Journal of Bone and Mineral Research最新文献

{"title":"Femoral neck width is associated with unique trajectories of age-related hip structural changes and fracture risk within populations of adult women and men.","authors":"Karl J Jepsen, Todd L Bredbenner, Carrie A Karvonen-Gutierrez, Aleda M Leis, Michelle M Hood, Siobán D Harlow, John Randolph, Gregory A Clines, Steffenie Merillat, Michael R Elliott, Jane A Cauley, Gail A Greendale, Arun S Karlamangla, Katherine W Peters, Stephanie L Harrison, Li-Yung Lui, Peggy M Cawthon, Eric Orwoll","doi":"10.1093/jbmr/zjaf090","DOIUrl":"10.1093/jbmr/zjaf090","url":null,"abstract":"<p><p>Osteoporosis management relies heavily on areal BMD (aBMD) to identify women and men with reduced bone strength. We tested the hypothesis that baseline FN external size is associated with different bone-loss and area-gain trajectories that are not reflected in aBMD-decline but have different biomechanical implications. We analyzed data from 4 longitudinal studies with repeated hip DXA scans of women and men over 10-15 yr of follow-up. Changes in FN BMC, area, and aBMD were compared across height-adjusted baseline FN area tertiles using linear models. Fracture risk differences across the tertiles were tested using Cox proportional-hazard models. Women and men with smaller baseline FN area had smaller BMC-declines and greater area-increases over 10-15 yr. In contrast, those with a larger FN area experienced twice the annual BMC-declines but much smaller area-increases. In general, these structural changes were not reflected in aBMD-changes for either sex. The likelihood of fracturing a hip was 2.5 times greater for women and 2.4-4.2 times greater for men in the larger FN area tertile compared to those in the smaller FN area tertile. Unique patterns of age-related structural changes with different biomechanical implications were identified within populations of women and men. These results challenge the general assumption that age-related structural changes are homogenous within a population and question whether aBMD-declines reflect strength-declines consistently among women and men. How these unique patterns of structural change affect the response of women and men to osteoporosis interventions remains to be determined.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1114-1126"},"PeriodicalIF":5.9,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144525722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging applications of feature selection in osteoporosis research: from biomarker discovery to clinical decision support.","authors":"Jihan Wang, Yangyang Wang, Jia Ren, Zitong Li, Lei Guo, Jing Lv","doi":"10.1093/jbmr/zjaf105","DOIUrl":"10.1093/jbmr/zjaf105","url":null,"abstract":"<p><p>Osteoporosis (OP), a systemic skeletal disease characterized by compromised bone strength and elevated fracture susceptibility, represents a growing global health challenge that necessitates early detection and accurate risk stratification. With the exponential growth of multidimensional biomedical data in OP research, feature selection has become an indispensable machine learning paradigm that improves model generalizability. At the same time, it preserves clinical interpretability and enhances predictive accuracy. This perspective article systematically reviews the transformative role of feature selection methodologies across 3 critical domains of OP investigation: (1) multi-omics biomarker identification, (2) diagnostic pattern recognition, and (3) fracture risk prognostication. In biomarker discovery, advanced feature selection algorithms systematically refine high-dimensional multi-omics datasets (genomic, proteomic, and metabolomic) to isolate key molecular signatures correlated with BMD trajectories and microarchitectural deterioration. For clinical diagnostics, these techniques enable efficient extraction of discriminative pattern from multimodal imaging data, including DXA, QCT, and emerging dental radiographic biomarkers. In prognostic modeling, strategic variable selection optimizes prognostic accuracy by integrating demographic, biochemical, and biomechanical predictors while mitigating overfitting in heterogeneous patient cohorts. Current challenges include heterogeneity in dataset quality and dimensionality, translational gaps between algorithmic outputs and clinical decision parameters, and limited reproducibility across diverse populations. Future directions should prioritize the development of adaptive feature selection frameworks capable of dynamic multi-omics data integration, coupled with hybrid intelligence systems that synergize machine-derived biomarkers with clinician expertise. Addressing these challenges requires coordinated interdisciplinary efforts to establish standardized validation protocols and create clinician-friendly decision support interfaces, ultimately bridging the gap between computational OP research and personalized patient care.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1106-1113"},"PeriodicalIF":5.9,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-urban differences in osteoporosis and sarcopenia prevalence among Gambian older adults: A pilot study.","authors":"Mícheál Ó Breasail, Ayse Zengin, Camille Pearse, Isatou Drammeh, Ramatoulie Janha, Landing Jarjou, Peter R Ebeling, Ann Prentice, Kate A Ward","doi":"10.1093/jbmr/zjaf130","DOIUrl":"https://doi.org/10.1093/jbmr/zjaf130","url":null,"abstract":"<p><p>Rural-urban bone mineral density (BMD) differences are well-described in high-income countries, typically with higher BMD in rural areas. However, despite rapid urbanization and longevity across Africa, such data remains scarce. This study compares bone and muscle health in older adults living in rural and urban Gambia. Participants aged ≥55 years from rural (n=209) and urban communities (n=101) were measured with dual-energy X-ray absorptiometry (DXA: total hip (TH), femoral neck [FN], and lumbar spine [LS]) and peripheral quantitative computed tomography (pQCT: diaphyseal and epiphyseal radius and tibia). Outcomes were: DXA areal BMD (aBMD), bone mineral content (BMC), bone area (BA); pQCT total volumetric BMD (vBMD), trabecular vBMD, bone strength indices (BSIc), cross-sectional area (CSA), BMC, and cortical vBMD. Osteoporosis (NHANES III, T-score <-2.5) and sarcopenia (EWGSOP2 ALM and HGS) prevalence were computed. Linear regression was used to describe rural-urban differences in DXA and pQCT outcomes (i) unadjusted and (ii) age and fat mass index (FMI) adjusted. Osteoporosis at either FN or TH was more prevalent in urban men (20% vs rural 10%) and rural women (45% vs urban 31%). LS T-scores <-2.5 were more common in rural participants (M: 27% vs 14%; F:61% vs 35%). Sarcopenia was also higher in rural participants (M:30% vs. 18%; F:18% vs. 15%). Adjusted for age and FMI urban Gambians had lower BMC but greater BA at the FN and TH, while aBMD differed little. Urban men had lower adjusted tibial cortical vBMD but greater tibial diaphyseal and radial epiphyseal CSA. After adjustment urban women had greater radial CSA and estimated strength. Our findings highlight that osteoporosis and sarcopenia are highly prevalent in older Gambian adults, with differences in rural-urban prevalence influenced by sex. Given ongoing nutrition transition and urbanization across Africa, larger population-based studies are urgently required to better inform targeted prevention strategies and interventions.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic bone loss during fracture healing: new evidence from HR-pQCT analyses.","authors":"Bettina M Willie, Seyedmahdi Hosseinitabatabaei","doi":"10.1093/jbmr/zjaf073","DOIUrl":"https://doi.org/10.1093/jbmr/zjaf073","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute effect of impact and resistance exercise on Wnt signaling modulators, bone and cartilage metabolism.","authors":"Benjamin Boxer, Zhuoyue Zhang, Jonathan P Folland, Richard Eastell, Fatma Gossiel, Ogulcan Caliskan, Katherine Brooke-Wavell","doi":"10.1093/jbmr/zjaf128","DOIUrl":"https://doi.org/10.1093/jbmr/zjaf128","url":null,"abstract":"<p><p>Impact and resistance exercise have potent osteogenic effects and may positively affect cartilage through tissue deformation. These effects may be mediated through inhibitors of Wnt signaling such as sclerostin and Dickkopf WNT signaling pathway inhibitor 1 (DKK1), which may also play a role in cartilage metabolism. This study evaluated the effect of acute bouts of impact and resistance exercise on biomarkers of bone turnover, signaling, and cartilage metabolism. Healthy young men completed impact or resistance exercise and a control trial in random order. Impact exercise involved 120 maximum-effort multidirectional jumps and hops. Resistance exercise involved 120 high load lower limb lifts. Jumps and lifts were interspersed with 1-3 s pauses. In control trial, participants rested in a supine position for same duration as exercise trial. Blood samples were taken pre, immediately and 24 h post exercise/rest and analyzed for sclerostin, DKK1, C-terminal telopeptide of type I collagen (CTX-I), procollagen I N-terminal propeptide (PINP), procollagen II C-terminal propeptide (PIICP) and cartilage oligomeric matrix protein (COMP). Repeated measures ANOVA compared time points, trials and their interaction. Participants were 26 men, mean (SD) age 23.4 (2.9) years. Impact exercise increased PINP immediately post exercise (by mean [95%CI] +10.8[4.8,17.2]%, p = .002) and 24 h later (+7.4[0.0,15.3]%, p = .05) whereas resistance exercise had no effect. A transient increase in sclerostin immediately post exercise occurred in the impact exercise trial only (+36.3[24.6,49.3]%, p < .001). Both exercise modes transiently increased DKK1 immediately post exercise (impact +32.4[23.1,42.4]%, p < .001; resistance +30.3[22.8,38.4]%, p < .001). COMP increased immediately after resistance exercise only (+36.2[16.0,59.8]%, p < .001). Neither form of exercise affected CTX-I. Impact and resistance exercise transiently increased Wnt signaling inhibitors. Resistance exercise increased a marker of cartilage turnover but did not affect markers of bone turnover. Impact exercise did not affect cartilage turnover markers. Increases in bone formation but not resorption markers may reflect positive adaptation to impact loading.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aromatase in adipose tissue exerts an osteoprotective function in male mice via phosphate regulation.","authors":"Aoi Ikedo, Michiko Yamashita, Maiko Hoshino, Yosuke Okuno, Megumi Koike, Minori Uga, Kazuya Tanifuji, Hiroko Segawa, Seiji Fukumoto, Yuuki Imai","doi":"10.1093/jbmr/zjaf129","DOIUrl":"https://doi.org/10.1093/jbmr/zjaf129","url":null,"abstract":"<p><p>Aromatase contributes to maintenance of bone mass because male patients with loss-of-function mutations of CYP19A1 exhibit bone loss. Treatment with aromatase inhibitor also causes bone loss in men and post-menopausal women, suggesting that part of the anabolic effect of testosterone in men is dependent on estradiol (E2) biosynthesized by aromatase in non-gonadal tissues. It remains unclear how locally biosynthesized E2 contributes to maintenance of bone mass. We examined the function of aromatase in local tissues rather than gonads using cell-type specific aromatase knockout (KO) mice. Because osteoblast-specific aromatase KO mice exhibited no bone phenotype, we focused on adipose tissue, known as a reservoir of steroid hormones and analyzed the bone phenotypes of adipose tissue-specific aromatase KO (AroΔaP2) mice. Sixteen-week-old male AroΔaP2 mice exhibited significantly lower bone mineral density in tibia and femur, especially in trabecular bone, than controls. Bone histomorphometry showed that AroΔaP2 mice exhibited an insufficient calcification bone phenotype with increased osteoid volume and width, and decreased osteoclast area and numbers. Moreover, serum phosphate, renal phosphate reabsorption and FGF23 were significantly lower in AroΔaP2, suggesting that the insufficient calcification phenotype in AroΔaP2 was not caused by excessive FGF23 activities. Finally, we analyzed NaPi2a and NaPi2c, phosphate transporters localized in the kidney and found that protein levels in renal brush border membrane vesicles were lower in AroΔaP2. These results indicate that estrogens locally biosynthesized by aromatase in adipocytes can play a significant role in bone mass maintenance via regulation of phosphate reabsorption in the kidney by NaPi2.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imprinting and skeletal disorders: Lessons from Pseudohypoparathyroidism and Related Disorders.","authors":"Yorihiro Iwasaki, Murat Bastepe","doi":"10.1093/jbmr/zjaf122","DOIUrl":"https://doi.org/10.1093/jbmr/zjaf122","url":null,"abstract":"<p><p>Pseudohypoparathyroidism (PHP) was first described as a syndrome characterized by parathyroid hormone (PTH) resistance combined with skeletal abnormalities known as Albright's hereditary osteodystrophy (AHO). Studies have since focused on genetic or epigenetic alterations underlying PHP and related disorders. The α-subunit of the stimulatory G protein (Gsα) mediates the signaling of G protein-coupled receptors that stimulate cAMP generation. The Gsα-cAMP cascade is pivotal for human skeletal growth, as evidenced by pathogenic mutations converging on this signaling pathway in a spectrum of skeletal dysplasias that overlap with AHO. The gene encoding Gsα, GNAS, is subject to genomic imprinting, an epigenetic mechanism governing allele-specific gene expression through differential methylation. Parental allele contribution to Gsα expression differs among tissues. While Gsα is biallelically transcribed in most tissues, including bone and cartilage, the paternal Gsα allele is suppressed in a limited number of cells/tissues, including the proximal renal tubule, where PTH exerts critical actions. Therefore, Gsα mutations cause distinct clinical manifestations according to the affected parental allele. While maternal mutations result in PHP type 1A, which consists of PTH resistance and AHO, paternal mutations lead to pseudo-pseudohypoparathyroidism (PPHP), ie, AHO without hormone resistance. Epigenetic alterations of GNAS cause PHP type 1B (PHP1B), defined by PTH resistance in the absence of AHO. Thus, genomic imprinting plays a key role in the phenotypes associated with GNAS alterations. Investigations on the genetic cause of PHP1B have identified crucial imprinting control regions of GNAS, whose functions were elucidated only recently using human embryonic stem cells to model imprinting regulatory mechanisms in the early embryo. We herein review the current understanding of the genetic and epigenetic basis of PHP and related disorders, focusing on their skeletal manifestations.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age and sex specific incidence rates and future projections for hip fractures in the Gambia, West Africa, and comparison across four countries in Africa.","authors":"Hannah Wilson, Kebba Marenah, Anya Burton, Momodou Jallow, Lucy Gates, Awa Touray, Samuel Hawley, Simon Graham, James Masters, Matthew Costa, Bintou Trawally, Kate A Ward, Celia L Gregson","doi":"10.1093/jbmr/zjaf126","DOIUrl":"https://doi.org/10.1093/jbmr/zjaf126","url":null,"abstract":"<p><p>Longevity in African populations is increasing, where deprivation and malnutrition are common; hence fragility fracture incidence is expected to increase. Healthcare systems must adapt to provide for this aging population; however, currently fragility fracture incidence has yet to be determined in any West African setting. This study aimed to determine age- and sex-specific hip fracture incidence rates in adults in The Gambia, compare these with rates from other Southern African countries, and estimate future national hip fracture projections. All hip fracture cases in adults aged ≥40 yr, presenting to a hospital or traditional bone setter (TBS) in the study area over 2-yr, were identified. Age- and sex-specific hip fracture incidence per 100 000 person-years were estimated using the 2024 Gambian Population census. Incidence rate estimates were compared between The Gambia, Zimbabwe, South Africa, and Botswana. In The Gambia, future hip fracture numbers were estimated through to 2054 using United Nations population projections. Over 2-yr, 226 hip fracture patients, mean (standard deviation [SD]) age 71.2(12.5) years, 64.6% female, presented to hospital (184[81.4%]) or TBS (42[18.6%]). Most presented with a fragility fracture (205[90.7%]). High-impact trauma (eg, traffic accidents) was more common in younger men. Delays in presentation were common (68[30.1%]). Incidence rates for adults ≥40 yr in The Gambia were 28.1 and 51.7 per 100 000 person years for men and women, respectively, increasing with age. In those age ≥ 80 yr, incidence rates plateaued in men. The number of hip fractures is estimated to increase from 166 in 2024 to 621 by 2054. Age-specific hip fracture incidence rates were broadly comparable between The Gambia, Zimbabwe, Botswana, and Black South Africans. In summary, fragility fractures in Gambian adults were common, indicative of age-associated osteoporosis. Hip fracture cases will almost quadruple over coming decades; therefore, health service capacity must expand to manage this rising demand.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CARD14-Mediated MYC Interaction Promotes Osteoclastogenesis and Bone Density Reduction in Adolescent Idiopathic Scoliosis.","authors":"Hao Luo, Sijian Lin, Jiachao Xiong, Wen Tan, Hao Lv, Zhiming Liu, Qin Wu, Junlong Zhong, Kai Cao","doi":"10.1093/jbmr/zjaf127","DOIUrl":"https://doi.org/10.1093/jbmr/zjaf127","url":null,"abstract":"<p><p>Adolescent idiopathic scoliosis (AIS) is characterized by decreased bone mineral density (BMD), which is associated with an increased risk of skeletal fragility and poor long-term outcomes. This study explores the role of the CARD14 gene in osteoclast differentiation and its contribution to bone metabolism dysregulation in AIS patients. RNA sequencing of peripheral blood mononuclear cells (PBMCs) from AIS patients identified significantly elevated CARD14 expression compared to controls. Functional in vitro assays demonstrated enhanced osteoclastogenesis in PBMC-derived cells from AIS patients, as evidenced by an increase in TRAP-positive multinucleated cells and resorption pit formation. To further elucidate CARD14's role, adenoviral vectors were constructed to overexpress CARD14 in bone marrow-derived macrophages (BMMs) from C57/B6 mice, leading to markedly increased osteoclast differentiation and activity. Next, we utilized bone marrow-specific Card14 knockout mice to investigate the in vivo role of CARD14. These mice exhibited reduced osteoclast activity, improved trabecular bone microarchitecture, and increased BMD, as evidenced by micro-CT and histological analyses. Additionally, serum biomarkers of bone metabolism further corroborated these findings. Mechanistically, CARD14 was found to interact with MYC and regulate osteoclast differentiation through a MYC-dependent pathway, while simultaneously activating NF-κB and MAPK signaling, which are critical for osteoclastogenesis. AIS patients consistently showed lower BMD and higher osteoclast counts than age-matched controls, establishing a link between abnormal osteoclast function and bone loss in AIS. The results highlight that elevated CARD14 expression promotes osteoclastogenesis and bone resorption, contributing to reduced BMD in AIS. Targeting CARD14 and its associated signaling pathways may represent a novel therapeutic approach to address bone density loss in AIS patients, potentially improving their skeletal health and quality of life.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between body composition and bone loss in early postmenopausal women.","authors":"Marina Vilar Geraldi, Giulia Gregori, Lisa Johansson, Ulrika Hjertonsson, Emma Brättemark, Mattias Lorentzon","doi":"10.1093/jbmr/zjaf125","DOIUrl":"https://doi.org/10.1093/jbmr/zjaf125","url":null,"abstract":"<p><p>The early postmenopausal period is characterized by rapid bone loss, accompanied by a decline in lean mass and an increase in fat mass, highlighting the importance of understanding how these changes influence bone health. This study aimed to assess the cross-sectional and longitudinal associations between body composition and bone characteristics in early postmenopausal women using linear mixed models for repeated measures. A total of 223 Swedish women, aged 50-60 and within 1-4 yr postmenopause, were followed for 2 yr as part of the ELBOW II clinical trial. Body composition-body weight, appendicular lean mass (ALM), and fat mass-was assessed by DXA. Bone outcomes included areal BMD at the TH, FN, LS (DXA), as well as tibia bone microarchitecture and volumetric BMD (vBMD), measured by HR-pQCT. Higher baseline body weight, BMI, fat mass, and ALM were significantly associated with greater cortical area, cortical vBMD, and total vBMD. Baseline body weight, BMI, and fat mass, but not ALM, were positively associated with TH BMD. Longitudinally, increases in ALM were significantly associated with favorable changes in TH BMD, LS BMD, total vBMD, trabecular bone volume fraction, and cortical area. Changes in body weight and BMI were associated with multiple bone outcomes, while fat mass change was linked only with cortical area. In exploratory group comparisons, women with low baseline fat mass (28.14%) and greater ALM loss (∆% ALM: -2.87 kg) experienced 2.4-fold and 5.2-fold greater reductions in TH BMD and tibia total vBMD, respectively, compared to those with high fat mass and maintained ALM. These findings underscore the importance of maintaining or increasing lean mass and preserving overall body weight to mitigate bone loss and reduce skeletal fragility in early postmenopausal women.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}