","authors":"Miao He, Haochuan Yong, Zhidong Cao, Jie Li","doi":"10.1007/s00774-025-01579-x","DOIUrl":"https://doi.org/10.1007/s00774-025-01579-x","url":null,"abstract":"<p><strong>Introduction: </strong>Numerous observational studies have identified a link between osteoporosis and stroke. However, the causal genetic relationship between these conditions remains unclear. This study employs a two-sample bidirectional Mendelian randomization (MR) approach to ascertain the causal relationship between osteoporosis and stroke.</p><p><strong>Materials and methods: </strong>We conducted a two-sample Mendelian randomization (MR) study to investigate the potential causal relationship between osteoporosis and stroke, including its subtypes. Genetic data for osteoporosis and stroke, along with their subtypes, were sourced from published genome-wide association studies (GWAS). Single nucleotide polymorphisms (SNPs) demonstrating genome-wide significance (p < 5 × 10^ - 8) and independence (r^2 < 0.001) were selected for further analysis, provided they had an F-statistic ≥ 10. The inverse-variance weighted (IVW) method was employed to evaluate causality, with results reported as odds ratios (ORs). Heterogeneity was assessed using Cochran's Q test, while pleiotropy was tested using the MR-Egger intercept test. A leave-one-out sensitivity analysis was performed to ensure the robustness of the results.</p><p><strong>Results: </strong>Employing the IVW method, MR Egger method, and median-weighted method, we found no significant bidirectional causal relationship between osteoporosis and stroke or its subtypes, irrespective of the inclusion of potential pleiotropic SNPs. Sensitivity analyses affirmed the reliability and stability of these findings.</p><p><strong>Conclusion: </strong>Our study findings indicate that there is no direct causal relationship between osteoporosis and stroke or its subtypes in either direction. Based on our results, although no direct link was found, secondary effects do exist.</p>","PeriodicalId":15116,"journal":{"name":"Journal of Bone and Mineral Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaolong Xiong, Hui Huang, Ning Wang, Kai Zhou, Xinghui Song
{"title":"Sirt1 overexpression inhibits chondrocyte ferroptosis via Ftl deacetylation to suppress the development of osteoarthritis.","authors":"Xiaolong Xiong, Hui Huang, Ning Wang, Kai Zhou, Xinghui Song","doi":"10.1007/s00774-024-01574-8","DOIUrl":"https://doi.org/10.1007/s00774-024-01574-8","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoarthritis (OA) is a chronic degenerative joint disorder characterized by an imbalance in chondrocyte metabolism. Ferroptosis has been implicated in the pathogenesis of OA. The role of Sirt1, a deacetylase, in mediating deacetylation during ferroptosis in OA chondrocytes remains underexplored. This study aimed to elucidate the mechanisms by which Sirt1 influences chondrocyte ferroptosis in the development of OA.</p><p><strong>Materials and methods: </strong>In vitro and in vivo models of OA were established using IL-1β-induced mouse chondrocytes and a destabilization of the medial meniscus (DMM) mouse model, respectively. Ferroptosis was evaluated through measurements of cell viability, lactate dehydrogenase (LDH) release, intracellular levels of Fe2+, glutathione (GSH), malondialdehyde (MDA), lipid reactive oxygen species (ROS), propidium iodide staining, and Western blot analysis. The underlying mechanisms were further investigated using quantitative real-time polymerase chain reaction, Western blotting, immunoprecipitation (IP), co-immunoprecipitation (Co-IP), and glutathione-S-transferase pulldown assays. In vivo validation was performed via Safranin O staining.</p><p><strong>Results: </strong>IL-1β induced ferroptosis and increased histone acetylation, effects that were partially reversed by Sirt1 overexpression. Mechanistically, Sirt1 overexpression upregulated ferritin light polypeptide (Ftl) expression by deacetylating Ftl at the K181 residue. Ftl knockdown inhibited the ferroptosis-enhancing effect of Sirt1 overexpression in chondrocytes. In vivo studies showed that Sirt1 overexpression mitigated the progression of OA and reduced ferroptosis in the DMM-induced OA mouse model.</p><p><strong>Conclusion: </strong>Our findings confirm that Sirt1 overexpression promotes Ftl expression through deacetylation at the K181 site, thereby suppressing chondrocyte ferroptosis and attenuating the progression of OA. These results suggest a potential therapeutic target for OA treatment.</p>","PeriodicalId":15116,"journal":{"name":"Journal of Bone and Mineral Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thoracolumbar kyphosis prognoses poor results after proximal femoral fracture: a 3-year multicenter prospective cohort study.","authors":"Yutaro Sugawara, Hotaka Ishizu, Kosuke Arita, Tetsuro Oue, Komei Sato, Renya Takahashi, Kenichi Kusunoki, Shun Shimodan, Tsuyoshi Asano, Norimasa Iwasaki, Tomohiro Shimizu","doi":"10.1007/s00774-024-01576-6","DOIUrl":"https://doi.org/10.1007/s00774-024-01576-6","url":null,"abstract":"<p><strong>Introduction: </strong>Proximal femoral fractures are critically associated with increased risk of mortality and secondary fractures. Identifying prognosis predictors related to sagittal imbalance that are known to have negative impact on fracture risk and mortality is crucial. This study aimed to explore the relationship between various sagittal imbalance parameters and the prognosis of proximal femoral fractures to identify the most important prognostic indicators.</p><p><strong>Materials and methods: </strong>This multi-center prospective cohort study included patients with proximal femoral fractures treated surgically from April 2020 to March 2021. Spinal standing radiographs were obtained to measure various sagittal spine parameters. Postoperative follow-ups were conducted at 6, 12, 18, 24, and 36 months to assess mortality and secondary fracture rates and examine the predictors and their effects.</p><p><strong>Results: </strong>Among the 137 patients who underwent spinal standing radiographs, 22 died and 23 developed secondary fractures. Multivariate analyses identified the number of previous vertebral fractures and thoracolumbar kyphosis (TLK) as significant risk factors for mortality and secondary fractures. Survival analysis revealed that patients with TLK < 20° had significantly higher survival rates than those with TLK ≥ 20° (P = 0.002 and P < 0.001 for mortality and secondary fractures, respectively). In addition, serum albumin was associated with mortality, and the intake of sleeping pills and antidepressants was associated with secondary fractures.</p><p><strong>Conclusion: </strong>TLK after surgery and the number of previous vertebral fractures affected both mortality and secondary fractures. When each risk factor, such as low serum albumin levels, intake of sleeping pills and antidepressants, was also considered, it was found that comprehensive postoperative care is essential.</p>","PeriodicalId":15116,"journal":{"name":"Journal of Bone and Mineral Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}