Osteoporosis International最新文献

{"title":"Osteoporosis screening in the mammography setting via digital wrist tomosynthesis.","authors":"Daniel Oravec, Ram N Yadav, Terra Cushman, Michael J Flynn, George W Divine, Sudhaker D Rao, Yener N Yeni","doi":"10.1007/s00198-025-07516-y","DOIUrl":"10.1007/s00198-025-07516-y","url":null,"abstract":"<p><p>Adherence to osteoporosis screening guidelines could be considerably higher if offered at the time of routine mammography using the same imaging modality. We found that forearm density measurements using a breast imaging system provides density information with excellent diagnostic capability for osteoporosis and osteopenia status determined by hip and spine DXA.</p><p><strong>Purpose: </strong>Adherence to osteoporosis screening guidelines via bone mineral density (BMD) measurements with dual-energy x-ray absorptiometry (DXA) is low. Since adherence to breast cancer screening is quite high, it was suggested that the rate of osteoporosis screening can be improved if wrist imaging were performed at the time of breast screening using the very same equipment.</p><p><strong>Methods: </strong>Digital wrist tomosynthesis (DWT) imaging was performed in 150 women using a 3D mammography system and BMD was measured from both 3D tomosynthesis and synthesized 2D images. In addition, standard DXA based BMD measurements were performed at the hip, spine, and forearm sites. We examined the extent to which DWT-derived ultradistal radius BMD correlates with DXA based BMD measurements, evaluated DWT measurement precision errors, and determined the accuracy of DWT in diagnosing low bone mass and osteoporosis in vivo.</p><p><strong>Results: </strong>DWT BMD strongly correlated with DXA-derived ultradistal radius BMD (R2 up to 0.814) and discriminated osteoporosis (AUC up to 0.978) and osteopenia (AUC up to 0.938) by ultradistal T-score with low in vivo precision errors (0.91-2.3%). BMD derived from 3D DWT BMD performed comparably to forearm DXA BMD in the diagnosis of osteopenia (AUC up to 0.916) and osteoporosis (AUC up to 0.946) determined by hip and spine DXA.</p><p><strong>Conclusions: </strong>DWT can be readily implemented in mammography settings with similar diagnostic accuracy to DXA, has the potential to increase adherence to osteoporosis screening recommendations, and offers a convenient means to measure bone density within the highly accessible breast screening environment.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1165-1173"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034082","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":"Bone microstructure and TBS in diabetes: what have we learned? A narrative review.","authors":"S Ferrari, K E Akesson, N Al-Daghri, E Biver, M Chandran, T Chevalley, R G Josse, D L Kendler, N E Lane, P Makras, C Meier, Ambrish Mithal, A Suzuki, S Vasikaran, D D Pierroz, W D Leslie","doi":"10.1007/s00198-025-07495-0","DOIUrl":"10.1007/s00198-025-07495-0","url":null,"abstract":"<p><p>Diabetes is associated with an increased risk of fracture. Areal bone mineral density (aBMD), the most reliable indicator of fracture risk in healthy adults, is low in patients with type 1 diabetes mellitus but normal or high in patients with type 2 diabetes mellitus. Most trabecular and cortical parameters measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) are lower in type 1 diabetes and higher in type 2 diabetes, in parallel with aBMD. In contrast, lumbar spine trabecular bone score (TBS) has been reported to be lower in women with both type 1 and type 2 diabetes. The discordance between improved bone microstructure and degraded TBS reflects the effect of central obesity (currently the subject of a revision to the TBS algorithm). Meanwhile, evidence supports use of TBS in conjunction with aBMD and/or FRAX for improved fracture prediction in patients with type T2D. This position paper, on behalf of the Bone and Diabetes Working Group of the International Osteoporosis Foundation, summarizes alterations in bone microarchitecture measured by HR-pQCT in diabetes. It also addresses the technical and clinical considerations of the trabecular bone score, particularly discussing the significance of this measurement in individuals with diabetes and the influence of abdominal fat.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1115-1128"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013412","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":"Comparison of the time-dependent discriminatory accuracy of femoral strength and bone mineral density for predicting future hip and major osteoporotic fractures: a 16-year follow-up of the AGES-Reykjavik cohort.","authors":"Anitha D Praveen, Dheeraj Jha, Alexander Baker, Ingmar Fleps, Páll Björnsson, Lotta María Ellingsen, Thor Aspelund, Sigurdur Sigurdsson, Vilmundur Gudnason, Halldór Pálsson, David Matchar, Fjola Johannesdottir, Stephen J Ferguson, Benedikt Helgason","doi":"10.1007/s00198-025-07503-3","DOIUrl":"10.1007/s00198-025-07503-3","url":null,"abstract":"<p><p>The discriminative accuracy of femoral strength was significantly higher than that of aBMD over 16 years of follow-up for classifying hip fractures and major osteoporotic fractures. The use of accurate thresholds, whether for aBMD or other imaging-based biomarkers, is crucial to improve sensitivity and identify high-risk older adults.</p><p><strong>Background: </strong>Areal bone mineral density (aBMD) is a surrogate for bone strength but has limited prognostic value. Finite element (FE)-derived femoral strength offers a biomechanical alternative to aBMD for fracture risk assessment, but its long-term predictive value remains unclear. This study compared the discriminatory accuracy of aBMD and femoral strength for hip (HFs) and major osteoporotic fractures (MOFs) over 16 years, accounting for mortality risk.</p><p><strong>Methods: </strong>In the prospective Age Gene/Environment Susceptibility-Reykjavik (AGES-Reykjavik) Study, elderly participants underwent CT scans at entry and automated algorithms were used to compute aBMD and femoral strength. Time-dependent area under the receiver operating characteristic curves (AUC) was used to compare the predictive abilities of aBMD and femoral strength. Optimal cutoffs at the Youden's index were compared with the World Health Organization (WHO)-defined aBMD cutoffs at various time points.</p><p><strong>Results: </strong>The cohort comprised 4621 older adults (mean age 76 ± 5 years). Femoral strength had a significantly higher AUC than aBMD in identifying HFs (p < 0.05) from the 6th year in males and females, while their AUCs in predicting MOFs were similar. WHO-defined aBMD showed low sensitivity (17-52%) but high specificity (78-94%) for both HFs and MOFs. The sensitivity of optimal femoral strength was significantly higher than that of aBMD at comparable specificity by 5-19% for HFs and 2-10% for MOFs (p < 0.05).</p><p><strong>Conclusions: </strong>Both image-based markers predict long-term fracture risk and enable opportunistic screening with existing CT scans. However, femoral strength demonstrates better discriminatory accuracy than aBMD. The low sensitivity of the WHO-defined aBMD demonstrates the necessity to revise current risk assessment criteria.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1175-1184"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997944","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":"Excess subsequent fracture and mortality risk after ankle fractures: a relative survival analysis of the 45 and Up Study.","authors":"Weiwen Chen, Lyn M March, Fiona M Blyth, Dunia Alarkawi, Robert D Blank, Dana Bliuc, Thach Tran, Jacqueline R Center","doi":"10.1007/s00198-025-07400-9","DOIUrl":"10.1007/s00198-025-07400-9","url":null,"abstract":"<p><p>Ankle fractures are one of the common fractures that account for hospitalization. Ankle fractures were often thought of inconsequential as limited data on their long-term consequences. After accounting for age, sex, and time, ankle fractures were associated with increased risk of subsequent fracture and mortality.</p><p><strong>Background: </strong>Ankle fractures are common but it is uncertain whether they are indicative of poor bone health. There are limited data about subsequent fracture and mortality risk following ankle fractures.</p><p><strong>Objective: </strong>To determine if there is increased subsequent fracture and mortality risk after ankle fractures.</p><p><strong>Methods: </strong>A prospective population-based cohort of 143,070 women and 123,818 men in the 45 and Up Study (NSW, Australia) had baseline questionnaire responses that were linked to Emergency Department Data Collection (EDDC), the Admitted Patient Data Collection (APDC), and the NSW Registry of Births Deaths & Marriages death registrations from 2006 to 2017. Secure data access was provided through the Sax Institute's Secure Unified Research Environment (SURE). Sex-specific excess risks of subsequent fracture and mortality following ankle fractures were quantified using relative survival analysis.</p><p><strong>Results: </strong>During 1,490,651 person-years, women and men experienced 1379 and 579 ankle fractures and 78 deaths and 76 deaths, respectively. Ankle fractures were associated with a 5-year 5% (95% CI 3-8%) excess risk of subsequent fracture in both women and men, compared to subjects' risk of an incident fracture in the study. There was a 5-year cumulative excess mortality of 10% (95% CI 6-13%) following ankle fractures in men but no excess mortality in women compared to the overall cohort. Participants with ankle fractures who died were older (P < 0.001), more likely to have had a second fracture (P < 0.001), have had a prior fracture (P < 0.001), and have more comorbidities (P < 0.001).</p><p><strong>Conclusion: </strong>In the 45 and Up cohort, there was a modest but significant increased risk of fracture following ankle fracture seen in both women and men. In men, but not women, ankle fractures were associated with 10% excess mortality. Ankle fractures should be considered for secondary fracture prevention in those who are older and have more comorbidities.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1031-1038"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033910","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":"Prognostic indicators in medication-related osteonecrosis of the jaw: A systematic review and meta-analysis.","authors":"Ling-Ying Wei, Ching-Ming Chiu, Sang-Heng Kok, Hung-Ying Lin, Wei-Yih Chiu, Chih-Wei Yang, Jang-Jaer Lee","doi":"10.1007/s00198-025-07464-7","DOIUrl":"10.1007/s00198-025-07464-7","url":null,"abstract":"<p><p>Modulation of bone turnover by antiresorptive agents impairs wound healing of jaw bones, and can result in an adverse event termed medication-related osteonecrosis of the jaw (MRONJ). In recent years, the prevalence, risk factors, and prevention strategies for MRONJ have been extensively investigated, but only few studies have focused on its treatment outcome, and the proposed prognostic factors have varied greatly. We systematically reviewed the prognostic factors in patients undergoing treatment for MRONJ. In total, 33 studies met the inclusion criteria out of 1,388 screened citations. For analysis, we grouped the prognostic factors into five categories as follows: medication-related, underlying conditions, lesion-related, serum markers, and treatment modalities. Discontinuation of antiresorptive therapy was a medication-related factor significantly associated with better treatment outcomes. Regarding underlying conditions, malignancy, especially multiple myeloma, was associated with worse treatment outcomes. Among lesion-related factors, better treatment outcome was noted for maxillary lesions and lesions with sequestrum formation. By contrast, lesions of advanced stages and those with periosteal reaction had poor treatment outcomes. Regarding treatment modality, surgical therapy was associated with a better chance of healing. Results of our meta-analysis helped identify prognostic indicators of MRONJ and will assist in decision-making in the clinical setting. Based on our results, surgeons may have a better cognitive context to discuss treatment options with patients. Additionally, our findings provide convincing evidence for physicians to consider postponing antiresorptive therapy in patients with MRONJ lesions.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"969-979"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701001","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":"Bridging the gap: validating AI for real-world osteoporosis screening.","authors":"Qurat Ul Ain Iftikhar","doi":"10.1007/s00198-025-07496-z","DOIUrl":"10.1007/s00198-025-07496-z","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1095-1096"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993075","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: The Healing and therapeutic effects of perioperative bisphosphonate use in patients with fragility fractures: meta-analysis of 19 clinical trials.","authors":"Wensi Ouyang, Guimei Guo, Changwei Zhao","doi":"10.1007/s00198-025-07430-3","DOIUrl":"10.1007/s00198-025-07430-3","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1097-1098"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008450","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: The effect of hypersensitive C-reactive protein to albumin ratio on the risk of fragility fracture in the Chinese male population.","authors":"Han Wang, Yizhuan Huang","doi":"10.1007/s00198-025-07509-x","DOIUrl":"10.1007/s00198-025-07509-x","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1101"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993078","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: OSIN-D-25-00317, \"Comment on: The effect of hypersensitive C-reactive protein to albumin ratio on the risk of fragility fracture in the Chinese male population\".","authors":"Lu Guo, Faming Tian","doi":"10.1007/s00198-025-07510-4","DOIUrl":"10.1007/s00198-025-07510-4","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1103-1104"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975243","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":"Pre-fracture functional status and 30-day recovery predict 5-year survival in patients with hip fracture: findings from a prospective real-world study.","authors":"Carmelinda Ruggiero, Marta Baroni, Monica Pizzonia, Andrea Giusti, Giuseppe Rinonapoli, Vittorio Bini, Emilio Martini, Ilaria Giovanna Macchione, Clemens Becker, Opinder Sahota, Antony Johansen","doi":"10.1007/s00198-025-07427-y","DOIUrl":"10.1007/s00198-025-07427-y","url":null,"abstract":"<p><p>Disability overcomes mortality burden in older adults with hip fracture, expanding unhealthy lifespan. Building comprehensive assessment, pre-fracture functional status and 30-day post-surgical recovery are the most powerful predictors of 5-years survival. A tool supporting estimation of long-term survival may optimize the appropriate delivery of targeted interventions.</p><p><strong>Background: </strong>Older people with hip fractures are highly heterogeneous patients, impacting health and economic systems. The availability of tools to estimate survival may help optimize patients' outcomes and treatment management decisions.</p><p><strong>Methods: </strong>A prospective observational study was conducted on older patients with hip fractures who received baseline and 30-day comprehensive assessment from discharge, focusing on functional status based on Basic Activity of Daily Living (BADL). The primary outcome was to identify predictors of 5-year survival and develop nomograms to be adopted at admission or 30 days after discharge.</p><p><strong>Result: </strong>Among 231 hip fracture patients, 5-year survival was 38.3% in men and 61.9% in women; women experienced a 1.8 higher likelihood of survival than men. Pre-fracture functional status predicted mortality as a function of age. At hospital admission, pre-fracture BADL level was a protective factor (HR 0.742; 95% CI 0.668-0.825), while male gender (HR 1.840; 95% CI 1.192-2.841), age (HR 1.070; 95% CI 1.037-1.105), and multimorbidity (HR 1.096; 95% CI 1.007-1.193) were independent mortality risk factors. At the 30-day follow-up visit, the BADL recovery gap was an independent predictor of 5-year survival (HR 1.439; 95% CI 1.158-1.789), in addition to male gender (HR 1.773; 95% CI 1.146-2.744), age (HR 1.046; 95% CI 1.010-1.083), and pre-fracture BADL (HR 0.621; 95% CI 0.528-0.730), while comorbidity disappeared (HR 1.083; 95% CI 0.994-1.179).</p><p><strong>Conclusion: </strong>More than half of hip fracture patients are still alive 5 years after surgical repair. Pre-fracture functional status and a 30-day functional recovery gap are the main predictors of survival. Nomograms may help to define prognosis and suitable interventions.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1019-1030"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811908","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}