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":"Peak bone mass development in U.S. females with varied physical activity patterns: a longitudinal view using three maturational clocks.","authors":"Jodi N Dowthwaite, Stephanie A Kliethermes, Tim J Cole, Tamara A Scerpella","doi":"10.1007/s00198-026-08189-x","DOIUrl":"https://doi.org/10.1007/s00198-026-08189-x","url":null,"abstract":"<p><p>Biological timing of peak bone mass is poorly characterized. Using whole body bone mass growth curves from childhood into adulthood, we show peak bone mass is reached 7 years after peak height velocity, 6 years post-menarche, and 19 years after birth. Early post-menarcheal screening would provide a window for intervention.</p><p><strong>Purpose: </strong>We evaluated bone mass growth curves for individuals representing diverse physical activity patterns from childhood into adulthood. We used three age clocks centered on birth (chronological age, CHRON_age), menarche (gynecological age, GYN_age), and peak height velocity (PHV_age). We evaluated whether this methodology improved estimates of peak bone mass (PBM) to inform the timing of interventions to boost PBM.</p><p><strong>Methods: </strong>Whole-body bone mineral content (WBBMC, g) was measured annually by DXA, with semi-annual stature measurements, in young females with heterogeneous musculoskeletal loading patterns. Data included participants with known menarche dates and ≥ 3 serial measures (CHRON_age 8-25 years). Super-imposition by translation and rotation (SITAR) longitudinal growth curves were modeled to extract individual ages at PHV to model PHV_age curves. SITAR models identified ages at peak velocity for WBBMC accrual (PKVBMC) and PBM (WBBMC gain < 3% to < 1%) using all three clocks.</p><p><strong>Results: </strong>Data were modeled for 137 females, median 11 scans per individual (IQR (7,12); range 3-17; total 1343 scans). Mean ages (years) at PHV and menarche were 11.9 (SD 0.9) and 13.2 (SD 1.3), respectively. Mean ages at PKVBMC and PBM were CHRON_age (PKVBMC 13.0, PBM 17-19), GYN_age (PKVBMC 0.0, PBM +4 to +6), and PHV_age (PKVBMC, +1.1; PBM, +5 to +7).</p><p><strong>Conclusion: </strong>On average, females reached PBM by CHRON_age 19 years, 6 years post-menarche, or 7 years post-PHV. Menarche-centered and PHV-centered analyses provide clocks for effective clinical assessment of early, average, and late maturers; we favor menarche-centering to handle divergent timing of menarche relative to PHV, which may be common in physically active females.</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":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815486","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 of response to \"letter of response to 'postpartum timing of teriparatide initiation and BMD response in pregnancy- and lactation-associated osteoporosis: an observational study'\".","authors":"Lauren K Lynch, Elizabeth Shane, Adi Cohen","doi":"10.1007/s00198-026-08194-0","DOIUrl":"https://doi.org/10.1007/s00198-026-08194-0","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":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815476","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":"Abaloparatide and pelvic fracture healing: a phase 2 randomized placebo-controlled trial.","authors":"Jeri W Nieves, Felicia Cosman, Donald McMahon, Heather Berman, Roger J Bartolotta, J Jacob Kazam, Isabelle Hentschel, Kenneth Egol, David Forsh, Yuan-Shan Zhu, Jae Eun Yoo, Joseph Lane","doi":"10.1007/s00198-026-08176-2","DOIUrl":"https://doi.org/10.1007/s00198-026-08176-2","url":null,"abstract":"<p><p>Pelvic fractures result in prolonged pain and immobility. In a randomized controlled trial of patients with pelvic fracture, whether abaloparatide (ABL) vs. placebo (PBO) improves healing at 3 months was evaluated. There was no significant difference in CT radiologic healing, physical performance, or change in pain in ABL vs. placebo.</p><p><strong>Purpose: </strong>To determine if abaloparatide (ABL) vs. placebo (PBO) improves radiologic healing, pain, and functional outcome at 3 months in patients with pelvic fracture.</p><p><strong>Methods: </strong>Postmenopausal women and men ≥ 50 years old, enrolled within 4 weeks of pelvic fracture (n = 48), were randomized to blinded ABL vs. PBO. The primary endpoint, fracture healing at 3 months, was assessed by two radiologists using a 5-point scale for cortical bridging from CT images comparing groups by Jonckheere-Terpstra test. The odds of healing (3 or 4 cortices bridged) were analyzed with Mantel-Haenszel relative risks (RR). Pain was assessed monthly by Numeric Rating Scale (NRS). The Short Physical Performance Battery (SPPB; walk speed, chair stands, and balance) evaluated functional mobility.</p><p><strong>Results: </strong>Groups were balanced with a mean age = 82, 93% were female, 98% had multiple rami fractures, 67% had sacral fracture, and 36% had ≥ 1 displaced fracture. CT images at 3 months showed no significant difference in bridging score distribution (indicator of healing) in patients with ABL vs. PBO (p = 0.15) after adjusting for age, sacral fracture, displacement, or compliance. When evaluating individual fractures (n = 81), similar bridging scores were seen with ABL and PBO (p = 0.13). When patients were stratified as healed or not healed, 39% were healed with ABL and 64% healed with PBO (RR 0.61; 95% CI 0.33, 1.12). When looking at the 81 individual fractures, 47% were healed with ABL and 53% healed with PBO (RR = 0.88; 95% CI 0.55, 1.40). Using least square means controlling for age, sacral, and displaced fracture, NRS pain score was higher in the placebo than the ABL group at baseline (p < 0.05), but there were no further group differences in change in pain score SPPB and TUG scores improved over time in both groups without group differences.</p><p><strong>Conclusion: </strong>In this small study, there was no significant difference in CT radiologic healing, physical performance, or change in pain with ABL vs. placebo in patients with acute pelvic fracture.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT04249232 registered January 27, 2020.</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":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805392","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":"Restoring skeletal remodeling in antiresorptive-treated patients: clinical outcomes of teriparatide in medication-related osteonecrosis of the jaw.","authors":"Ana Karina Sarmiento Liévano, Hannah Vanessa Ceballos Sarmiento, Nicolás Jiménez Vega, Yeisson Alejandro Arias Avila, Maria Paula Monroy Becerra","doi":"10.1007/s00198-026-08150-y","DOIUrl":"https://doi.org/10.1007/s00198-026-08150-y","url":null,"abstract":"<p><p>Medication-related osteonecrosis of the jaw (MRONJ) is a challenging complication associated with antiresorptive and antiangiogenic therapies. Prolonged suppression of bone remodeling has been implicated as a key mechanism in its pathophysiology. Teriparatide, an osteoanabolic agent that restores coupled bone remodeling, has been proposed as a potential therapeutic strategy. This review aimed to synthesize reported clinical outcomes of teriparatide use in MRONJ within a systemic remodeling-based framework. We conducted a structured descriptive review based on a systematic literature search and reported in accordance with PRISMA 2020. Studies reporting therapeutic use of teriparatide in established MRONJ were included regardless of the triggering medication. Data were extracted on patient characteristics, MRONJ stage, lesion site, antiresorptive exposure, teriparatide regimen, antiresorptive interruption, antiresorptive type, and clinical outcomes. Because of substantial heterogeneity in study design, patient populations, co-interventions, and outcome reporting, evidence was synthesized qualitatively. Thirty-four publications including 207 patients were included. Clinical outcomes were available for 201 patients: complete coverage/healing was reported in 163, partial improvement in 24, no change in 12, and worsening in 2. Teriparatide discontinuation or dropout after treatment initiation was reported in 13 patients. Stage 2 disease predominated among stageable cases, mandibular involvement was the most frequent anatomical site, and daily teriparatide dosing was more commonly reported than weekly regimens. Bisphosphonate exposure predominated, whereas denosumab-associated cases were fewer; therefore, differential effectiveness by antiresorptive class could not be determined. Published reports describe frequent clinical improvement after teriparatide use in MRONJ. However, the evidence remains descriptive, heterogeneous, and commonly confounded by concomitant therapies. These findings support a biologically plausible remodeling-based interpretation but do not establish efficacy or define teriparatide as standard therapy.</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":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805368","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":"Bracing versus balloon kyphoplasty for acute osteoporotic vertebral fractures with poor prognostic radiological factors: a propensity score-matched comparison.","authors":"Hiroyuki Inose, Shinji Takahashi, Masatoshi Teraguchi, Tsuyoshi Kato, Kentaro Yamada, Hiroyuki Yasuda, Masaki Terakawa, Masakazu Minetama, Yukihiro Nakagawa, Toshitaka Yoshii","doi":"10.1007/s00198-026-08195-z","DOIUrl":"https://doi.org/10.1007/s00198-026-08195-z","url":null,"abstract":"<p><p>Among acute osteoporotic vertebral fractures with poor prognostic MRI findings, early balloon kyphoplasty did not improve 12-week pain compared with bracing after propensity score matching. However, kyphoplasty better preserved vertebral body height, suggesting that its main early benefit in this subgroup may be structural rather than analgesic.</p><p><strong>Purpose: </strong>The optimal management for acute osteoporotic vertebral fractures (OVFs) with radiological signs suggesting a poor prognosis remains controversial. This study aimed to compare 12-week clinical and radiographic outcomes of early balloon kyphoplasty (BKP) versus brace treatment in acute OVFs with poor prognostic magnetic resonance imaging (MRI) findings.</p><p><strong>Methods: </strong>We compared a prospective BKP cohort (n = 82) with historical brace-treated controls (n = 62) from a prior randomized trial. Eligible patients were aged ≥ 65 years, had acute OVFs with fluid or diffuse low-intensity signal on T2-weighted MRI, and had back pain visual analog scale (VAS) scores ≥ 4/10. The primary outcome was 12-week back pain VAS; the secondary outcome was anterior vertebral body compression percentage (AVBCP). The primary analysis involved a direct comparison of these 12-week post-treatment measurements between the BKP and brace groups. One-to-one propensity score matching was performed using age, sex, and the anatomical location of the fracture (thoracic, thoracolumbar junction, or lumbar).</p><p><strong>Results: </strong>Back pain improved significantly from baseline to 12 weeks within both the BKP group (from 73.6 ± 27.3 to 21.8 ± 19.5, p < 0.0001) and the brace group (from 74.9 ± 23.9 to 30.2 ± 23.3, p < 0.0001). In the crude analysis, BKP was associated with lower VAS scores (21.8 ± 19.5 vs. 30.2 ± 23.3, p = 0.047) and higher AVBCP (67.4 ± 12.3% vs. 49.4 ± 14.1%, p < 0.0001) at 12 weeks. After propensity score matching, 42 pairs were analyzed; no significant between-group difference in 12-week VAS was observed (23.5 ± 20.7 in the BKP group vs. 27.2 ± 21.0 in the brace group, p = 0.45), whereas AVBCP remained significantly higher in the BKP group (66.4 ± 13.3% vs. 48.6 ± 14.7%, p < 0.0001).</p><p><strong>Conclusion: </strong>In acute OVFs with poor prognostic radiological factors, early BKP did not provide superior 12-week pain relief compared with bracing after adjustment for baseline confounders. However, BKP was more effective in limiting early vertebral body collapse.</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":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763534","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":"Parity, age at first birth, breastfeeding, and risk of major osteoporotic fractures in middle-aged women. The HUNT study.","authors":"Maryam Gharehkhani, Ingebjørg Tronstad, Tom Ivar Lund Nilsen, Sigrid Anna Aalberg Vikjord, Jonas Johansson, Mari Hoff, Arnulf Langhammer, Julie Horn","doi":"10.1007/s00198-026-08155-7","DOIUrl":"https://doi.org/10.1007/s00198-026-08155-7","url":null,"abstract":"<p><p>This population-based cohort study investigated the associations of parity, age at first birth, and breastfeeding duration with risk of major osteoporotic fractures in Norwegian women. Higher parity, higher age at first birth, and longer breastfeeding duration were associated with modestly reduced fracture risk.</p><p><strong>Purpose: </strong>Reproductive factors may influence long-term bone health, yet studies on their associations with fracture risk have yielded inconsistent results. This study examined associations between parity, age at first birth, and lifetime breastfeeding duration with risk of major osteoporotic fractures in Norwegian women.</p><p><strong>Methods: </strong>We included 41,274 women aged ≥ 45 years in the Trøndelag Health Study (HUNT) linked with the Medical Birth Registry of Norway and hospital-based fracture records. We used Cox proportional hazards regression to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for first major osteoporotic fracture (MOF) in hip, spine, proximal humerus, or distal forearm.</p><p><strong>Results: </strong>A total of 7520 MOF occurred during 501,204 person-years (median follow-up time: 12.3 years). Compared to women with two births, those with four births had lower fracture risk (HR: 0.92, 95% CI: 0.86-0.98). Each additional birth was associated with reduced fracture risk (HR: 0.98, 95% CI: 0.96-0.99). Women with first birth at age ≥ 30 showed HR of 0.92 (95% CI: 0.85-1.00) compared to those with first birth at ages 20-24. Women with the longest breastfeeding duration (≥ 21 months) had lower fracture risk (HR: 0.89, 95% CI: 0.76-1.02) compared to those who never breastfed.</p><p><strong>Conclusion: </strong>Higher parity, later age at first birth, and longer breastfeeding duration were each associated with modest reductions in fracture risk after adjusting for potential confounding factors. These findings suggest that reproductive history may have long-lasting effects on women's skeletal health and could be considered in fracture 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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762517","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":"Effects of weighted vest on bone health and body fat in middle-aged and older adults: a systematic review and meta-analysis.","authors":"Xingfei Wang, Lewei Zhou, Tengbo Shi, Xiangxi Meng, Chenyang Li, Chenyi Zhu, Chaowei Guo, Chen Yue, Yanfeng Tang, Youwen Liu","doi":"10.1007/s00198-026-08196-y","DOIUrl":"https://doi.org/10.1007/s00198-026-08196-y","url":null,"abstract":"<p><p>This systematic review and meta-analysis of nine randomized controlled trials assesses whether weighted vests enhance bone health and reduce body fat in middle-aged and older adults. Vest plus exercise significantly increased bone mineral density and reduced body fat compared to usual activity. Adding a vest to existing exercise provided additional fat reduction but no significant benefit to bone health.</p><p><strong>Background: </strong>Weighted vests may improve bone health and body composition in middle-aged and older adults, but evidence is heterogeneous, and additive effects beyond exercise remain unclear.</p><p><strong>Objective: </strong>To evaluate the effects of weighted vest interventions on bone mineral density (BMD), bone turnover markers, and body fat mass in middle-aged and older adults, comparing vest plus exercise versus usual activity and versus exercise alone.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus from inception to March 9, 2026, and supplemented with manual searches (PROSPERO: CRD420261335254). Meta-analyses used fixed-effect models where feasible; otherwise narrative synthesis. GRADE assessed certainty.</p><p><strong>Results: </strong>Nine RCTs (368 participants) were included. Vest plus exercise significantly improved femoral neck BMD (SMD = 0.59, 95% CI: 0.05 to 1.13, P = 0.03; I² = 37%) and lumbar spine BMD (SMD = 0.73, 95% CI: 0.29 to 1.16, P = 0.001; I² = 0%) compared to usual activity, and significantly reduced body fat mass in both subgroups (vs. usual activity: MD = -2.67 kg, 95% CI: -4.08 to -1.27, P = 0.0002; vs. exercise alone: MD = -0.73 kg, 95% CI: -1.20 to -0.27, P = 0.002). Adding a vest to exercise alone did not confer a significant BMD benefit compared with exercise alone, although this finding is derived from a single study. Body fat mass evidence was high certainty; other outcomes were low to moderate.</p><p><strong>Conclusions: </strong>Vest plus exercise improves BMD and reduces adiposity versus usual activity. As an exercise adjunct, it yields additional fat loss without confirmed skeletal benefit, based on limited data. Weighted vests present a viable option for generally healthy middle-aged and older adults, although further research is needed to determine whether similar effects occur in individuals with restricted exercise capacity.</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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764815","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":"AI-derived opportunistic screening using chest radiographs identifies age- and sex-associated bone mineral density patterns and supports earlier osteoporosis evaluation.","authors":"Yi-Chieh Huang, Sheng-Wen Kao, Yi-Chou Chen, Ming-Te Cheng","doi":"10.1007/s00198-026-08192-2","DOIUrl":"https://doi.org/10.1007/s00198-026-08192-2","url":null,"abstract":"<p><p>AI-derived opportunistic screening using routine chest radiographs was evaluated in 6,028 adults and internally validated against DXA in a subset of participants. AI-derived T-scores identified marked age- and sex-associated skeletal differences, particularly among women aged 50-59 years, a population often underrepresented in current DXA-based screening strategies.</p><p><strong>Background: </strong>Osteoporosis is associated with substantial fracture-related morbidity, yet many individuals with low bone mineral density (BMD) remain undetected during midlife, when routine dual-energy X-ray absorptiometry (DXA) is not commonly performed. We evaluated whether AI-derived opportunistic screening using routine chest radiographs could identify age-associated skeletal patterns and potential high-risk periods for osteoporosis evaluation.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, 6,028 adults aged ≥ 50 years underwent chest radiographs with AI-derived lumbar spine BMD estimation using a validated deep learning model. Participants were stratified by sex and 5-year age cohorts to assess age-associated differences in AI-derived T-scores and osteoporosis prevalence. In an internal validation subset (n = 446), AI-derived T-scores were compared with DXA measurements using correlation, diagnostic performance, and Bland-Altman agreement analyses.</p><p><strong>Results: </strong>The mean AI-derived T-score was - 1.64 ± 1.08; women exhibited significantly lower T-scores than men (- 2.15 ± 0.97 vs. - 1.19 ± 0.96; P < 0.001). Lower mean T-scores and higher osteoporosis prevalence were observed with advancing age in both sexes. Osteoporosis prevalence increased from 10.3% (ages 50-54) to 67.0% (≥ 80) in women, compared to 5.0% and 24.6% in men. A marked between-group difference in mean T-scores was observed in women between the 50-54 and 55-59 age groups, identifying a potentially important early postmenopausal age range. Female sex was independently associated with osteoporosis (OR 7.04; 95% CI 5.22-9.50). In the validation subset, AI-derived T-scores demonstrated strong correlation with lumbar spine DXA T-scores (r = 0.859) and moderate-to-strong correlation with total hip (r = 0.730) and femoral neck (r = 0.635) T-scores (all P < 0.001).</p><p><strong>Conclusion: </strong>AI-derived opportunistic screening using chest radiographs identified marked age- and sex-associated differences in skeletal status, particularly among women in the early postmenopausal age range. These findings suggest that AI-derived chest radiograph assessment may help identify individuals who could benefit from further osteoporosis evaluation. Prospective studies are needed to validate potential screening thresholds and clinical implementation strategies.</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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766278","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":"Bone organic matrix quality indices associate with fragility fracture occurrence independently of bone mineral density values.","authors":"Eleftherios P Paschalis, Sonja Gamsjaeger, Norbert Hassler, Susan P Bare, Mohammed P Akhter","doi":"10.1007/s00198-026-08182-4","DOIUrl":"10.1007/s00198-026-08182-4","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Bone mineral density measures are not the sole determinant whether a patient suffers fragility fractures. We tested the hypothesis that changes in bone organic matrix quality indices strongly associate with Fx occurrence. Fx-suffering patients have altered quantitative and qualitative organic matrix attributes, offering new insights into the pathogenesis of Fx. Fragility fractures present a considerable socioeconomic burden. We tested the hypothesis that organic matrix attributes associate with fragility fracture occurrence independent of BMD. We used Raman microspectroscopy to analyze iliac crest biopsies from age- and BMD-matched postmenopausal women that either sustained (n = 60) fragility fractures or not (n = 60) in the cortical and cancellous compartments at specific tissue ages. The measured indices were mineral/matrix, mineral crystallinity, nanoporosity, glycosaminoglycan, and pyridinoline contents. Tissue-age unadjusted data were compared by 2-way ANOVA with anatomical compartment and fracture incidence as the two factors, while tissue-age-adjusted data by 2-way ANOVA with tissue age and patient group as the two factors. Tissue-age-unadjusted data indicated differences between anatomical compartments but no differences between the two patient groups. Tissue-age-adjusted data showed that the fracture-sustaining patients had higher mineral/matrix values in both compartments (in cortical, this was due to lower organic matrix content). At forming cortical surfaces, they had higher nanoporosity and lower pyridinoline content. They also had higher glycosaminoglycan content in the interstitial bone of the cancellous compartment. The results indicate that fracture-suffering patients have altered quantitative and qualitative organic matrix attributes. The elevated mineral/matrix in fracture-suffering patients may imply stiffer, thus of decreased toughness, bone, while the decreased pyridinoline content at cortical actively forming surfaces would decrease collagen fiber stiffness. The data of the present study offer new insight into the pathogenesis of fragility fractures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Fragility fractures present a considerable socioeconomic burden. We tested the hypothesis that organic matrix attributes associate with fragility fracture occurrence independent of BMD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used Raman microspectroscopy to analyze iliac crest biopsies from age- and BMD-matched postmenopausal women that either sustained (n=60) fragility fractures or not (n=60) in the cortical and cancellous compartments at specific tissue ages. The measured indices were mineral/matrix, mineral crystallinity, nanoporosity, and glycosaminoglycan, and pyridinoline contents. Tissue-age unadjusted data were compared by 2way ANOVA with anatomical compartment and fracture incidence as the two factors, while tissue-age adjusted data by 2way ANOVA with tissue age and patient group as the two factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;","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":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724212","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":"Validation of the AO Spine Osteoporotic Fracture Classification-effect of geographical region on reliability and reproducibility.","authors":"Sebastian Frederick Bigdon, Julian Scherer, Gaston Camino-Willhuber, Ulrich Spiegl, Andrei Fernandes Joaquim, Chhabra Harvinder Singh, Marcel Dvorak, Gregory Schroeder, Mohammad El-Sharkawi, Richard Bransford, Lorin Michael Benneker, Klaus John Schnake","doi":"10.1007/s00198-026-08112-4","DOIUrl":"10.1007/s00198-026-08112-4","url":null,"abstract":"<p><p>Regional differences affect the reliability of the AO Spine-DGOU Osteoporotic Fracture Classification. European participants showed the highest agreement. This study underscores the need for addressing regional factors to improve the system's global clinical utility.</p><p><strong>Purpose: </strong>To evaluate the influence of geographic region on the reliability and reproducibility of the AO Spine-DGOU Osteoporotic Fracture Classification System.</p><p><strong>Methods: </strong>This study included 320 participants from various global regions who classified 27 cases of osteoporotic vertebral fractures using the AO Spine-DGOU system which categorizes the fractures to 5 subtypes (OF 1-OF 5). Participants underwent training via an online webinar. Interobserver reliability and intraobserver reproducibility were assessed using Fleiss' kappa coefficient, and agreement with a gold standard committee was evaluated.</p><p><strong>Results: </strong>The classification system showed moderate to substantial agreement with the gold standard globally (initial kappa 0.58, improving to 0.61). European participants had the highest agreement (kappa 0.64 and 0.66). OF4 fractures were most accurately classified, while OF3 fractures showed the least agreement. Intraobserver reliability was highest among European participants. Post hoc analysis indicated significantly better reliability among German-speaking participants compared to other Europeans (kappa 0.79 vs. 0.70, p = 0.0026).</p><p><strong>Conclusion: </strong>The AO Spine-DGOU Osteoporotic Fracture Classification System demonstrates moderate to substantial reliability and reproducibility, with regional differences influenced by factors such as training and clinical experience. This underlines the necessity of proper education adapted to the regional particularities.</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":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727658","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}