Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA最新文献

{"title":"The phenotype of pelvic and acetabular fractures in adults aged 50 and older: a national database analysis in the Netherlands.","authors":"M I Lommerse, S J B van der Jagt, H J Schuijt, J P van den Bergh, F W Bloemers, D van Embden, H C Willems","doi":"10.1007/s00198-026-08221-0","DOIUrl":"https://doi.org/10.1007/s00198-026-08221-0","url":null,"abstract":"<p><p>Brief Nationwide data show rising pelvic and acetabular fracture incidence, yet patient profiles and outcomes remain underexplored. In our cohort of 7,120 patients ≥50 years, pelvic fractures were frailer overall while mortality was similar to acetabular fracture patients. Findings support distinguishing fracture types and considering pelvic fractures as major osteoporotic fractures.</p><p><strong>Purpose: </strong>Pelvic and acetabular fractures are increasingly common in aging populations and carry substantial clinical and societal burdens. As these injuries are often grouped together despite potentially different patient characteristics and outcomes, this study aimed to provide a comprehensive, nationwide phenotypic description of patients aged 50 years and older with pelvic or acetabular fractures in the Netherlands.</p><p><strong>Methods: </strong>A retrospective population-based cohort study was conducted using national claims and population data from Statistics Netherlands (CBS). All individuals aged ≥50 years diagnosed with a pelvic or acetabular fracture in 2019 were included. Demographics, comorbidities, treatment modality, care utilization, 1-year readmission, and mortality were compared between fracture types and sex.</p><p><strong>Results: </strong>7120 patients were included (6091 pelvic, 1029 acetabular). Pelvic fracture patients were older than acetabular fracture patients (mean age 77 vs 74), often female (79% vs 36%), with higher pre-injury rates of osteoporosis, connective tissue disease, and polypharmacy (all p < 0.05). Acetabular fractures showed more hospital admissions (53% vs 35%), surgical treatment (28% vs 4.4%), and complication-related readmission (9.7% vs 1.8%), most evident in male patients. New major fracture rates (6.6% vs 8.4%) and 1-year mortality rates (15% vs 17%) were comparable.</p><p><strong>Conclusion: </strong>Pelvic and acetabular fractures reflect distinct phenotypes in patients aged 50 and older, with pelvic fractures more closely linked to frailty and osteoporosis, most apparent in females. These findings support differentiating between fractures in research and clinical care and call for reconsideration of pelvic fractures within major osteoporotic fracture definitions, as their clinical profile seems similar to that of hip fracture patients.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122920","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":"Letter to the Editor regarding \"AI-derived bone mineral density from standard radiographs compared with DXA for fracture prediction in a 10-year real-world cohort study\".","authors":"Kun Zhang","doi":"10.1007/s00198-026-08232-x","DOIUrl":"https://doi.org/10.1007/s00198-026-08232-x","url":null,"abstract":"","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122960","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":"OsteoCHAT: real-world patient evaluation and benchmarking of a guideline-grounded osteoporosis chatbot.","authors":"Nils Schulz, Martin Gehlen, Karin Mahn, Björn Bühring, Paula Hoff, Olga Seifert, Edgar Wiebe, Asarnusch Rashid, Sebastian Kuhn, Frank Buttgereit, Alexander Pfeil, Peter Oelzner, Uwe Lange, Johannes Knitza, Philipp Klemm","doi":"10.1007/s00198-026-08247-4","DOIUrl":"https://doi.org/10.1007/s00198-026-08247-4","url":null,"abstract":"<p><p>Patients with osteoporosis have information needs that routine care inconsistently addresses. In this multicenter real-world evaluation, the LLM-based, guideline-grounded chatbot OsteoCHAT showed high participant acceptability and achieved expert-rated answer quality comparable to general-purpose LLMs. Despite challenges in complex treatment and safety-related topics, guideline-grounded chatbots may represent useful educational adjuncts.</p><p><strong>Purpose: </strong>Patients with osteoporosis have information needs that routine care inconsistently addresses. Guideline-grounded chatbots may offer scalable educational support METHODS: We developed OsteoCHAT, a retrieval-augmented conversational system based on the current German osteoporosis guideline, and conducted a multicenter evaluation at seven centers in Germany. Participants interacted with OsteoCHAT, provided real-time feedback on individual responses, and completed a standardized questionnaire assessing usability, comprehensibility, usefulness, trust, perceived quality, and preference over conventional internet search. In parallel, OsteoCHAT was benchmarked against three general-purpose large language models (LLMs) using ten osteoporosis frequently asked questions derived from the BfO patient guideline as the gold standard. Five clinical experts independently rated these responses across five domains, each scored 0-3.</p><p><strong>Results: </strong>Overall, 1,075 question-answer interactions were recorded. Of 389 individually rated responses, 379 (97.4%) received positive feedback. Among 217 complete questionnaire responses, 84.3% rated answers as easily understandable, 79.8% found OsteoCHAT easy to use, 77.2% perceived time savings, and 78.7% considered it a useful addition to existing educational materials. Trust was comparatively lower (64.7% agreement). Blinded expert benchmarking showed acceptable-to-high-quality responses across all LLMs (median total scores 14/15 for Gemini, ChatGPT, and OsteoCHAT and 13/15 for Meta AI), with expert-identified weaknesses mainly concerning pharmacological treatment indication and communication of adverse and rare safety-critical events.</p><p><strong>Conclusion: </strong>OsteoCHAT demonstrated high user acceptability and usability in a real-world multicenter evaluation, was rated as a valuable addition to existing educational materials, and achieved expert-rated response quality comparable to general-purpose LLMs, although limitations in safety communication were identified across all examined systems.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122934","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":"Interaction between vitamin D and the growth hormone/insulin-like growth factor 1 axis in children: a systematic review and meta-analysis.","authors":"Qiutong Song, Hanqi Lv, Yuheng Li, Yueyang Zhao, Na Wu","doi":"10.1007/s00198-026-08225-w","DOIUrl":"https://doi.org/10.1007/s00198-026-08225-w","url":null,"abstract":"<p><strong>Background: </strong>This article presents a systematic review and meta-analysis of relevant studies to clarify the relationship between vitamin D and the growth hormone/insulin-like growth factor 1(GH/IGF-1) axis.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Web of Science, SCOPUS, Embase, and CNKI databases were searched. Relevant articles on the effect of vitamin D on IGF-1 levels were reviewed. The effect of recombinant human growth hormone supplementation on 25-hydroxyvitamin D[25(OH)D] levels was meta-analyzed, and subgroup analyses were conducted.</p><p><strong>Results: </strong>IGF-1 levels increased after vitamin D supplementation. Vitamin D combined with rhGH therapy resulted in higher IGF-1 levels than rhGH alone. The meta-analysis included 24 studies. Vitamin D levels increased after rhGH treatment (WMD: 5.83 ng/mL, 95% CI: 3.72 to 7.94, I² = 99%, p < 0.00001), both in children with GHD (WMD: 7.78 ng/mL, 95% CI: 2.02 to 13.55, I² = 99%, p = 0.008) and ISS(WMD: 2.74 ng/mL, 95% CI: 1.25 to 4.23, I² = 98%, p = 0.0003). Results showed that vitamin D levels in children with growth hormone deficiency (GHD) were significantly lower than those in healthy children (WMD: -8.69 ng/mL, 95% CI: -15.91 to -1.46, I² = 96%, p = 0.02). There was no significant difference in vitamin D levels between children with idiopathic short stature (ISS) and healthy children (WMD: -3.86 ng/mL, 95% CI: -7.70 to -0.01, I² = 98%, p = 0.05). However, vitamin D levels in short children remained lower than those in healthy children after rhGH treatment (WMD: -1.68 ng/mL, 95% CI: -2.53 to -0.82, I² = 84%, p = 0.0001).</p><p><strong>Conclusion: </strong>The increase in IGF-1 levels following vitamin D supplementation should be accounted for in clinical practice when evaluating IGF-1 values to optimize the diagnosis of short stature causes. Children with GHD have lower vitamin D levels, and rhGH supplementation can increase vitamin D levels. Combined vitamin D and rhGH therapy can better promote growth and development in children with short stature.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122912","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":"Prevalence, risk factors and adverse health outcomes of osteosarcopenia in middle-aged and older adults with type 2 diabetes mellitus-a scoping review.","authors":"Alvin Wai Kit Tan, Chia Siong Wong, Helen Elizabeth Smith, Yasmin Lynda Munro, James Donovan Best, Wee Shiong Lim","doi":"10.1007/s00198-026-08228-7","DOIUrl":"https://doi.org/10.1007/s00198-026-08228-7","url":null,"abstract":"<p><p>Osteoporosis and sarcopenia are increasingly recognised as important complications of type 2 diabetes mellitus (T2D). As both conditions share common pathophysiological mechanisms, they can coexist in the same individual. The coexistence of osteoporosis and sarcopenia, known as osteosarcopenia (OS), is an emerging geriatric syndrome. Compared with its individual components, OS has received much less attention. The overall objective of this scoping review was to summarise the existing literature on the prevalence, risk factors, biomarkers, and adverse health outcomes associated with OS in adults with T2D aged ≥ 40. A search was conducted in eight online databases (Ovid MEDLINE®, Embase (Ovid), PubMed, CINAHL, Cochrane Library, Web of Science, Scopus and PsycINFO) and grey literature sources for relevant articles published in English up to 31 July 2024. A total of ten articles reporting findings from nine distinct studies (7 cross-sectional, 2 case-control) were included. Despite significant heterogeneity in its definition, OS was shown to be prevalent in T2D. The risk of OS was increased in individuals with T2D who had poor β-cell function, low body mass index, and smaller waist circumference. Insulin resistance, duration of T2D, glycaemic control, and metformin, sulfonylurea and insulin use were not shown to be significant risk factors. Osteocalcin was a potentially useful biomarker of OS in T2D, and OS may be associated with falls and leg fractures in T2D. In conclusion, this scoping review revealed a paucity of information about OS in T2D. Longitudinal studies with comprehensive phenotyping are required to address the many knowledge gaps.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122944","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":"Differential efficacy of initial versus sequential combination of denosumab and teriparatide in osteoporosis at high fracture risk.","authors":"Xin-Ping Li, Rong Chen, Cheng Cheng, Jingyi Wang, Ning Li, Hailing Chen","doi":"10.1007/s00198-026-07979-7","DOIUrl":"https://doi.org/10.1007/s00198-026-07979-7","url":null,"abstract":"<p><p>For patients already on denosumab, adding teriparatide is a suboptimal last resort: it offers limited spinal benefit but carries a significant risk of hip bone loss, mandating a site-specific risk-benefit assessment.</p><p><strong>Background: </strong>The management of patients with osteoporosis who exhibit a suboptimal response to denosumab remains clinically challenging. Adding teriparatide to established denosumab therapy is not well defined for high-risk patients in real-world settings.</p><p><strong>Objective: </strong>This study aimed to directly compare the 12-month effects on bone mineral density (BMD) and bone turnover markers between an \"initial combination\" versus \"sequential combination\" (adding teriparatide to ongoing denosumab) in a cohort of postmenopausal women at high fracture risk.</p><p><strong>Methods: </strong>In this 1-year retrospective cohort study, patients were assigned to one of two groups based on treatment history: the initial combination group (n = 54), in which teriparatide was initiated within 6 months of starting denosumab, and the sequential combination group (n = 25), in which teriparatide was added after more than 6 months of continuous denosumab monotherapy. The primary outcome was the percent change in lumbar spine (L1-L4) BMD.</p><p><strong>Results: </strong>The mean increase in lumbar spine BMD was significantly greater in the initial combination group (+13.4%; 95% CI 9.9 to 22.5%) compared with the sequential combination group (+8.3%; 95% CI 1.9 to 9.2%; P = 0.030). A critical divergence was observed at the total hip. The initial combination group showed an increase in BMD (+6.0%; 95% CI -0.5 to 12.2%), whereas the sequential combination group experienced a significant decrease (-5.1%; 95% CI -7.1 to -3.9%; P = 0.009). Bone turnover markers (P1NP and CTX) were markedly elevated in the sequential combination group compared to the initial combination group (both P < 0.01). These differential effects were consistent across subgroups, regardless of prior bisphosphonate use or the duration of denosumab pretreatment.</p><p><strong>Conclusion: </strong>Initial combination is optimal, while if sequential combination is necessary, it requires caution and may be more suitable for patients with predominant vertebral risk, mandating a site-specific benefit-risk assessment.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122961","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":"Interpreting romosozumab-associated BMD changes in osteogenesis imperfecta: design, densitometry, and multiplicity.","authors":"Mehmet Serkan Kılıçoğlu","doi":"10.1007/s00198-026-08246-5","DOIUrl":"https://doi.org/10.1007/s00198-026-08246-5","url":null,"abstract":"","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122956","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":"From prescription claims to treatment gaps after hip fracture: methodological considerations.","authors":"Mehmet Serkan Kılıçoğlu","doi":"10.1007/s00198-026-08254-5","DOIUrl":"https://doi.org/10.1007/s00198-026-08254-5","url":null,"abstract":"","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122942","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":"Denosumab-efficacy, safety, persistence and sequential strategies-a systematic review.","authors":"Natasha Amran Laursen, Anne Sophie Sølling, Torben Harsløf, Bente L Langdahl","doi":"10.1007/s00198-026-08237-6","DOIUrl":"https://doi.org/10.1007/s00198-026-08237-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Denosumab (DMAB), a monoclonal antibody targeting receptor activator of nuclear factor kappa-Β ligand (RANKL), is an effective antiresorptive therapy for osteoporosis that increases bone mineral density (BMD) and reduces the risk of vertebral and non-vertebral fractures. However, its effects are rapidly reversible, and treatment delays or discontinuation are associated with bone turnover overshoot, loss of BMD, and an increased risk of vertebral fractures. Despite generally high treatment persistence, DMAB is frequently discontinued, necessitating appropriate sequential therapy to prevent overshoot in bone turnover. This review summarizes the literature on the efficacy, safety, and persistence of DMAB treatment, as well as strategies for transitioning to other anti-osteoporosis therapies after discontinuation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A literature search was conducted on September 22, 2025, across multiple databases, including Embase, PubMed, and the Cochrane Library. Randomized controlled trials (RCTs) and observational studies evaluating the efficacy, safety, and persistence of DMAB, as well as clinical outcomes following DMAB discontinuation and subsequent sequential therapy, were included. Data extraction and quality assessment were conducted independently by two authors in accordance with PRISMA guidelines. The efficacy of DMAB compared with placebo and bisphosphonates (BPs) was assessed by meta-analyses of the relevant trials. The remaining outcomes were assessed and described using a narrative synthesis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 71 studies met the inclusion criteria. Compared with placebo, DMAB consistently increased BMD, reduced BTMs, and lowered the risk of vertebral and non-vertebral fractures. Across included studies, DMAB generally resulted in greater BMD gains and improved fracture outcomes compared with BPs. Changes in BMD were comparable to those observed with teriparatide, while romosozumab resulted in larger gains in the lumbar spine. No data was available on fracture risk when comparing DMAB to osteoanabolic therapies. Real-world studies generally reported high short-term persistence and compliance with DMAB, but treatment persistence declined over longer follow-up periods. Discontinuation of DMAB was associated with rapid increases in BTMs, loss of BMD gains, and an increased risk of vertebral fractures. Sequential treatment with oral or IV BPs attenuated but did not completely prevent bone turnover overshoot and bone loss.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;DMAB is an effective treatment for osteoporosis, superior to BPs and comparable to anabolic treatments in improving BMD and superior to BPs in reducing fracture risk, but its discontinuation carries clinically significant risks of bone loss and vertebral fractures. Consequently, discontinuing DMAB requires long-term treatment planning, and the timely initiation of appropriate sequential therapy is essential to optim","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122965","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":"Author Response to \"Interpreting romosozumab for cancer treatment-induced bone loss: measurement, missing data, and surveillance\".","authors":"Hirotaka Koyanagi, Shohei Tsujino, Chigusa Sawamura, Katsunori Tozuka, Tabu Gokita","doi":"10.1007/s00198-026-08233-w","DOIUrl":"https://doi.org/10.1007/s00198-026-08233-w","url":null,"abstract":"","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122898","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}