Osteoporosis and Sarcopenia最新文献

{"title":"An integrated deep learning and large language model for automated knee osteoarthritis grading and reporting from the Vietnam Osteoporosis Study","authors":"Dinh T. Nguyen,&nbsp;Duy K. Hoang,&nbsp;Linh N. Luu,&nbsp;An T. Truong,&nbsp;Hien Q. Kha,&nbsp;Huy T. Tran,&nbsp;Phu D. Ho,&nbsp;Thach S. Tran,&nbsp;Sai Ho Ling,&nbsp;David J. Hunter,&nbsp;Lan T. Ho-Pham,&nbsp;Tuan V. Nguyen","doi":"10.1016/j.afos.2026.05.003","DOIUrl":"10.1016/j.afos.2026.05.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Knee osteoarthritis (KOA) is a prevalent joint condition affecting multiple structures of the knee. Clinicians need reliable tools for early detection and accurate grading to support timely management, but radiographic grading remains subjective and time-consuming. We aimed to develop a deep learning and large language model (LLM) hybrid system for KOA severity classification and automated clinical reporting.</div></div><div><h3>Methods</h3><div>We analysed bilateral knee radiographs from 2435 adults (≥40 years) in the Vietnam Osteoporosis Study (VOS), using the Kellgren–Lawrence (KL) scale. Data were split into training (N = 1944) and independent testing (N = 491) sets. A hybrid deep learning pipeline combined knee-region object detection with KL grading, screening and feature localization. Outputs were integrated into a Gemini LLM module to generate structured clinical reports.</div></div><div><h3>Results</h3><div>The hybrid model achieved 79.1% accuracy and AUC 88.8% for five-class KL grading, and 89.5% accuracy (sensitivity: 87.5%, specificity: 90.2%) for KOA screening. The localization module consistently highlighted KOA-relevant features, including osteophytes, joint space narrowing, and subchondral sclerosis. The Gemini module converted model outputs into coherent, structured reports and provided context-aware answers to clinician queries grounded in the imaging results.</div></div><div><h3>Conclusions</h3><div>We developed a deployable deep learning–Gemini system for KOA assessment. This integrated framework offers an interpretable, automated approach to KOA assessment that may improve screening and decision support in resource-limited settings.</div></div><div><h3>Demo</h3><div><span><span>https://www.youtube.com/watch?v=apXipdeXD5k</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"12 3","pages":"Pages 32-39"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149028132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance in bone mineral density between lumbar spine and hip in patients with rheumatoid arthritis: A cross-sectional study","authors":"Takeshi Mochizuki,&nbsp;Koichiro Yano,&nbsp;Naoko Koenuma,&nbsp;Katsunori Ikari,&nbsp;Ken Okazaki","doi":"10.1016/j.afos.2026.05.002","DOIUrl":"10.1016/j.afos.2026.05.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Osteoporosis is a common comorbidity in patients with rheumatoid arthritis (RA). In this study, we investigated the discordance in T-scores between the lumbar spine and hip in patients with RA.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 520 patients with RA with T-scores for the lumbar spine, total hip, and femoral neck. T-score discordance was defined as differences in the WHO T-score categories between the spine and femur. Major discordance indicated osteoporosis at one site and a normal T-score at the other, whereas minor discordance represented a one-category difference. Discordance was also defined as a ≥1.5 difference in T-scores between the two sites.</div></div><div><h3>Results</h3><div>A comparison of the major, minor, and no discordance groups regarding T-scores of the lumbar spine and hip identified significant variables, including age (P &lt; 0.001), body mass index (P = 0.008), duration of RA (P = 0.001), Health Assessment Questionnaire Disability Index (P &lt; 0.001), pharmacotherapy for osteoporosis (P &lt; 0.001), scoliosis (P = 0.006), and vertebral fracture (P = 0.030). Analysis of the presence or absence of a discordance ≥1.5 in T-scores between the lumbar spine and hip, showed that age (P = 0.010), sex (P &lt; 0.001), duration of RA (P = 0.033), and type 2 diabetes mellitus (P = 0.034) were associated with discordance.</div></div><div><h3>Conclusions</h3><div>This study identified factors associated with discordance in bone mineral density between the lumbar spine and hip in patients with RA, highlighting the need for careful interpretation of site-specific measurements, particularly in high-risk patients.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"12 2","pages":"Pages 98-103"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of mandibular cortical erosion with chronic periodontitis, apical periodontitis, and tooth fracture in Japanese women aged 40 years and older: An artificial intelligence-based analysis","authors":"Hirofumi Otaki,&nbsp;Soyo Otaki,&nbsp;Noriyuki Sugino,&nbsp;Nobuo Yoshinari,&nbsp;Nobuyuki Udagawa,&nbsp;Akira Taguchi","doi":"10.1016/j.afos.2025.12.001","DOIUrl":"10.1016/j.afos.2025.12.001","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the association between mandibular inferior cortical erosion on dental panoramic radiographs (DPRs) and tooth loss and related dental pathologies in women aged 40 years and older, using a novel artificial intelligence (AI)-based assessment system.</div></div><div><h3>Methods</h3><div>We evaluated 307 Japanese women (mean age ± SD, 66.0 ± 12.5 years) who underwent DPRs at a dental clinic. Mandibular inferior cortical morphology was classified as normal, mildly to moderately eroded, or severely eroded using an AI system for automated cortical analysis. Full-mouth dental parameters included the number of present teeth, periodontal pockets ≥ 4 mm, bleeding on probing (BOP), mobile teeth, apical periodontitis, tooth fractures, and decayed or treated teeth. Poisson regression analyses were performed after adjusting for age, body size, medical history, use of osteoporosis medication, and oral hygiene behavior.</div></div><div><h3>Results</h3><div>Increasing mandibular inferior cortical erosion was significantly associated with fewer premolars and molars (P for trend &lt; 0.05) but not anterior teeth (P for trend = 0.573). The number of periodontal pockets, BOP sites, mobile teeth, and cases of apical periodontitis increased progressively as cortical morphology worsened (all P for trend &lt; 0.001). The association with apical periodontitis remained significant even after additional adjustment for mobile teeth (P for trend &lt; 0.001). Cortical erosion was also associated with tooth fractures (P for trend = 0.005).</div></div><div><h3>Conclusions</h3><div>AI-based mandibular cortical assessment using DPRs is associated with tooth loss and multiple dental pathologies in women aged ≥ 40 years and may help identify individuals at risk of oral disease.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"12 2","pages":"Pages 86-92"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical femur fractures: insights from the Asian Federation of Osteoporosis Societies consensus paper","authors":"Hanh H. Nguyen,&nbsp;Peter R. Ebeling","doi":"10.1016/j.afos.2026.03.002","DOIUrl":"10.1016/j.afos.2026.03.002","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"12 2","pages":"Pages 51-52"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia in cognitive disorders: Toward a shared pathophysiological framework","authors":"Yiming Liu,&nbsp;Kah Hwei Clarice Chua,&nbsp;Clement Gwee You Qi,&nbsp;Jia Dong James Wang","doi":"10.1016/j.afos.2026.04.001","DOIUrl":"10.1016/j.afos.2026.04.001","url":null,"abstract":"<div><div>Sarcopenia and cognitive disorders frequently co-occur and may share convergent biology spanning systemic inflammation, vascular dysfunction, oxidative stress, and hormonal–metabolic dysregulation. Literature search was conducted using PubMed, Cochrane, Embase, and CENTRAL from January 2000 to March 2026. Search terms included “Sarcopenia”, “Mild Cognitive Impairment”, and “Dementia”. Eighty-two studies met inclusion criteria (54 clinical; 28 interventions), discussing epidemiological trends, mechanistic pathways, biomarkers, and therapeutic targets. Clinical evidence clustered across inflammation, vascular change and energetics, hormonal–metabolic dysregulation, and biomarkers. Elevated inflammatory mediators tracked slower gait, weaker grip, and poorer cognition, mapping to mobility decline and Montreal Cognitive Assessment (MoCA) deficits. Cross-domain readouts linked muscle and brain: muscular fat infiltration related to worse cognitive–motor performance; temporalis muscle thickness correlated with MoCA and tau signal; impaired post-exercise phosphocreatine recovery associated with higher neurodegeneration risk and slower processing/gait. Blood biomarkers consistently stratified motor–cognitive status/decline. Among intervention reports, aerobic/resistance training improved strength, mobility, and often processing outcomes; protein (± vitamin D) and n-3 polyunsaturated fatty acid showed supportive but heterogeneous effects; vitamin D alone showed mixed muscle results but associated with lower dementia incidence; single-pathway metabolic/anti-cytokine strategies were mixed. Few studies powered dual musculoskeletal–cognitive endpoints, limiting quantitative synthesis. There is compelling evidence for bidirectional crosstalk between sarcopenia and cognitive impairment. However, evidence substantiating shared interventions remains limited and could benefit from more multi-center dual-outcome randomized controlled trials. Establishing consensus risk stratification criteria based on common biomarkers may support integrated management of these conditions, improving patient outcomes.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"12 2","pages":"Pages 53-76"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis and fragility fracture burden in Asia Pacific: Key findings from the APCO-IOF Asia Pacific Regional Audit","authors":"Hui Min Charlotte Choo ,&nbsp;Paul Mitchell ,&nbsp;Peter R. Ebeling ,&nbsp;Philippe Halbout ,&nbsp;Nicholas C. Harvey ,&nbsp;Eugene V. McCloskey ,&nbsp;Ambrish Mithal ,&nbsp;Manju Chandran","doi":"10.1016/j.afos.2026.05.004","DOIUrl":"10.1016/j.afos.2026.05.004","url":null,"abstract":"<div><div>Rapid population aging in the Asia Pacific region will significantly increase its burden of osteoporosis and fragility fractures. The Asia Pacific Consortium on Osteoporosis (APCO)-International Osteoporosis Foundation (IOF) Asia Pacific Regional Audit was developed through a coordinated effort of these two organizations. Spanning data from 22 countries and regions in the Asia Pacific, it comprehensively assembles the most current regionally relevant osteoporosis evidence available. The audit used a structured questionnaire covering 12 domains, supplemented by demographic projections, registry data, government statistics, and expert consensus estimates where formal data were unavailable. The audit revealed that osteoporosis is a national health priority in only six countries, limiting attention, funding, and coordinated service development. It also highlights glaring infrastructural gaps: insufficient fracture surveillance, uneven diagnostic access, misaligned reimbursement, and limited secondary fracture prevention. Collectively, these deficiencies point not to a lack of evidence, but to an implementation deficit in translating evidence into routine care. The audit proposes several key solutions including implementing fracture registries and post-fracture care pathways, developing coherent country-specific guidelines, aligning reimbursement with risk profile, and tracking quality outcomes. These findings provide a timely roadmap for governments and health care systems to reduce fracture burden and improve equitable osteoporosis care across the Asia Pacific region.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"12 2","pages":"Pages 77-85"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the mediating role of bone marrow fat in the liver iron-bone density relationship: A quantitative magnetic resonance imaging study","authors":"Feng Lu,&nbsp;YanJun Zhao,&nbsp;Zhongjuan Wang,&nbsp;Zhuiyang Zhang,&nbsp;Ninghan Feng","doi":"10.1016/j.afos.2026.03.001","DOIUrl":"10.1016/j.afos.2026.03.001","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore whether bone marrow proton density fat fraction (PDFF) mediates the relationship between liver iron concentration (LIC), assessed via magnetic resonance imaging (MRI)-derived R2∗, and lumbar spine (LS) bone mineral density (BMD) in women.</div></div><div><h3>Methods</h3><div>This prospective study included 103 female volunteers (median age 50 years, range 20–80) recruited between June 2019 and January 2021. All participants underwent 3.0T MRI (liver R2∗ mapping and lumbar VIBE-Dixon sequences) and dual-energy X-ray absorptiometry (DXA) on the same day. Mediation analysis was performed using the PROCESS macro, with age as covariate.</div></div><div><h3>Results</h3><div>Among the 103 participants (median age 50 years, IQR 38–60; 44% with elevated liver R2∗ &gt; 67.7 s⁻¹), liver R2∗ was positively associated with bone marrow PDFF (β = 0.36, P &lt; 0.001) and negatively associated with LS BMD (β = −0.273, P = 0.004). Bone marrow PDFF showed a negative association with LS BMD (β = −0.286, P = 0.006). Mediation analysis revealed that bone marrow PDFF significantly mediated 37.6% of the liver R2∗-BMD relationship (indirect effect = −0.103; 95% CI: 0.210 to −0.028). Subgroup analyses revealed that these associations were statistically significant only in participants aged ≥ 50 years.</div></div><div><h3>Conclusions</h3><div>Bone marrow PDFF partially mediates the inverse relationship between liver iron and BMD in women, particularly in those aged ≥ 50 years, suggesting a potential link between iron metabolism and bone loss that warrants further investigation. Combined MRI assessment of liver R2∗ and bone marrow PDFF may enhance osteoporosis risk stratification.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"12 2","pages":"Pages 93-97"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asia-Pacific consensus statement on medication-related osteonecrosis of the jaw in patients with osteoporosis","authors":"Akira Taguchi ,&nbsp;Daisuke Inoue ,&nbsp;Jin-Woo Kim ,&nbsp;Keskanya Subbalekha ,&nbsp;Wai Sin Chan ,&nbsp;Hee Dong Chae ,&nbsp;Chung-Hwan Chen ,&nbsp;Ching-Lung Cheung ,&nbsp;Eddie Siu Lun Chow ,&nbsp;Yoon-Sok Chung ,&nbsp;Linsey Gani ,&nbsp;Muhammad Kamil bin Hassan ,&nbsp;Unnop Jaisamrarn ,&nbsp;Chakorn Vorakulpipat ,&nbsp;Nutchada Sriyaranya ,&nbsp;Aasis Unnanuntana ,&nbsp;Tanawat Amphansap ,&nbsp;Seng Bin Ang ,&nbsp;Fen Lee Hew ,&nbsp;Julie Li-Yu ,&nbsp;Natthinee Charatcharoenwitthaya","doi":"10.1016/j.afos.2026.02.001","DOIUrl":"10.1016/j.afos.2026.02.001","url":null,"abstract":"<div><div>A unified consensus statement on medication-related osteonecrosis of the jaw (MRONJ) has not yet been established among the Asian member countries or regions of the Asian Federation of Osteoporosis Societies (AFOS). This study aimed to develop a consensus on MRONJ in patients with osteoporosis across these countries and regions. In this study, the term “Asia-Pacific” refers specifically to the Asian member countries and regions of AFOS. A structured survey consisting of nine MRONJ-related questions was distributed across 10 countries and regions to assess the level of agreement and summarize regional perspectives. In addition, a manual literature review and voting were conducted to evaluate the current evidence on MRONJ. The key aspects of MRONJ, including definition, staging, diagnosis, pathogenesis, risk factors, management, and prevention, were generally consistent among the AFOS countries and regions. The annual incidence and incidence rate of MRONJ associated with low-dose antiresorptive therapy in patients with osteoporosis ranged from 0.025% to 0.136% and 21 to 283 cases per 100,000 person-years, respectively. However, evidence regarding the benefits of drug discontinuation before dental surgery, such as tooth extraction, remains insufficient. Large-scale, multinational studies across AFOS countries and regions are warranted to determine the incidence of MRONJ better and evaluate the impact of antiresorptive drug discontinuation before dental procedures. These findings may contribute to the development of effective evidence-based strategies for preventing MRONJ in patients with osteoporosis.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"12 1","pages":"Pages 1-17"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147584477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of genetic polymorphisms of aldehyde dehydrogenase 2 on the efficacy of intermittent parathyroid hormone treatment and bone mineral density: A retrospective multicenter study","authors":"Hinako Obara ,&nbsp;Takafumi Tajima ,&nbsp;Manabu Tsukamoto ,&nbsp;Yoshiaki Yamanaka ,&nbsp;Hitoshi Suzuki ,&nbsp;Masato Nagashima ,&nbsp;Satoshi Nishida ,&nbsp;Satoshi Ikeda ,&nbsp;Kazumichi Maekawa ,&nbsp;Akinori Sakai","doi":"10.1016/j.afos.2026.02.002","DOIUrl":"10.1016/j.afos.2026.02.002","url":null,"abstract":"<div><h3>Objectives</h3><div>In a mouse model, aldehyde dehydrogenase 2 (ALDH2) knockout resulted in lower bone mineral density; however, higher parathyroid hormone receptor expression than wild-type mice. This study aimed to investigate whether ALDH2 polymorphisms influence efficacy of intermittent parathyroid hormone therapy and bone mineral density changes in humans.</div></div><div><h3>Methods</h3><div>Eighty-two patients with primary osteoporosis treated with parathyroid hormone for &gt; 1 year were divided into wild-type ALDH2 (ALDH2∗1) and variant (ALDH2∗2) groups. Bone mineral densities were measured by dual-energy X-ray absorptiometry. Changes in bone mineral density, treatment response, bone turnover markers, and new fracture incidence were evaluated. Furthermore, bone mineral density was analyzed using a mixed-effects model.</div></div><div><h3>Results</h3><div>Femoral neck bone mineral density increased by 1.0 ± 7.4% in the ALDH2∗1 group and 4.3 ± 8.1% in the ALDH2∗2 group (P &lt; 0.05), whereas lumbar spine bone mineral density increased by 5.7 ± 8.2% and 9.4 ± 9.1% without significance. Treatment success rates were higher in ALDH2∗2 group (femoral neck 38.7%, lumbar spine 68.8%) compared with ALDH2∗1 (16.3%, 51.0%). Statistical significance was observed only at the femoral neck. Bone turnover markers and fracture incidence were comparable between groups. Mixed-effects analysis adjusting for confounders showed a significant ALDH2 genotype × duration interaction for femoral neck, indicating genotype-related differences in the rate of bone mineral density increase over time. For lumbar spine, the genotype main effect was significant, whereas the interaction was not.</div></div><div><h3>Conclusions</h3><div>These findings suggest that ALDH2 polymorphisms may influence the therapeutic response to PTH treatment and highlight the need for larger future studies.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"12 1","pages":"Pages 26-33"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147584479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normative data and standardized scores for sarcopenia indicators in middle-aged and older adults: a large screening-based cohort study","authors":"Hsiu-Wen Kuo,&nbsp;Chih-Dao Chen,&nbsp;Ariel Chang-Yu Wu","doi":"10.1016/j.afos.2026.01.001","DOIUrl":"10.1016/j.afos.2026.01.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Sarcopenia, an age-related skeletal muscle disorder, is assessed by handgrip strength, gait speed, and muscle mass, yet population-specific reference data and standardized scores for Asian adults remain limited. We aimed to establish sex- and age-specific normative reference distributions, smoothed centile curves, and model-based standardized T scores for these indicators in Asian adults.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed adults aged ≥ 40 years attending a tertiary-center Adult Preventive Health Program in 2023–2024. To assess construct validity, we compared sarcopenia indicators across age groups using analysis of variance (ANOVA). Sex- and age-specific reference distributions were estimated using Generalized Additive Models for Location, Scale, and Shape (GAMLSS), from which smooth model-based age-specific centiles (5th–95th) were derived. Individual values were standardized to model-based Z scores and transformed to T scores on an approximate 100-point scale. Asian Working Group for Sarcopenia (AWGS) cut-offs were used in receiver operating characteristic (ROC) analyses to determine corresponding T-score thresholds.</div></div><div><h3>Results</h3><div>Among 8095 participants, model-based mean handgrip strength, gait speed, and skeletal muscle mass were 20.03±5 kg, 1.12±0.37 m/s, and 6.93±1.43 kg/m² in women and 30.69±7.46 kg, 1.12±0.37 m/s, and 8.79±1.95 kg/m² in men. GAMLSS-derived centile curves demonstrated age-related declines in strength and gait speed and milder changes in muscle mass. AWGS cut-offs corresponded to T scores in the mid-40s for strength and gait and around 40–41 for muscle mass.</div></div><div><h3>Conclusions</h3><div>We established sex- and age-specific normative values and GAMLSS-based reference distributions, and derived model-based Z and T scores that provide standardized sarcopenia metrics in Asian adults, align with AWGS thresholds, and support detection of muscle decline and risk stratification.</div></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"12 1","pages":"Pages 34-43"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147584480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}