Osteoporosis International最新文献

{"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":"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":"Clinical experience with denosumab discontinuation.","authors":"Natasha Laursen, Anne Sophie Sølling, Torben Harsløf, Bente Langdahl","doi":"10.1007/s00198-024-07351-7","DOIUrl":"10.1007/s00198-024-07351-7","url":null,"abstract":"<p><p>In patients receiving long-term treatment with denosumab, denosumab discontinuation via sequential treatment with zoledronate, resulted in a minor decrease in bone mass density (BMD) of 0-2.5% within the first year and stabile BMD in the second year, thus showing that repeated treatments with zoledronate limit the loss of BMD, when discontinuing denosumab.</p><p><strong>Purpose: </strong>Discontinuing denosumab (DMAb) rapidly decreases bone mineral density (BMD) and increases the risk of multiple vertebral fractures. We wanted to examine if the recommendation stated in the ECTS position paper on DMAb discontinuation can prevent the bone loss in a clinical setting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study based on medical records of patients referred for DMAb discontinuation. We administered zoledronate (ZOL) 6 months after the last DMAb injection and 3, 6, 12, and 24 months thereafter if p-C-terminal collagen crosslinks (CTX) increased above 0.5 μg/l or BMD decreased (≥ 5% at the hip, ≥ 3% at the spine) at months 12 and 24.</p><p><strong>Results: </strong>We included 66 women and men discontinuing DMAb after a mean treatment duration of 6.7 ± 2.7 (mean ± SD) years. BMD decreased 12 months after the initial ZOL treatment by 2.5 ± 4.2% and 1.9 ± 2.5% at the LS and TH, respectively (n = 44) (p ≤ 0.001 for all). There was no significant change in FNBMD (0.0 ± 5.1) (p > 0.05). No significant change in BMD was seen from month 12 to month 24 at any site (p > 0.05 for all). Thirty percent and twenty-two percent of patients experienced flu-like symptoms after the first and second ZOL infusion. No fractures occurred during the study period.</p><p><strong>Conclusion: </strong>Adhering to the recommendation in the ECTS position statement, a mean of 3 infusions of ZOL limited the bone loss 12 and 24 months after DMAb discontinuation, thereby preserving most of the BMD gained during DMAb treatment. The frequent occurrence of flu-like symptoms after ZOL proves to be a challenge, showing that routine prophylaxis against acute phase responses should be considered in patients treated with ZOL after discontinuing DMAb.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"435-446"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952835","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":"Hypoparathyroidism: Similarities and differences between Western and Eastern countries.","authors":"Yu-Ying Yang, Yan-Hua Deng, Li-Hao Sun, Lars Rejnmark, Ling Wang, Peter Pietschmann, Claus-Christian Glüer, Aliya A Khan, Salvatore Minisola, Jian-Min Liu","doi":"10.1007/s00198-024-07352-6","DOIUrl":"10.1007/s00198-024-07352-6","url":null,"abstract":"<p><strong>Backgroud: </strong>Hypoparathyroidism (hypoPT) is characterized by acute and chronic complications due to insufficient parathyroid hormone (PTH) production or action. Several management guidelines have been developed, but mostly based on evidence from Western countries. Data from Eastern countries have not been systematically compared with those from Western countries.</p><p><strong>Methods: </strong>Literatures regarding to the epidemiology, genetics, risk factors, clinical manifestations and therapies for hypoPT in Easten and Western countries, including China, South Korea, Japan, India, and USA, Canada, Italy, and etc., were searched through PubMed and CNKI. This review was officially endorsed by European Calcified Tissue Society (ECTS) board.</p><p><strong>Results: </strong>Postoperative hypoPT is the major form of hypoPT in both Western and Eastern countries. The genetic profiles and clinical features of hypoPT are similar in Eastern and Western countries. The most commonly used medications in Eastern countries are calcium and native vitamin D or active vitamin D analogues, similar to their Western counterparts. While PTH replacement therapy is not available and approved to use in most Eastern countries.</p><p><strong>Conclusion: </strong>Physicians and surgeons should follow the guidelines on the management of thyroid nodules, taking more care of protecting parathyroid glands during surgery. The cross-talk between East and West in the management of hypoPT should be continued. Direct comparisons of the management strategies in patients with hypoPT between Eastern and Wester countries regarding to the morbidity, mortality, quality of life, optimal dosage, efficacies and side-effects of conventional therapies or newer medications, as well as pharmacogenetics and pharmacoeconomics, would be valuable.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"391-402"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952842","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}

{"title":"The association between blood cadmium levels and bone mineral density in U.S. adolescents aged 12-19 years.","authors":"Fen Chen, Jiao Luo, Lin Li","doi":"10.1007/s00198-024-07349-1","DOIUrl":"10.1007/s00198-024-07349-1","url":null,"abstract":"<p><p>According to the multivariable adjusted models, there was an inverse association between B-Cd levels and BMD, which was particularly evident in the subgroup analyses of other Hispanic and female individuals in the adolescent population. Clinicians and policy-makers should thoroughly consider the genetic implications of B-Cd levels in relation to BMD during the prevention and treatment of osteoporosis.</p><p><strong>Objective: </strong>To investigate the associations between blood cadmium (B-Cd) levels and bone mineral density (BMD) in adolescents.</p><p><strong>Methods: </strong>On the basis of the National Health and Nutrition Examination Survey (NHANES) database spanning from 2011 to 2018, we used weighted multiple regression, a generalized weighted model and smoothed curve methods to investigate the associations between B-Cd levels and BMD in adolescents. Subgroup analyses were also conducted to examine potential differences across age, sex, race, tobacco exposure status and other relevant variables.</p><p><strong>Results: </strong>Among the 2427 participants, 52% were males, and 48% were females. In this study, multistage sampling data from the NHANES database were analysed, and the positive association between B-Cd levels and BMD shifted to a negative association after adjustment for age, sex and race. Subgroup analyses revealed a more pronounced association among females (β =  - 0.07, 95% CI: - 0.09, - 0.04, P < 0.001), other Hispanic individuals (β =  - 0.08, 95% CI: - 0.14, - 0.02, P = 0.012) and individuals exposed to tobacco (β =  - 0.04, 95% CI: - 0.06, - 0.01, P = 0.016).</p><p><strong>Conclusion: </strong>The findings revealed a negative association between B-Cd levels and BMD in multivariable adjusted models.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"485-500"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952850","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":"Long-term adherence to anti-osteoporosis medication and determinants of adherence in the population-based screening trial ROSE.","authors":"Tanja Gram Petersen, Katrine Hass Rubin, Muhammad Kassim Javaid, Anne Pernille Hermann, Kristina E Åkesson, Bo Abrahamsen","doi":"10.1007/s00198-025-07436-x","DOIUrl":"https://doi.org/10.1007/s00198-025-07436-x","url":null,"abstract":"<p><p>Screening initiatives for osteoporosis must facilitate treatment of those at elevated fracture risk. In a randomized controlled trial of 24,229 women, those in the screening group with FRAX ≥ 15% were invited for DXA with AOM treatment offered as per national guidelines. Treatment initiation in the following year was 9.5 times higher compared with controls.</p><p><strong>Purpose: </strong>To determine if screened individuals have lower adherence to anti-osteoporotic medication (AOM) than unscreened and to examine determinants for low treatment adherence.</p><p><strong>Method: </strong>In 2010/2011, women aged 65-80 (N = 34,229) in the Region of Southern Denmark were invited to the risk-stratified osteoporosis strategy evaluation (ROSE) randomized study. Women in the screening group with moderate to high 10-year fracture risk (FRAX® ≥ 15%) were invited for dual-energy x-ray absorptiometry with AOM treatment as per national guidelines. Screened, controls, and an age-matched general population sample were compared for adherence to AOM using 10-year follow-up data on prescription and hospital records.</p><p><strong>Results: </strong>Among ROSE participants with FRAX ≥ 15%, 5864 screened and 5790 controls were eligible for analysis, along with an equal number from the general population. AOM initiation in the first year was 9.5 times higher in screened compared to controls (HR 9.50, 7.16; 12.61). There was no difference in implementation assessed as medication possession ratio. The 5-year persistence rates were similar in screened and controls (51-52%), but lower in the general population (44%). FRAX risk factors partly influenced AOM initiation in the screened, with different patterns in other groups. Immobilization, comorbidities, and co-medications were key determinants of discontinuation in both the short and long term.</p><p><strong>Conclusion: </strong>The ROSE screening programme significantly increased treatment initiation in postmenopausal women. Screened women showed similar treatment adherence levels to non-screened once they started medication. However, frail women were more prone to treatment discontinuation, highlighting the need for targeted support in this subgroup.</p><p><strong>Trial registration: </strong>The original ROSE trial is registered at ClinicalTrials.gov (NCT01388244). The study protocol has been published in Rubin et al. The risk-stratified osteoporosis strategy evaluation study (ROSE): a randomized prospective population-based study. Design and baseline characteristics. Calcif Tissue Int. 2015;96(2):167-79.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483737","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":"TBS as a complementary tool for assessing vertebral fractures and spinal deformity in children and adolescents with osteogenesis imperfecta.","authors":"Jiayi Liu, Yi Zhang, Wei Yu, Lei Sun, Jing Hu, Yan Jiang, Ou Wang, Xiaoping Xing, Weibo Xia, Mei Li","doi":"10.1007/s00198-025-07423-2","DOIUrl":"https://doi.org/10.1007/s00198-025-07423-2","url":null,"abstract":"<p><p>This study evaluated trabecular bone score (TBS) for assessing vertebral fractures and spinal deformity in children and adolescents with osteogenesis imperfecta (OI). TBS showed superior performance in identifying vertebral fractures compared to areal bone mineral density (aBMD), especially in patients without densitometric osteoporosis, suggesting its potential for monitoring vertebral fractures and spinal deformity risk.</p><p><strong>Background: </strong>TBS, derived from a textural greyscale analysis of lumbar spine dual-energy X-ray absorptiometry (DXA) images, offers a non-invasive and indirect evaluation of bone microarchitecture. This method potentially enhances the assessment of skeletal phenotypes beyond the scope of aBMD. We aim to explore the utility of TBS in assessing vertebral fractures and spinal deformity in children and adolescents with OI.</p><p><strong>Methods: </strong>In this cross-sectional study, 153 children and adolescents with OI were enrolled. DXA was used to measure TBS and aBMD, and their Z-scores were calculated based on reference values for BMD and TBS in normal children and adolescents with the same age and sex. Lateral thoracolumbar films were used to evaluate vertebral fractures and calculate the spine deformity index (SDI). The accuracy of TBS and aBMD for identifying vertebral compression fractures (VCFs) was assessed using area under the curve (AUC).</p><p><strong>Results: </strong>TBS Z-score was negatively correlated with the age of children with OI (r =  - 0.435, P < 0.001) and was positively correlated to aBMD Z-score at the lumbar spine and femoral neck (both P < 0.01), even after adjusting for confounding factors. TBS Z-score was as effective as lumbar spine aBMD Z-score in discriminating VCFs (AUC, 0.667 vs 0.666, P > 0.05). Notably, in patients without densitometric osteoporosis, TBS Z-score demonstrated superior discriminative power for VCFs compared to lumbar spine aBMD Z-score (AUC, 0.719 vs 0.545, P < 0.05). In this population, only the TBS Z-score (r =  - 0.358, P < 0.05), rather than the lumbar spine aBMD Z-score, was negatively correlated with the SDI.</p><p><strong>Conclusion: </strong>TBS has a close correlation with bone mineral density in children and adolescents with OI. In patients without densitometric osteoporosis, the Z-score of TBS is more effective than that of bone mineral density in assessing VCFs and spinal deformity, highlighting the potential of TBS in evaluating the risk of VCFs and monitoring the progression of spinal deformity.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493165","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 effect of hypersensitive C-reactive protein to albumin ratio on the risk of fragility fracture in the Chinese male population.","authors":"Lu Guo, Nan Zhang, Xinhao Fan, Xiaoli Hou, Man Li, Wenqi Xu, Peipei Liu, Lei Xing, Jingyao Wang, Shuohua Chen, Shouling Wu, Faming Tian","doi":"10.1007/s00198-025-07428-x","DOIUrl":"https://doi.org/10.1007/s00198-025-07428-x","url":null,"abstract":"<p><p>This study explored the association between the hypersensitive C-reactive protein to albumin ratio (CAR) and fragility fractures in Chinese males. Results show that elevated levels of CAR were associated with an increased risk of fragility fractures and that this association was robust to adjustment for multiple potential confounders.</p><p><strong>Purpose: </strong>This study investigates the relationship between the hypersensitive C-reactive protein to albumin ratio (CAR) and fragility fractures in a Chinese male population.</p><p><strong>Methods: </strong>A total of 48,186 male participants (age range 18-98 years old, average age 53.92 years) at baseline were recruited from the Kailuan Study and followed up for outcomes until 2022. The Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident fragility fractures. The dose response between CAR and fracture risk was analyzed using restricted cubic splines. Additionally, the concordance index (C-index), net reclassification index (NRI), and integrated discrimination improvement (IDI) were utilized to assess the incremental predictive value of various indicators for the discrimination of fragility fractures.</p><p><strong>Results: </strong>During an average follow-up of 11.17 years, 728 incident fragility fractures occurred among the 48,186 participants. Compared to participants in the second quartile of CAR, those in the highest quartile had a 49% increased risk of fragility fractures (HR = 1.49, 95% CI = 1.21-1.84) after adjusting for risk factors. Restricted cubic spline analysis showed a nonlinear relationship between CAR and the risk of fragility fractures. The C-index, continuous NRI, and IDI for predicting the risk of fragility fractures were 61.142%, 0.089 (p < 0.05), and 0.00009 (p < 0.05), respectively, which were higher than those of hs-CRP (C-index 0.6137, NRI 0.086, IDI 0.000074) and albumin (C- index 0.6116, NRI 0.068, IDI - 0.000004).</p><p><strong>Conclusion: </strong>Elevated levels of CAR were associated with an increased risk of fragility fractures and that this association was robust to adjustment for multiple potential confounders.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468291","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}