Osteoporosis International最新文献

{"title":"Gut microbiome and bone health: update on mechanisms, clinical correlations, and possible treatment strategies.","authors":"Andrea Ticinesi, Carmine Siniscalchi, Tiziana Meschi, Antonio Nouvenne","doi":"10.1007/s00198-024-07320-0","DOIUrl":"10.1007/s00198-024-07320-0","url":null,"abstract":"<p><p>The intestinal microbiome is increasingly regarded as a relevant modulator of the pathophysiology of several age-related conditions, including frailty, sarcopenia, and cognitive decline. Aging is in fact associated with alteration of the equilibrium between symbiotic bacteria and opportunistic pathogens, leading to dysbiosis. The microbiome is able to regulate intestinal permeability and systemic inflammation, has a central role in intestinal amino acid metabolism, and produces a large number of metabolites and byproducts, with either beneficial or detrimental consequences for the host physiology. Recent evidence, from both preclinical animal models and clinical studies, suggests that these microbiome-centered pathways could contribute to bone homeostasis, regulating the balance between osteoblast and osteoclast function. In this systematic review, we provide an overview of the mechanisms involved in the gut-bone axis, with a particular focus on microbiome function and microbiome-derived mediators including short-chain fatty acids. We also review the current evidence linking gut microbiota dysbiosis with osteopenia and osteoporosis, and the results of the intervention studies on pre-, pro-, or post-biotics targeting bone mineral density loss in both animal models and human beings, indicating knowledge gaps and highlighting possible avenues for future research.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"167-191"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of FRAX®-based intervention thresholds for management of osteoporosis in Indian women: a Markov microsimulation model analysis.","authors":"Lakshmi Nagendra, Manju Chandran, Jean-Yves Reginster, Sanjay Kumar Bhadada, Saptarshi Bhattacharya, Deep Dutta, Mickael Hiligsmann","doi":"10.1007/s00198-024-07328-6","DOIUrl":"10.1007/s00198-024-07328-6","url":null,"abstract":"<p><p>A cost-effectiveness analysis of FRAX® intervention thresholds (ITs) in Indian women over 50 years indicated that generic alendronate was cost-effective for age-dependent major osteoporotic fracture (MOF) ITs and hip fracture (HF) ITs starting at ages 60 and 65 years for full and real-world adherence, respectively. Alendronate was cost-effective at fixed MOF IT of 14% and HF IT of 3.5%, regardless of age.</p><p><strong>Purpose: </strong>Osteoporosis represents a significant public health challenge in India, with an increasing economic burden due to the aging population. This study evaluated the cost-effectiveness of using fracture risk assessment tool (FRAX®)-based intervention thresholds (ITs) for managing osteoporosis with generic alendronate in Indian women.</p><p><strong>Methods: </strong>A Markov microsimulation model, adapted to the Indian healthcare context, was used to simulate the costs and quality-adjusted life years (QALYs) associated with different treatment strategies. The one-time gross domestic product (GDP) per capita (estimated at INR 1,97,468/QALY gained) was used as the cost-effectiveness threshold.</p><p><strong>Results: </strong>The model revealed that generic alendronate is cost-effective for major osteoporotic fracture (MOF) ITs beginning at age 60 years with full adherence-incremental cost-effectiveness ratio (ICER) of INR 102,151 per QALY gained, and age 65 with real-world adherence-ICER of INR 28,203 per QALY gained (conversion rate used is 1 US dollar (USD) = INR 83.97 and 1 EURO = INR 92.70). Hip fracture (HF) ITs showed similar cost-effectiveness at ages 60 (ICER of INR 67,144) and was the dominant strategy (i.e., more QALYs for lower costs) at ≥ 65 years. Fixed ITs of 14% for MOF and 3.5% for HF proved cost-effective across all age groups (dominant strategy for ages ≥ 65 years). Limitations of our study include the reliance on fracture incidence data from Singaporean Indians and variability in fracture prevalence across India.</p><p><strong>Conclusion: </strong>The results support the integration of FRAX®-based fixed ITs from the age of 50 years and age-based ones from the age of 65 years in India to optimize resource allocation and improve osteoporosis management.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"311-322"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Higher prevalence of thyroid‑specific autoantibodies (TPOAb and TgAb) is related to a higher prevalence of fractures in females: results from NHANES 2007-2010\".","authors":"Ping Xu, Jianyang Luo","doi":"10.1007/s00198-024-07334-8","DOIUrl":"10.1007/s00198-024-07334-8","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"355-356"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author response to 01530, Proactive strategies for fracture risk in androgen deprivation therapy: a call for multidisciplinary collaboration.","authors":"Marsha van Oostwaard, J P van den Bergh, C E Wyers","doi":"10.1007/s00198-024-07322-y","DOIUrl":"10.1007/s00198-024-07322-y","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"371-372"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Rapid reduction in fracture risk after the discontinuation of long-term oral glucocorticoid therapy: a retrospective cohort study using a nationwide health insurance claims database in Japan.","authors":"Dongdong Cao, Zhiyang Cao, Aifeng Liu","doi":"10.1007/s00198-024-07374-0","DOIUrl":"10.1007/s00198-024-07374-0","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"361-362"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of trabecular bone Hounsfield units in the lumbar spine for osteoporosis evaluation in individuals aged 65 and above: a review.","authors":"Ahmed Alharthy","doi":"10.1007/s00198-024-07340-w","DOIUrl":"10.1007/s00198-024-07340-w","url":null,"abstract":"<p><p>Osteoporosis is a prevalent condition that significantly increases fracture risk, particularly in the elderly population. Despite its widespread occurrence, osteoporosis is often underdiagnosed and inadequately managed. Traditional diagnostic methods, such as dual-energy X-ray absorptiometry (DXA), have limitations in terms of accessibility and accuracy, necessitating exploration of alternative diagnostic approaches.This review aims to evaluate the diagnostic potential of Hounsfield Unit (HU) values derived from abdominal computed tomography (CT) scans, specifically focusing on the trabecular bone of the lumbar spine, for osteoporosis assessment in individuals aged 65 and older. The review seeks to assess the sensitivity, specificity, and overall diagnostic performance of HU values in distinguishing between normal bone density, osteopenia, and osteoporosis, and to identify areas for further investigation to establish standardized diagnostic criteria.This review compiles existing studies on the use of HU values from abdominal CT scans for osteoporosis diagnosis. It examines the relationship between HU values and DXA T-scores, analyzes optimal HU thresholds for classifying bone density categories, and explores the potential of CT scans as a viable alternative to DXA.The findings indicate that HU values from abdominal CT scans show strong correlations with DXA T-scores, suggesting a promising diagnostic tool for assessing bone density and quality. HU values have demonstrated the ability to differentiate between osteopenia, osteoporosis, and normal bone density, with varying sensitivity and specificity depending on the established HU threshold. CT scans are identified as a scalable, cost-effective alternative to DXA, with the added benefit of utilizing routine abdominal CT scans, which are often conducted for other clinical reasons, thereby reducing additional costs and radiation exposure.HU values derived from abdominal CT scans represent a promising approach for osteoporosis screening, offering a potential solution for routine, cost-effective, and accurate diagnosis, especially in older adults. However, there is a need for standardized HU thresholds and further research to refine diagnostic criteria and enhance the accuracy of osteoporosis detection. Establishing standardized guidelines would improve diagnostic consistency and facilitate early intervention, potentially improving patient outcomes and reducing healthcare burdens.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"225-233"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the guidance on fracture Liaison Services and the introduction of a new fee for secondary fracture prevention in Japan: Implementation of secondary fracture prevention during hospitalization for fragility fractures.","authors":"Gaku Gondo, Jung-Ho Shin, Susumu Kunisawa, Yuichi Imanaka","doi":"10.1007/s00198-024-07269-0","DOIUrl":"10.1007/s00198-024-07269-0","url":null,"abstract":"<p><p>In Japan, the publication of the Fracture Liaison Service Clinical Standard (FLS-CS) had no apparent effect on the implementation of secondary fracture prevention, but the introduction of a new management fee for secondary fracture prevention significantly promoted the implementation of secondary fracture prevention for the target disease.</p><p><strong>Background: </strong>Secondary fracture prevention is important for managing fragility fractures. In Japan, the FLS-CS was published in 2019, alongside the introduction of a new management fee for secondary fracture prevention, launched in 2022 for patients who underwent surgery for hip fracture. FLS programs were hospital-based. This study evaluated the impact of these interventions on the implementation of secondary fracture prevention during hospitalization for fragility fractures.</p><p><strong>Methods: </strong>Using claims data from the Quality Indicator/Improvement Project database, patients aged 50 years or older with hip fracture who underwent surgery or with vertebral fractures were included. The publication of FLS-CS was the first intervention, followed by the introduction of the management fee as the second intervention. To evaluate the impact of these interventions, we performed an interrupted time series analysis separately for hip and vertebral fractures.</p><p><strong>Results: </strong>For hip fractures, there was no immediate change after the first intervention, and the monthly rate of change decreased (incidence rate ratio [IRR]: 0.985, 95% confidence interval [CI]: 0.979-0.991). After the second intervention, there was an immediate increase (IRR: 1.890, 1.761-2.029), and the monthly rate of change also increased (IRR: 1.050, 1.044-1.056). For vertebral fractures, the proportion of change increased only immediately after the second intervention (IRR: 1.148, 1.038-1.270).</p><p><strong>Conclusion: </strong>The publication of FLS-CS had no apparent effect on the implementation of secondary fracture prevention in patients with either hip or vertebral fractures. Conversely, the introduction of the management fee had the effect of increasing that for the target disease.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"235-244"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap: enhancing osteoporosis management through AI-driven predictive models.","authors":"Alishba Noor, Rayyan Nabi, Heeba Tariq Khan, Amna Noor","doi":"10.1007/s00198-025-07396-2","DOIUrl":"https://doi.org/10.1007/s00198-025-07396-2","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter \"OSIN-24-D-01312, letter to the editor commenting on 'evaluation of bone mineral density (BMD) and trabecular bone score (TBS) in pheochromocytoma and paraganglioma; a multi-centric case-control study from India'\".","authors":"Shinjan Patra","doi":"10.1007/s00198-024-07354-4","DOIUrl":"https://doi.org/10.1007/s00198-024-07354-4","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First fracture in rheumatoid arthritis: analysis by fracture site, gender, age, and comorbidities.","authors":"Owen Taylor-Williams, Helen Keen, David B Preen, Johannes Nossent, Charles A Inderjeeth","doi":"10.1007/s00198-024-07311-1","DOIUrl":"10.1007/s00198-024-07311-1","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a potentially devastating disorder associated with increased risk of fractures, but current studies do not completely evaluate the RA fracture risk profile. This study estimates fracture incidence by site of fracture and makes comparisons between RA and controls using the key variables gender, age, and comorbidities.</p><p><strong>Background: </strong>Rheumatoid arthritis RA is a potentially devastating osteoimmunological disorder, predisposing to osteoporosis (OP), fragility fracture (FF), and major osteoporotic fractures (MOF). As few studies incorporate statistical matching, comorbidity and non-MOF sites, we compared the incidence of first FF, MOF, and non-MOF in RA patients with a matched control cohort adjusting for comorbidities.</p><p><strong>Methods: </strong>This longitudinal cohort study uses routinely collected administrative data from the West Australian Rheumatic Disease Epidemiological Registry (WARDER) between 1980 and 2015. RA patients, as defined using International Classification of Disease (ICD) codes, were compared to hospitalised patients free of rheumatic disease. Case-control matching adjusted for age, gender, and comorbidities (Charlson Comorbidity Index). Incidence rates (IR) per 1000 person years (PY) with 95% confidence intervals (CI) were compared by incidence rate ratios (IRR).</p><p><strong>Findings: </strong>In RA patients from 2000 to 2010, the first fracture IR was 18.3 (15.7-21.2) for an IRR of 1.32 (1.10-1.60). Upper limb, lower limb, and axial IR were 5.56 (95% CI 4.18-7.26), 10.60 (95% CI 8.66-12.87), and 2.47 (95% CI 2.58-3.68) with IRR of 1.18 (95% CI 0.84-1.65), 1.44 (95% CI 1.19-1.86), and 1.01 (95% CI 0.61-1.63) respectively. The first fracture IR increased 6 years before first RA hospital record (RR 1.58, CI 1.05-2.39).</p><p><strong>Conclusions: </strong>After age, gender, and comorbidity adjustment, RA is associated with a 32% higher incidence of first fracture, increased MOF, and a fracture incidence that is already increased before a first recorded RA diagnosis. This suggests a need for early attention to prevention of all fractures in RA patients.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"113-121"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}