Current Osteoporosis Reports最新文献

{"title":"Osteoporosis and Alzheimer's Disease: The Role of Sclerostin.","authors":"Lorelé Gagiano, Ziming Chen, William G Blakeney, Christopher Jones, Frank Mastaglia, Minghao Zheng, Jun Yuan","doi":"10.1007/s11914-026-00993-y","DOIUrl":"10.1007/s11914-026-00993-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Little is known about the underlying cause contributing to the association between Osteoporosis (OP) and Alzheimer's disease (AD). This review highlights the emerging role of sclerostin, a protein mainly produced by osteocytes, in the newly discovered crosstalk between bone and brain, with a focus on its potential contribution to the relationship between OP and AD.</p><p><strong>Recent findings: </strong>Circulating sclerostin levels increase with aging and are positively associated with brain amyloid-β burden in older adults. Studies demonstrate that elevated sclerostin can cross the blood-brain barrier, promote amyloid-β peptide deposition, and impair synaptic plasticity by suppressing Wnt/β-catenin signalling, whereas sclerostin inhibition restores neuronal plasticity and attenuates AD pathology. Sclerostin represents a promising target in the bone-brain interaction pathway. Its dual role as a measurable circulating biomarker and a modifiable component offers new opportunities for early risk assessment and therapeutic repurposing. Future longitudinal and interventional studies are essential to confirm the association between sclerostin and risk of AD, and to clarify whether targeting sclerostin can delay the onset of the disease or modify its trajectory.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239943","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":"Osteocyte-Derived Extracellular Vesicles: Bridging the Gap in Skeletal Physiology and Pathophysiology.","authors":"Daoyan Yang, Jing Yang","doi":"10.1007/s11914-026-00987-w","DOIUrl":"https://doi.org/10.1007/s11914-026-00987-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Osteocytes are the most abundant cells in bone and serve as central skeletal regulators. Recent findings from our and other groups demonstrate that beyond soluble mediators, osteocytes communicate by releasing extracellular vesicles (EVs). This review provides a systematic overview of osteocyte-derived EVs and highlights their importance in diagnostic and therapeutic innovation.</p><p><strong>Recent findings: </strong>Accumulating evidence has linked osteocyte mechanotransduction to EV biogenesis and secretion. Mechanically induced calcium oscillations and signaling pathways impact load-induced EV release. Under normal conditions, osteocyte-derived EVs contribute to local and systemic intercellular communication within experimental models, whereas their direct role in immune-microenvironment remodeling remains insufficiently defined. In pathological states, alterations in osteocyte EV release and cargo composition are associated with both benign diseases and malignancies. Engineered osteocyte-derived EVs and EV-inspired delivery systems are being investigated as cell-free therapeutic platforms for skeletal regeneration. Continued research in osteocyte-derived EVs will deepen understanding of bone communication networks and resolve the principal conceptual and technical challenges.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228873","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":"Osteoporosis in Pediatric Orthopaedics: Congenital Diseases, Medical Management, and Perioperative Considerations.","authors":"Aki S Puryear, Laura E Bess, Linda A DiMeglio","doi":"10.1007/s11914-026-00985-y","DOIUrl":"10.1007/s11914-026-00985-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Pediatric osteoporosis is a heterogeneous group of primary and secondary disorders that creates challenges for orthopaedic surgeons. This review summarizes evidence on conditions commonly encountered in pediatric orthopedic practice, medical management strategies, and perioperative care for children with bone fragility.</p><p><strong>Recent findings: </strong>Diagnostic approaches have been evolving toward integrating fracture characteristics, skeletal risk factors, and bone mineral density (BMD). A single low-trauma vertebral compression fracture is now sufficient for diagnosis of osteoporosis in children regardless of BMD. Intravenous bisphosphonates remain first-line therapy, with recent meta-analyses confirming consistent BMD gains and, observationally, a reduction in fracture risk. Bisphosphonates are generally given to children who have sustained low-trauma vertebral fractures and considered for other children with recurrent long bone fractures with low BMD. Early intervention with bisphosphonates may also be warranted for children with high-risk diseases, such as Duchenne's Muscular Dystrophy (DMD). Biologic agents are emerging in clinical trials and select specialized use, but further research is needed to understand their role in pediatric osteoporosis. Denosumab carries a substantial risk for rebound hypercalcemia in children with osteogenesis imperfecta (OI), limiting its use to selected indications. Preliminary reporting from a large trial of anti-sclerostin therapy in children with osteogenesis imperfecta suggests significant BMD increases while fracture-reduction endpoints were not met, underscoring the limitations of BMD as a surrogate in pediatric bone fragility trials. Providing optimal care for this unique group of patients requires multidisciplinary coordination amongst orthopaedic surgeons, endocrinologists, geneticists, and rehabilitation specialists. Evidence-based management includes preoperative bone health evaluation, procedure-specific modifications in fragile bone, nutritional optimization, and coordinated bisphosphonate timing.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117102","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":"Microgravity-Induced Osteocyte Dysfunction: An Osteocyte Mechanobiology Unit Framework.","authors":"Arlyn M Roque, Owen Brylle L Acosta, Mary Jean R Lozano, Hyacinth N Suarez, Rommel G Bacabac","doi":"10.1007/s11914-026-00989-8","DOIUrl":"10.1007/s11914-026-00989-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review synthesizes evidence from diverse experimental platforms and proposes the Osteocyte Mechanobiology Unit (OMU), a conceptual framework integrating the mechanical and biochemical processes underlying microgravity-induced alterations in osteocytes and their surrounding microenvironment.</p><p><strong>Recent findings: </strong>Current evidence indicates that microgravity disrupts two interconnected OMU domains: the Mechanical Sensing Domain, through alterations in the local mechanical microenvironment and mechanosensory structures, and the Biochemical Signaling Domain, through dysregulated cellular homeostasis, altered osteocyte functional phenotype, and disrupted intercellular and systemic signaling. This synthesis highlights important knowledge gaps, including the fragmented nature of current evidence, the limited understanding of the relationships among these alterations and their contribution to bone loss, and the need for validation under actual spaceflight conditions. The OMU framework provides a unifying physiological perspective for interpreting fragmented evidence and organizing countermeasures against microgravity-induced bone loss according to the functional domains they target. It also identifies priorities for developing integrated, mechanism-informed strategies to preserve skeletal health during long-duration human spaceflight.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117080","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":"Exercise Improves Upper-Limb Bone Health in Women: A Systematic Review and Meta-Analysis of Exercise Type and Intensity.","authors":"Gonzalo Reverte-Pagola, Jose Luis Gil-Delgado, David Wing, Borja Sañudo","doi":"10.1007/s11914-026-00988-9","DOIUrl":"10.1007/s11914-026-00988-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Distal radius fractures are common fragility fractures in women, but exercise-related evidence has focused mainly on the hip and spine. This review and meta-analysis examined whether exercise improves upper-limb bone outcomes and whether exercise modality and intensity influence the response.</p><p><strong>Recent findings: </strong>Twenty-six controlled trials involving 1,880 women were included. The pooled estimate favored exercise with a standardized mean difference (SMD) of 1.05; with a 95% confidence interval (CI) from 0.68 to 1.43; p < 0.001), representing a large positive average effect. The direction of effect was positive in the majority of trials, and the pooled estimate remained statistically significant in all leave-one-out analyses. Between-study heterogeneity was very high (I² = 91%), and the prediction interval crossed the null (- 0.96 to 3.06), indicating that effects may vary substantially across interventions and populations. Exploratory within-category estimates were positive for combined and dynamic weight-bearing interventions and for high- and moderate-to-high-intensity programs. These intensity categories were modality-specific operational classifications rather than directly comparable measures of skeletal loading. The GRADE certainty was very low for the specifically assessed body of evidence on distal radius bone mineral density (BMD) or bone mineral content (BMC) measured by dual-energy X-ray absorptiometry (DXA) at the end of the intervention. Exercise may improve upper-limb bone outcomes in women, and the positive pooled estimate and its stability in leave-one-out analyses provide an encouraging basis for further investigation. Combined, dynamic weight-bearing, and progressively intensified programs emerged as promising candidates, although the subgroup and mechanobiological interpretations remain hypothesis-generating. The analyzed outcomes were surrogate measures of bone health, and the effect of exercise on distal radius fracture incidence remains unknown.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026446","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":"Artificial Intelligence and Machine Learning for Outcome Prediction After Osteoporotic Hip Fracture: A Systematic Review and Meta-analysis of Prediction Model Performance.","authors":"Gaurav Jha, Gautam Chadalavada, Zuhaib Shahid, Gagandeep Mahi, Amit Bishnoi","doi":"10.1007/s11914-026-00986-x","DOIUrl":"10.1007/s11914-026-00986-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Hip fracture is a major consequence of osteoporosis and is associated with mortality, complications, prolonged hospitalisation and loss of independence. This systematic review evaluated artificial intelligence (AI) and machine learning (ML) models for predicting clinical outcomes after hip fracture, focusing on model performance, validation, reporting quality and clinical readiness.</p><p><strong>Recent findings: </strong>This PRISMA-compliant review was registered with PROSPERO (CRD420261414142). Searches of PubMed, Ovid MEDLINE, Embase and EBSCO CINAHL identified 40 eligible studies published between 2010 and 2026. Mortality prediction was the most frequently studied outcome, while delirium, medical complications, resource utilisation, rehabilitation outcomes and surgical failure were less consistently examined. AI/ML models generally showed moderate to strong discrimination, particularly for mortality prediction. Current AI/ML models show promise for outcome prediction after hip fracture, but inconsistent external validation, limited calibration reporting, incomplete uncertainty estimates and variable methodological quality restrict clinical implementation. Future research should prioritise transparent reporting, external validation and prospective clinical evaluation.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026394","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":"Angiogenic and Osteogenic Strategies for Skeletal Regeneration in Aging.","authors":"Mariana Moraes de Lima Perini, Jiliang Li","doi":"10.1007/s11914-026-00983-0","DOIUrl":"10.1007/s11914-026-00983-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Aging disrupts skeletal homeostasis, resulting in impaired fracture healing, increased risk of nonunion, and reduced regenerative capacity. These deficits are associated with dysregulated inflammation, impaired angiogenesis, and reduced osteogenesis, while current treatments remain limited in aged populations. This review examines emerging regenerative approaches that target both vascular and osteogenic dysfunction during skeletal repair.</p><p><strong>Recent findings: </strong>Recent studies have emphasized the importance of angiogenic-osteogenic coupling in successful bone repair. Endothelial progenitor cells (EPCs) promote neovascularization, improve vascular function, and support osteogenesis, while EPC-derived extracellular vesicles (EV), particularly exosomes, enhance intercellular communication, angiogenesis, and tissue repair with fewer limitations than cell-based therapies. In addition, signal transducer and activator of transcription 3 (STAT3) has been identified as a key regulator of osteoblast function, angiogenesis, and bone remodeling, making it an attractive molecular target for enhancing skeletal regeneration. EPC-based therapies, exosome-mediated interventions, and modulation of STAT3 signaling are promising strategies to enhance skeletal regeneration by addressing both vascular dysfunction and impaired osteogenesis. Continued investigation into the mechanisms, safety, and translational potential of these approaches will be critical for advancing regenerative therapies for age-related skeletal disorders.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921444","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":"Why Do We Lose Bone During Weight Loss: Can It Be Prevented?","authors":"Sue A Shapses, Brandon D McGuire","doi":"10.1007/s11914-026-00984-z","DOIUrl":"10.1007/s11914-026-00984-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Weight loss is recommended for obesity management, but it also increases bone turnover and reduces bone mineral density (BMD) and bone quality (microarchitecture, geometry, and strength). This review examines mechanisms and the multiple factors that influence skeletal responses to caloric restriction.</p><p><strong>Recent findings: </strong>Bone loss during weight loss likely reflects multiple interacting mechanisms, including alterations in endocrine signaling, impaired calcium absorption, reduced mechanical loading, and alterations in the gut microbiota. The extent of bone loss is further influenced by age, sex, initial body weight, nutrient intake, and method of weight loss, with greater loss in older and lean adults, and after severe caloric restriction, such as with incretin mimetics or bariatric surgery. Current evidence emphasizes the importance of adequate nutrient intake (e.g., calcium, protein, etc.) and exercise as countermeasures to attenuate bone loss. Emerging evidence also suggests that additional countermeasures, including osteoporosis medications and other lifestyle interventions, may affect weight-loss-induced bone loss, and randomized trials are needed. Weight-loss-induced bone loss is multifactorial, involving endocrine, metabolic, nutritional, mechanical, and gut microbiota-mediated mechanisms that remain incompletely understood. These mechanisms influencing skeletal responses to weight loss can inform targeted strategies to preserve bone health and reduce fracture risk during obesity management.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921371","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":"Phytocannabinoids and bone health.","authors":"Hayley Palmer, Diana E Roopchand","doi":"10.1007/s11914-026-00982-1","DOIUrl":"10.1007/s11914-026-00982-1","url":null,"abstract":"<p><strong>Purpose of the review: </strong>Phytocannabinoids have received attention for their therapeutic properties, however, it is unclear how they affect bone homeostasis. Additionally, increased use of cannabis and hemp-derived products have raised questions about their impact on musculoskeletal health. This review summarizes recent studies that investigate the impact of phytocannabinoids on bone.</p><p><strong>Recent findings: </strong>The most well studied phytocannabinoid in relation to bone health is cannabidiol (CBD). In vitro data suggests CBD inhibits osteoclasts and promotes osteoblast activity. Rodent studies have demonstrated CBD may be useful for managing bone loss associated with osteoporosis and periodontitis, as well as reducing fracture pain and promoting healing. Recent studies suggest other phytocannabinoid isolates and extracts containing multiple phytocannabinoids have varying effects on bone. The first clinical study in this area reported that a medical cannabis product reduced markers of bone turnover in healthy adults. Cannabinoids bind to receptors in the endocannabinoid system which is involved in regulation of bone metabolism. Phytocannabinoids may improve bone health; however, additional work is required to determine factors such as the optimal dose, timing, and route of administration.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913875","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":"Correction: Management of Adverse Skeletal Effects Following Bariatric Surgery Procedures in People Living with Obesity.","authors":"Léa Karam, Julien Paccou","doi":"10.1007/s11914-026-00981-2","DOIUrl":"10.1007/s11914-026-00981-2","url":null,"abstract":"","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"24 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898144","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}