Osteoporosis International最新文献

{"title":"Time trend analysis of osteoporosis prevalence among adults 50 years of age and older in the USA, 2005-2018.","authors":"Chris M Naso, Shuo-Yu Lin, Ge Song, Hong Xue","doi":"10.1007/s00198-025-07395-3","DOIUrl":"10.1007/s00198-025-07395-3","url":null,"abstract":"<p><p>Using data from NHANES for years 2005-2018, we examined temporal trends in osteoporosis prevalence and the proportion of undiagnosed osteoporosis in the United States of America. Our results suggested statistically significant increases in osteoporosis prevalence across several demographic groups. These findings carry profound implications for public health, given increased life expectancy and burden of chronic diseases.</p><p><strong>Introduction: </strong>This is the first study to assess osteoporosis prevalence trends over time and the proportion of undiagnosed osteoporosis across gender, ethnicity/race, and age groups.</p><p><strong>Methods: </strong>Observational time trend analyses were conducted using the 2005-2006, 2007-2008, 2009-2010, 2013-2014, and 2017-2018 National Health and Nutrition Examination Survey (NHANES) datasets, along with a descriptive analysis using the 2017-2018 NHANES dataset to capture the proportion of undiagnosed osteoporosis.</p><p><strong>Results: </strong>The findings showed a statistically significant increase in osteoporosis prevalence among women, non-Hispanic Whites, and all age groups (except for individuals 80 years of age and older) during the study period. A subsequent analysis examining individuals by both gender and ethnicity/race demonstrated a statistically significant increase among Other Hispanic men and non-Hispanic White women. Additional descriptive analyses found that 69.12% of individuals with osteoporosis went undiagnosed. Specifically, 86.88% of men and 84.77% of individuals 50-59 years of age with osteoporosis went undiagnosed, representing the two highest groups.</p><p><strong>Discussion and conclusion: </strong>The substantial and increasing prevalence among certain groups and sub-groups, along with the lack of diagnostic capture of osteoporosis, highlights existing gaps in public health efforts and care delivery infrastructure. This paper highlights high-risk groups and sub-groups that may benefit most from accelerated initiatives to reduce the burden of illness associated with osteoporosis.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"547-554"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053094","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":"Impact of switching from bisphosphonates to denosumab, teriparatide, or romosozumab in patients with postmenopausal osteoporosis: a case-control study.","authors":"Toshitaka Yukishima, Kosuke Ebina, Yuki Etani, Takaaki Noguchi, Shin-Ichiro Ohmura, Ken Nakata, Seiji Okada, Tomonori Kobayakawa","doi":"10.1007/s00198-025-07386-4","DOIUrl":"10.1007/s00198-025-07386-4","url":null,"abstract":"<p><p>This case-control study investigated the impact of switching from bisphosphonates to denosumab, teriparatide, or romosozumab in postmenopausal osteoporosis. Romosozumab demonstrated the most significant improvements in bone mineral density, particularly in the lumbar spine and total hip, by reducing bone resorption and increasing bone formation markers.</p><p><strong>Purpose: </strong>To investigate the impact of switching from bisphosphonates (BP) to denosumab (DMAb), teriparatide (TPTD), or romosozumab (ROMO) in postmenopausal osteoporosis.</p><p><strong>Methods: </strong>This retrospective, case-controlled, multicenter study included 389 patients who switched from BP to DMAb, TPTD, or ROMO due to treatment inefficacy. Propensity score matching was used to align patient backgrounds, resulting in 45 patients per group. Baseline characteristics included a mean age of 73.8 years, prior BP treatment duration of 37.1 months, and bone mineral density (BMD) T-scores of -2.8 in the lumbar spine (LS), -2.5 in the total hip (TH), and -2.7 in femoral neck (FN). BMD and bone turnover markers were assessed over 12 months.</p><p><strong>Results: </strong>Following the switch from BP, the ROMO group demonstrated a dual effect of decreased bone resorption and increased bone formation markers. The TPTD group exhibited the highest increases in both markers, while the DMAb group suppressed both. After 12 months, the ROMO group demonstrated significantly greater BMD increases in the LS (11.4%) compared to the DMAb (6.3%; p < 0.001) and TPTD (5.9%; p < 0.001) groups. Additionally, the ROMO group showed greater increases in the TH (3.3%) than TPTD group (0.8%; p < 0.01). Only the ROMO group showed a significant BMD increase in the FN (2.0%; p < 0.01 from baseline).</p><p><strong>Conclusion: </strong>Significant BMD increases were observed in the LS for all groups, in the TH for the ROMO and DMAb groups, and in the FN for the ROMO group. ROMO showed the most substantial BMD improvements following BP therapy.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"531-538"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009275","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":"Enhancing emergency management for osteoporotic patients: a commentary on physical activity and mortality insights.","authors":"Zhongxing Liu, Mengzhe Tian, Lincheng Duan","doi":"10.1007/s00198-024-07371-3","DOIUrl":"10.1007/s00198-024-07371-3","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"561-562"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984512","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":"Trends in screening and treatment of osteoporosis after periprosthetic fractures from 2010 to 2020.","authors":"Jackson W Durbin, Amy Y Zhao, Eric Cui, Amil R Agarwal, Andrew Smith, Alex Gu, Gregory J Golladay, Savyasachi C Thakkar","doi":"10.1007/s00198-025-07385-5","DOIUrl":"10.1007/s00198-025-07385-5","url":null,"abstract":"<p><p>Osteoporosis is often underrecognized and undertreated following periprosthetic fractures (PPF). Our study found that between 2010 and 2020, there has been no significant change in the rates of osteoporosis screening or treatment within 1 year following PPF. Orthopedic surgeons can play an integral role in helping to curtail the osteoporosis epidemic.</p><p><strong>Purpose: </strong>Periprosthetic fractures (PPF) typically occur from low-energy mechanisms and are pathognomonic for osteoporosis. However, osteoporosis is often underrecognized and undertreated. The aim of this study was to examine trends in dual energy X-ray absorptiometry (DXA) scans and treatment of osteoporosis after PPF between 2010 and 2020.</p><p><strong>Methods: </strong>Patients older than 40 who experienced a lower extremity PPF between 2010 and 2020 and had no prior history of osteoporosis screening or treatment were identified utilizing a large national administrative database. Rates of bone mineral density (BMD) measurement using DXA and anti-osteoporotic treatment with pharmacotherapy, or either intervention within 1 year following experiencing a PPF were determined. The rate of change for these interventions was calculated using the compounded annual growth rate (CAGR), with linear regression used to determine whether trends were statistically significant.</p><p><strong>Results: </strong>In total, 5.7% and 3.6% of patients were screened and treated for osteoporosis, respectively. Between 2010 and 2020, there was no significant change in rates of osteoporosis screening (CAGR + 0.1%; p = 0.13), treatment (CAGR - 2.4%; p = 0.29), or either intervention (CAGR - 1.1%; p = 0.77) within 1 year following PPF. Factors associated with intervention included older age, female sex, and increased comorbidities.</p><p><strong>Conclusion: </strong>Our study found that there has been no significant change in the rates of osteoporosis screening or treatment within 1 year following PPF. Orthopedic surgeons and allied healthcare workers can play an integral role in helping to curtail the osteoporosis epidemic.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"513-519"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984518","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":"Osteoporotic fracture risks of thiazides and dihydropyridines in angiotensin modulator users.","authors":"Yang-Chi Lin, Ping-Hao Chiang, Jing-Yang Huang, Wen-Shiann Wu","doi":"10.1007/s00198-024-07356-2","DOIUrl":"10.1007/s00198-024-07356-2","url":null,"abstract":"<p><p>This study examined the impact of thiazide and RAAS antihypertensive medications vs DHP-RAAS medications on fracture risk. The close alignment of such settings with clinical use, combined with the potential bone benefits of ACEis and ARBs, provides enhanced accuracy in bone health evidence.</p><p><strong>Purpose: </strong>To determine whether thiazides, combined with either angiotensin-converting enzyme inhibitor (ACEi) or angiotensin II receptor blocker (ARB), offer bone-protective benefits compared with dihydropyridine (DHP) drugs combined with ACEi or ARB.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted on the US Collaborative Network from the TriNetX database on March 5th, 2024. It included hypertensive ACEi or ARB users under thiazide or DHP drug treatments spanning from January 1st, 2015, to December 31st, 2022, with exclusion criteria applied. The primary outcome is a composite typical osteoporotic fracture (TOPF). Kaplan Meier analyses were performed after 1:1 propensity-score matching (PSM) with a 5-year follow-up. Besides investigating fracture-related outcomes in thiazide-ACEi/ARB and DHP-ACEi/ARB users, this study explores whether the effects differ between ACEi and ARB users. Subgroup analyses were also performed, and the heterogeneity among the results was assessed using Cochran's Q-tests.</p><p><strong>Results: </strong>Post-PSM results yield 54,240 patients per cohort in the primary analysis, aging 61.5 ± 12.2 versus 61.4 ± 13.7 (thiazide-ACEi/ARB versus DHP-ACEi/ARB) with predominantly white ethnicity. Thiazide-ACEi/ARB users exhibit lower TOPF risk than DHP-ACEi/ARB users (hazard ratio (HR) = 0.65, 95% confidence interval (CI) 0.61-0.70), and such benefits from thiazides are similar between ACEi and ARB users (ACEi: HR = 0.69; ARB: HR = 0.67, Cochran's Q-test p-value = 0.78). Additionally, the effects of thiazides reveal significant heterogeneity between patients with and without inflammatory polyarthropathy (ICD-10, M05-M14) and benzodiazepine usage (Cochran's Q-test p-value = 0.01, 0.04).</p><p><strong>Conclusion: </strong>Thiazides are associated with lower risks of typical osteoporotic fractures compared to DHP drugs in patients treated with ACEi or ARB, while such benefits may diminish in those with a diagnosis of inflammatory polyarthropathy and benzodiazepine usage.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"411-422"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896642","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 clinical trial landscape of anti-RANKL agents for osteoporosis: current status and future directions.","authors":"Xin Li, Lin Cheng","doi":"10.1007/s00198-025-07389-1","DOIUrl":"10.1007/s00198-025-07389-1","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"573-575"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984515","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":"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":"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":"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}