Osteoporosis International最新文献

{"title":"Error in Mendelian randomization analysis in \"Higher risk of osteoporosis in adult-onset asthma than childhood-onset asthma\".","authors":"Xinghai Yue, Shaoshun Shi","doi":"10.1007/s00198-024-07344-6","DOIUrl":"10.1007/s00198-024-07344-6","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"571-572"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910020","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":"The definition of atypical femoral fractures should include periprosthetic femoral fractures (PAFFs).","authors":"Binni Makkar, William Obremskey, Ryan Avidano, Susan Ott, Brinda Basida, Colton Hoffer, John T Schousboe, Joan Lo, Jared Huling, Kim Ristau, Howard A Fink, Robert A Adler, Joshua I Barzilay, Laura Carbone","doi":"10.1007/s00198-025-07401-8","DOIUrl":"10.1007/s00198-025-07401-8","url":null,"abstract":"<p><p>Periprosthetic hip fractures may have features of atypical femoral fractures.</p><p><strong>Purpose: </strong>Atypical femoral fracture (AFF) is a rare complication of treatment with bisphosphonates (BPs) or denosumab. The American Society for Bone and Mineral Research (ASBMR) Task Force definition for AFFs excludes periprosthetic fractures. The purpose of this study was to determine prodromal symptoms, frequency, treatment, and outcomes of periprosthetic AFFs (PAFFs) in persons prescribed a BP or denosumab for osteoporosis and later diagnosed with a periprosthetic hip fracture.</p><p><strong>Methods: </strong>Participants were all veterans (age ≥ 50) from the VA Corporate Data Warehouse with at least one filled prescription for an oral or intravenous BP or denosumab from October 1999 through December 2022, prior to an ICD code for a periprosthetic fracture around a hip joint. Radiographs were reviewed for features of AFF. In those with a PAFF, the presence of a contralateral AFF was sought. Medical records of those with a PAFF were reviewed to identify prodromal symptoms, treatments, and outcomes.</p><p><strong>Results: </strong>Among approximately 400,000 veterans who received a BP or denosumab, there were 76 ICD-coded periprosthetic hip fractures, including one AFF. This fracture met all five ASMBR-defined AFF criteria. The PAFF, a Vancouver C cemented periprosthetic femur fracture, occurred in a man with > 7 years of BP therapy. There was no contralateral AFF. The BP was discontinued and the fracture was treated with an interlocking plate with cerclage wires. In the 12 months following PAFF, there were no infectious complications, but the fracture had a chronic nonunion.</p><p><strong>Conclusion: </strong>Periprosthetic hip fractures may rarely have features of AFFs. Fracture nonunion may complicate PAFFs.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"539-546"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370904","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":"Improving readability in AI-generated medical information on fragility fractures: the role of prompt wording on ChatGPT's responses.","authors":"Hakan Akkan, Gulce Kallem Seyyar","doi":"10.1007/s00198-024-07358-0","DOIUrl":"10.1007/s00198-024-07358-0","url":null,"abstract":"<p><p>Understanding how the questions used when interacting with chatbots impact the readability of the generated text is essential for effective health communication. Using descriptive queries instead of just keywords during interaction with ChatGPT results in more readable and understandable answers about fragility fractures.</p><p><strong>Purpose: </strong>Large language models like ChatGPT can enhance patients' understanding of medical information, making health decisions more accessible. Complex terms, such as \"fragility fracture,\" can confuse patients, so presenting its medical content in plain language is crucial. This study explored whether conversational prompts improve readability and understanding compared to keyword-based prompts when generating patient-centered health information on fragility fractures.</p><p><strong>Methods: </strong>The 32 most frequently searched keywords related to \"fragility fracture\" and \"osteoporotic fracture\" were identified using Google Trends. From this set, 24 keywords were selected based on relevance and entered sequentially into ChatGPT. Each keyword was tested with two prompt types: (1) plain language with keywords embedded and (2) keywords alone. The readability and comprehensibility of the AI-generated responses were assessed using the Flesch-Kincaid reading ease (FKRE) and Flesch-Kincaid grade level (FKGL), respectively. The scores of the responses were compared using the Mann-Whitney U test.</p><p><strong>Results: </strong>The FKRE scores indicated significantly higher readability with plain language prompts (median 34.35) compared to keyword-only prompts (median 23.60). Similarly, the FKGL indicated a lower grade level for plain language prompts (median 12.05) versus keyword-only (median 14.50), with both differences achieving statistical significance.</p><p><strong>Conclusion: </strong>Our findings suggest that using conversational prompts can enhance the readability of AI-generated medical information on fragility fractures. Clinicians and content creators should consider this approach when using AI for patient education to optimize comprehension.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"403-410"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952844","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":"Focal dermal hypoplasia: a probable underrecognized low bone mass disorder secondary to aberrant Wnt signaling.","authors":"Diana Ovejero, Natalia Garcia-Giralt, Juan David Patiño-Salazar, Raquel Rabionet, Xavier Nogués","doi":"10.1007/s00198-024-07382-0","DOIUrl":"10.1007/s00198-024-07382-0","url":null,"abstract":"<p><p>A 29-year-old Spanish Caucasian man, without relevant family history, was attended in our unit due to an undiagnosed skeletal dysplasia associated with low bone mass and several fragility fractures throughout his childhood and adolescence. DXA exams throughout his life showed very low BMD values; currently, his spinal and femoral neck T-scores were - 4.3 and - 3.5, respectively. Blood and urinary tests were normal. Other relevant features included right hand and foot syndactyly, aplasia cutis, right hemibody hypoplasia, vertebral malformations, abnormal-looking humerii, and Asperger's syndrome among others. Whole exome sequencing retrieved a highly probable pathogenic variant in the PORCN gene p.(Arg296Pro) in mosaicism. PORCN mutations cause focal dermal hypoplasia (FDH), an X-linked ultra-rare ecto-mesodermal disorder characterized by several of the findings the patient presented. However, low BMD has not been classically associated with the disease. Noteworthy, PORCN is key for canonical Wnt signaling. Literature scrutiny has yielded other cases of FDH with skeletal fragility during childhood. In addition, preclinical studies with PORCN inhibitors, currently under development as an antitumoral therapy, have shown rapid detrimental effects on bone mass. Collectively, these findings indicate that FDH is probably an underrecognized monogenic cause of low bone mass due to defective Wnt signaling.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"555-559"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024213","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-24-01586, \"Revisiting the safety of romosozumab in Japan: the need for clear contraindications for patients with cardiovascular risk\".","authors":"Soichiro Masuda, Toshiki Fukasawa, Shuichi Matsuda, Satomi Yoshida, Koji Kawakami","doi":"10.1007/s00198-024-07348-2","DOIUrl":"10.1007/s00198-024-07348-2","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"565-567"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952831","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":"Revisiting the safety of romosozumab in Japan: the need for clear contraindications for patients with cardiovascular risk.","authors":"Hiroshi Kawaguchi","doi":"10.1007/s00198-024-07347-3","DOIUrl":"10.1007/s00198-024-07347-3","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"563-564"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952848","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: Among people on osteoporosis medication, loss of appendicular or total body lean mass is an independent risk factor for hip and major osteoporotic fractures.","authors":"Dongdong Cao, Jixin Chen, Weijie Yu","doi":"10.1007/s00198-024-07306-y","DOIUrl":"10.1007/s00198-024-07306-y","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"569-570"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847268","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":"Metaphyseal comminution in distal radius fractures: a predictor of secondary fragility fractures and the role of osteoporosis treatment.","authors":"Kota Kawamura, Shizumasa Murata, Yoji Kitano, Yoshimasa Mera, Hiroki Iwahashi, Toshiya Shitahodo, Shingo Inoue, Aozora Kadono, Hiroshi Yamada","doi":"10.1007/s00198-025-07404-5","DOIUrl":"10.1007/s00198-025-07404-5","url":null,"abstract":"<p><p>Metaphyseal comminution in distal radius fracture (DRF) cases might indicate severe osteoporosis. The patients with DRFs and metaphyseal comminution showed 5.2-fold increased secondary fractures compared with those receiving combination osteoporosis therapy. High-risk DRF patients require aggressive osteoporosis management and fracture risk stratification.</p><p><strong>Purpose: </strong>Distal radius fractures (DRFs) are common in patients with osteoporosis and associated with increased risks for subsequent fractures. Metaphyseal comminution in patients with DRFs may indicate severe osteoporosis and heightened bone fragility. However, its relationship with the risk of secondary fragility fractures remains unclear. This study aimed to evaluate the incidence of secondary fractures in patients with DRFs involving metaphyseal comminution and assess the effectiveness of osteoporosis treatment in reducing this risk.</p><p><strong>Methods: </strong>In this retrospective cohort study, 134 patients aged ≥ 50 years underwent DRF surgery at a single institution from July 2018 to December 2022. The patients were allocated into groups by the presence (n = 45) or absence (n = 89) of metaphyseal comminution. The primary outcome was secondary fracture incidence. A multivariate Cox model was used, adjusting for age, sex, body mass index, bone mineral density, osteoporosis treatment type, and dementia.</p><p><strong>Results: </strong>Secondary fractures were significantly more frequent in the comminution group (17.8%) than in the non-comminution group (3.4%) (p = 0.004). Metaphyseal comminution was associated with 5.2-fold increased secondary fracture risk (hazards ratio: 5.2, 95% confidence interval: 1.4-10.7, p = 0.004). The patients administered combination therapy (active vitamin D plus bisphosphonates or anabolic agents) had notably lower secondary fracture rate than did those receiving vitamin D alone (5.6% vs. 15.4%, p = 0.046).</p><p><strong>Conclusions: </strong>Metaphyseal comminution in patient with DRFs significantly elevated secondary fracture risk; combination osteoporosis therapy might mitigate this risk. These findings underscore the need for robust osteoporosis management in high-risk patients, suggesting metaphyseal comminution should be crucial for fracture risk stratification.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"447-454"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053092","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":"Cervicothoracic volumetric bone mineral density assessed by opportunistic QCT may be a reliable marker for osteoporosis in adults.","authors":"Constanze Ramschütz, Nico Sollmann, Malek El Husseini, Karina Kupfer, Karolin J Paprottka, Maximilian T Löffler, Moritz R Hernandez Petzsche, Julian Schwarting, Jannis Bodden, Thomas Baum, Su Hwan Kim, Maria Wostrack, Claus Zimmer, Jan S Kirschke, Sebastian Rühling","doi":"10.1007/s00198-024-07373-1","DOIUrl":"10.1007/s00198-024-07373-1","url":null,"abstract":"<p><p>This study aimed to validate the correlation between volumetric bone mineral density in the cervicothoracic and lumbar spine using measurements from opportunistic CT scans. The bone density assessment proved feasible, allowing us to propose optimal cut-off values for diagnosing osteoporosis and predicting vertebral fractures in the cervical and thoracic spine.</p><p><strong>Objectives: </strong>To investigate the performance of cervicothoracic volumetric bone mineral density (vBMD), obtained through opportunistic quantitative computed tomography (QCT), in discriminating patients with/without osteoporosis and with/without vertebral fractures (VFs), using lumbar vBMD as the reference.</p><p><strong>Methods: </strong>Three hundred twenty-five patients (65.3 ± 19.2 years, 140 women) with routine non-contrast or contrast-enhanced multi-detector CT (MDCT) scans were included. Trabecular vBMD was automatically extracted from each vertebra using a convolutional neural network (CNN)-based framework (SpineQ software v1.0) with asynchronous calibration and contrast phase correction. The correlations of vBMD between each vertebra spanning C2-T12 and the averaged lumbar spine (L1-L3, or L4 and L5) vBMD values were analyzed, considering fracture status and degeneration. Vertebra-specific linear regression equations were used to approximate lumbar vBMD at the cervicothoracic spine.</p><p><strong>Results: </strong>Cervicothoracic vBMD correlated well with lumbar vBMD (r = 0.79), with significant improvement after excluding degenerated vertebrae (p < 0.05; r = 0.89), except for C7-T3 and T9. Cervical (AUC = 0.94) and thoracic vBMD (AUC = 0.97) showed strong discriminatory ability for osteoporosis (vBMD < 80 mg/cm³). Excluding degenerated vertebrae at the cervical spine increased the AUC to 0.97. Cervical and thoracic vBMD (AUC = 0.74, AUC = 0.72) were comparable to lumbar vBMD (AUC = 0.72) in differentiating patients with and without prevalent VFs. Trabecular vBMD < 190 mg/cm³ for the cervical spine and < 100 mg/cm³ for the thoracic spine were potential indicators of osteoporosis, similar to < 80 mg/cm³ at the lumbar spine.</p><p><strong>Conclusion: </strong>Cervicothoracic vBMD may allow for determination of osteoporosis and prediction of VFs.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"423-433"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910019","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":"Is there an association between birth characteristics and fractures in young adults? The HUNT Study, Norway.","authors":"Hilde Thomasli Holltrø, T I L Nilsen, B Schei, I Tronstad, J Horn, K Holvik, A K N Daltveit, E M Dennison, N C Harvey, A Langhammer, M Hoff","doi":"10.1007/s00198-024-07361-5","DOIUrl":"10.1007/s00198-024-07361-5","url":null,"abstract":"<p><p>This population study investigated the association between birth characteristics and fracture risk in 11,099 young adults (aged 19-54 years). Our findings indicate that birth weight, gestational age, and birth weight for gestational age were not associated with fractures in the wrist, humerus, hip, and spine in this population.</p><p><strong>Purpose: </strong>Skeletal development starts during fetal life, and it is estimated that most bone formation occurs in the 3rd trimester. This study examined the association between birth characteristics and fractures of the wrist, humerus, hip, and spine, in young adults (19-54 years).</p><p><strong>Methods: </strong>11.099 participants in the 3^rd survey of the HUNT Study (2006-2008) were linked with the Medical Birth Registry of Norway and hospital records. Fractures of the wrist, humerus, hip, and spine were identified using ICD9/10 codes between 1988 and 2021. Follow-up was from date of participation in HUNT until a first fracture, emigration, death, or end of study. Cox regression was used to estimate hazard ratios (HR) of fracture associated with birth characteristics (95% CI), adjusted for birth year, sex, maternal age, and maternal morbidity. In a secondary analysis, follow-up started in 1988.</p><p><strong>Results: </strong>During a median follow-up of 14.0 years (153,657 person-years), 290 fractures occurred. Mean age at first fracture was 41.4 years (SD 7.4). Overall, there were no clear associations between birth characteristics and fractures in these data. HR for fracture was 0.43 (0.15-1.24) for those with a birth weight < 2.5 kg (reference birth weight 3.5 - 3.9 kg); 1.04 (0.74 - 1.46) for those born small for gestational age (< 10th percentile, reference 10 - 90^th percentile); and 0.63 (0.33 - 1.23) for those born preterm (reference term births). The secondary analysis from 1988, including 539 fractures, gave similar results as the main analysis.</p><p><strong>Conclusion: </strong>Birth weight, gestational age, or birth weight for gestational age was not associated with an increased risk of fractures of the wrist, humerus, hip, and spine in young adults.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"475-484"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952846","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}