Osteoporosis International最新文献

{"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":"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":"685-694"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","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}

{"title":"Rheumatoid arthritis and subsequent fracture risk: an individual person meta-analysis to update FRAX.","authors":"John A Kanis, Helena Johansson, Eugene V McCloskey, Enwu Liu, Marian Schini, Liesbeth Vandenput, Kristina E Åkesson, Fred A Anderson, Rafael Azagra, Cecilie L Bager, Charlotte Beaudart, Heike A Bischoff-Ferrari, Emmanuel Biver, Olivier Bruyère, Jane A Cauley, Jacqueline R Center, Roland Chapurlat, Claus Christiansen, Cyrus Cooper, Carolyn J Crandall, Steven R Cummings, José A P da Silva, Bess Dawson-Hughes, Adolfo Diez-Perez, Alyssa B Dufour, John A Eisman, Petra J M Elders, Serge Ferrari, Yuki Fujita, Saeko Fujiwara, Claus-Christian Glüer, Inbal Goldshtein, David Goltzman, Vilmundur Gudnason, Jill Hall, Didier Hans, Mari Hoff, Rosemary J Hollick, Martijn Huisman, Masayuki Iki, Sophia Ish-Shalom, Graeme Jones, Magnus K Karlsson, Sundeep Khosla, Douglas P Kiel, Woon-Puay Koh, Fjorda Koromani, Mark A Kotowicz, Heikki Kröger, Timothy Kwok, Olivier Lamy, Arnulf Langhammer, Bagher Larijani, Kurt Lippuner, Fiona E A McGuigan, Dan Mellström, Thomas Merlijn, Tuan V Nguyen, Anna Nordström, Peter Nordström, Terence W O Neill, Barbara Obermayer-Pietsch, Claes Ohlsson, Eric S Orwoll, Julie A Pasco, Fernando Rivadeneira, Anne-Marie Schott, Eric J Shiroma, Kristin Siggeirsdottir, Eleanor M Simonsick, Elisabeth Sornay-Rendu, Reijo Sund, Karin Swart, Pawel Szulc, Junko Tamaki, David J Torgerson, Natasja M van Schoor, Tjeerd P van Staa, Joan Vila, Nicole C Wright, Noriko Yoshimura, M Carola Zillikens, Marta Zwart, Nicholas C Harvey, Mattias Lorentzon, William D Leslie","doi":"10.1007/s00198-025-07397-1","DOIUrl":"10.1007/s00198-025-07397-1","url":null,"abstract":"<p><p>The relationship between rheumatoid arthritis (RA) and fracture risk was estimated in an international meta-analysis of individual-level data from 29 prospective cohorts. RA was associated with an increased fracture risk in men and women, and these data will be used to update FRAX®.</p><p><strong>Introduction: </strong>RA is a well-documented risk factor for subsequent fracture that is incorporated into the FRAX algorithm. The aim of this study was to evaluate, in an international meta-analysis, the association between rheumatoid arthritis and subsequent fracture risk and its relation to sex, age, duration of follow-up, and bone mineral density (BMD) with a view to updating FRAX.</p><p><strong>Methods: </strong>The resource comprised 1,909,896 men and women, aged 20-116 years, from 29 prospective cohorts in which the prevalence of RA was 3% or less (primary analysis) and an additional 17 cohorts with a prevalence greater than 3% (supplementary analysis). The association between RA and fracture risk (any clinical fracture, osteoporotic fracture, major osteoporotic fracture (MOF), and hip fracture) was examined using an extension of the Poisson regression model in each cohort and each sex, followed by random-effects meta-analyses of the weighted beta coefficients.</p><p><strong>Results: </strong>In the primary analysis, RA was reported in 1.3% of individuals. During 15,683,133 person-years of follow-up, 139,002 fractures occurred, of which 27,518 were hip fractures. RA was associated with an increased risk of any clinical fracture (hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.35-1.65). The HRs were of similar magnitude for osteoporotic fracture and MOF but higher for hip fracture (HR = 2.23; 95% CI 1.85-2.69). For hip fracture, there was a significant interaction with age with higher HRs at younger ages. HRs did not differ between men and women and were independent of exposure to glucocorticoids and femoral neck BMD. Lower HRs were observed in the supplementary analysis cohorts, particularly in those with a high apparent prevalence of RA, possibly from conflation of RA with osteoarthritis.</p><p><strong>Conclusions: </strong>A diagnosis of RA confers an increased risk of fracture that is largely independent of BMD, sex, and corticosteroids. RA should be retained as a risk factor in future iterations of FRAX with updated risk functions to improve fracture risk prediction.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"653-671"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425641","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: 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":"10.1007/s00198-025-07396-2","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"749-750"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","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":"Effects of combined protein and exercise interventions on bone health in middle-aged and older adults - A systematic literature review and meta-analysis of randomized controlled trials.","authors":"Julia V E Wolf, Daniel Schoene, Matthias Kohl, Wolfgang Kemmler, Eva Kiesswetter","doi":"10.1007/s00198-025-07393-5","DOIUrl":"10.1007/s00198-025-07393-5","url":null,"abstract":"<p><strong>Purpose: </strong>Osteoporosis has become a global public health concern making prevention and treatment essential to reduce severe consequences for individuals and health systems. This systematic review with meta-analysis aimed to determine the effects of combined protein and exercise interventions compared to (a) exercise alone and (b) protein alone on bone mineral content (BMC) or density (BMD) in middle-aged and older adults.</p><p><strong>Methods: </strong>We systematically searched Medline, CINAHL, CENTRAL, Web of Science, and SPORTDiscus until 24th January 2023. Pairwise random-effects meta-analyses were performed to calculate weighted mean differences (WMD) with 95% confidence intervals (95% CI). We evaluated risk of bias (Cochrane RoB2) and certainty of evidence (CoE; GRADE). If pooling was not possible, the results were summarized descriptively.</p><p><strong>Results: </strong>For the comparison of combined protein supplementation and exercise vs. exercise alone, no meta-analysis for BMD (2 RCTs) was possible. For BMC, little to no intervention effect was found (WMD 0.03 kg; 95% CI - 0.00 to 0.05; 4 RCTs; IG = 97/CG = 98; I² = 58.4%). In a sensitivity analysis, restricted to combined milk-protein supplementation and exercise, the result remained similar (0.01 kg; 95% CI - 0.01 to 0.03; 4 RCTs; IG = 71/CG = 71; I² = 0.0%; low CoE). For the comparison of combined protein and exercise interventions vs. protein alone, no RCT on BMC was identified; the results on total or regional BMD (2 RCTs) were inconclusive.</p><p><strong>Conclusion: </strong>Based on our findings, no robust conclusions can be drawn on whether combining protein and exercise interventions is more beneficial for bone health than one component alone. Sufficiently powered studies with longer duration are required to clarify these questions (CRD42022334026).</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"609-625"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365347","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":"Skeletal health status among patients with chronic hypoparathyroidism: results from the Canadian National Hypoparathyroidism Registry (CNHR).","authors":"Aliya A Khan, Hajar AbuAlrob, Dalal S Ali, Zayd Al Kassem, Abdulrahman Almoulia, Habiba Afifi, Manoela Braga, Alice Cheng, Jouma Malhem, Adam Millar, Emmett Morgante, Parwana Muhammad, Terri L Paul, Ally Prebtani, Zubin Punthakee, Tayyab Khan, Sarah Khan, Muhammad Shrayyef, Stan Van Uum, James Edward Massey Young, Maria Luisa Brandi, Michel Ovize, Blandine Weiss","doi":"10.1007/s00198-025-07410-7","DOIUrl":"10.1007/s00198-025-07410-7","url":null,"abstract":"<p><p>In the CNHR study, 35% of postmenopausal women had osteoporosis by BMD or fragility fracture, and 4% had both. Three men ≥ 50 had osteoporosis by BMD or fragility fracture (33.3%; n = 3/9). This suggests that close follow-up of skeletal health is necessary in postmenopausal women, and men ≥ 50 with chronic HypoPT.</p><p><strong>Purpose: </strong>Chronic hypoparathyroidism (HypoPT) has been associated with decreased bone turnover and abnormalities in bone mineral density (BMD), microarchitecture, and strength. Current guidelines do not recommend systematic evaluation of skeletal health in patients with chronic HypoPT. Our study assessed skeletal health in pre- and postmenopausal women with chronic HypoPT and adult men.</p><p><strong>Methods: </strong>This prospective study enrolled adults with chronic HypoPT from the Canadian National Hypoparathyroidism Registry. Clinical characteristics, bone fractures, biochemistry, and serum bone biomarkers were assessed at baseline. Skeletal health evaluation included assessments of fragility fractures, BMD at lumbar spine (LS), femoral neck (FN), total hip (TH), 1/3 radial sites, trabecular bone score (TBS), and bone biomarkers.</p><p><strong>Results: </strong>We present the baseline data of the patients enrolled in the registry. We analyzed a total of 101 patients: 18 men, 35 premenopausal, and 48 postmenopausal women. The mean (SD) age at the onset of HypoPT was 40.7 (16.8) years, and the average disease duration was 11.2 (8.6) years. The most common etiology was postsurgical (74.3% vs. 25.7% non-surgical). Most patients received calcium supplements (89%) and active vitamin D (80%) at baseline. No fragility fractures or low BMD were reported in premenopausal women. However, BMD at LS, FN, TH, and TBS were significantly lower in postmenopausal compared to premenopausal women.</p><p><strong>Conclusions: </strong>Overall, 35% of postmenopausal women had osteoporosis by BMD or prior fragility fracture, and 4% had both. Three men ≥ 50 years had osteoporosis by BMD or fragility fracture (33.3%; n = 3/9). This study suggests that close follow-up of skeletal health is necessary in postmenopausal women with chronic HypoPT and men ≥ 50 years.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"673-684"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425746","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":"Update on the role of bone turnover markers in the diagnosis and management of osteoporosis: a consensus paper from The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), International Osteoporosis Foundation (IOF), and International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).","authors":"Harjit Pal Bhattoa, Samuel Vasikaran, Ioulia Trifonidi, Georgia Kapoula, Giovanni Lombardi, Niklas Rye Jørgensen, Richard Pikner, Masakazu Miura, Roland Chapurlat, Mickael Hiligsmann, Mathias Haarhaus, Pieter Evenepoel, Hanne Skou Jørgensen, Markus Herrmann, Jean-Marc Kaufman, Patricia Clark, Şansın Tuzun, Nasser Al-Daghri, Stuart Silverman, Majed S Alokail, Sif Ormarsdóttir, María Concepción Prieto Yerro, Radmila Matijevic, Andrea Laslop, Mario Miguel Coelho da Silva Rosa, Leith Zakraoui, Nansa Burlet, Eugene McCloskey, Nicholas C Harvey, Régis P Radermecker, Maria Fusaro, Carla Torre, John A Kanis, René Rizzoli, Jean-Yves Reginster, Konstantinos Makris, Etienne Cavalier","doi":"10.1007/s00198-025-07422-3","DOIUrl":"10.1007/s00198-025-07422-3","url":null,"abstract":"<p><strong>Purpose: </strong>The International Osteoporosis Foundation (IOF) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) have proposed procollagen type I N propeptide (PINP) and β isomerized C-terminal telopeptide of type I collagen (β-CTX-I) as reference bone turnover markers (BTMs) for osteoporosis. This report examines the published literature since the 2011 IOF-IFCC position paper in order to determine the clinical potential of the reference BTMs and newer markers for the prediction of fracture risk and monitoring the treatment of osteoporosis.</p><p><strong>Methods: </strong>Evidence for the relationship between BTMs and subsequent fractures was gathered from prospective studies through literature review of the Medline database from years 2011 to May 2024. The impact of treatment on BTMs was also studied by examining publications in that period. Studies of the accuracy of BTMs in the assessment of bone turnover in the setting of advanced chronic kidney disease were also examined.</p><p><strong>Results: </strong>Increased BTM concentrations are associated with higher fracture risk in postmenopausal women. PINP and β-CTX-I measured in blood are associated with fracture risk but their interaction with other risk factors has not been sufficiently studied limiting their incorporation into fracture risk algorithms. Treatment-induced changes in PINP and β-CTX-I account for a substantial proportion of fracture risk reduction and are useful for improving adherence; they are recommended for inclusion in studies to examine adherence in individual patients. However, total PINP (tPINP) and β-CTX-I may be elevated in CKD due to renal retention. Bone alkaline phosphatase (BALP), intact PINP (iPINP), and tartrate resistant acid phosphatase 5b (TRACP5b) show the most promise in discriminating high and low turnover bone diseases in patients with advanced CKD and for predicting fracture risk, monitoring treatment response, and assessing the risk of treatment-related complications.</p><p><strong>Conclusion: </strong>We re-affirm the use of serum/plasma tPINP and plasma β-CTX-I as reference BTMs with appropriate patient preparation and sample handling and measurement by standardized/harmonized assays in clinical studies to accumulate further data, and for monitoring treatment of osteoporosis in the setting of normal renal function in clinical practice. BALP and TRACP5b, measured by standardized assays, are recommended as reference BTMs for CKD-associated osteoporosis and should be included in observational and intervention studies to ascertain their utility for risk-evaluation, treatment initiation, and assessment of treatment response in CKD-associated osteoporosis.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"579-608"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736110","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":"Early administration of zoledronic acid after hip fracture.","authors":"Kevin McCarroll, James Mahon, Rosaleen Lannon, Aisling Carroll, Donal Fitzpatrick","doi":"10.1007/s00198-025-07450-z","DOIUrl":"10.1007/s00198-025-07450-z","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"765-766"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557492","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-24-01894 comment on \"Osteoporosis in older patients with idiopathic normal pressure hydrocephalus\".","authors":"Mehmet Selman Ontan, Ahmet Turan Isik","doi":"10.1007/s00198-025-07387-3","DOIUrl":"10.1007/s00198-025-07387-3","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"759-760"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399686","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 \"Association of serum alkaline phosphatase levels with bone mineral density, osteoporosis prevalence, and mortality in US adults with osteoporosis: evidence from NHANES 2005-2018\".","authors":"Jiashen Shao, Huixin Zhang, Qi Fei","doi":"10.1007/s00198-025-07417-0","DOIUrl":"10.1007/s00198-025-07417-0","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"751-752"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365346","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":"Osteoclast in CRPS: an alleged guilty fully acquitted.","authors":"Massimo Varenna, Francesca Zucchi, Raffaele Di Taranto, Francesco Orsini, Chiara Crotti","doi":"10.1007/s00198-025-07415-2","DOIUrl":"10.1007/s00198-025-07415-2","url":null,"abstract":"<p><p>Contrary to popular belief, a recent study did not show increased osteoclastic activity in acute complex regional pain syndrome. Conversely, osteoblastic activity seems to be enhanced. The real meaning of diagnostic tools needs to be reassessed. Therefore, bisphosphonates act through mechanisms of action different from their anti-osteoclastic effect.</p><p><strong>Introduction: </strong>Bone tissue involvement is a widely acknowledged event in the course of complex regional pain syndrome (CRPS), and it is invariably depicted as \"high turnover osteoporosis.\" This statement needs to be revised in light of a recent biochemical study on bone turnover markers and regulators in patients with early CRPS.</p><p><strong>Methods: </strong>The real meaning of the findings arising from biochemical, radiological, and histopathological studies and the possible mechanism of action of parenteral bisphosphonates have been reviewed according to the bone metabolism derangement specific to this disease.</p><p><strong>Results: </strong>Consistent with the results of the recent biochemical study, no reliable data emerge from diagnostic studies sustaining an increased osteoclastic activity. Conversely, osteoblastic activity seems to be enhanced for an increased Wnt signaling due to lower levels of Sclerostin and Dickkopf-1. These results may provide a different and alternative interpretation of previous diagnostic and therapeutic studies.</p><p><strong>Conclusions: </strong>For the emerging role of bone in CRPS pathogenesis, these remarks could be useful for improving knowledge of the pathophysiology of the disease.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"737-740"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365314","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}