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":"Objectively measured sleep parameters and bone health: results from the Human Phenotype Project (HPP) cohort.","authors":"Christa Meisinger, Dennis Freuer","doi":"10.1007/s00198-026-08041-2","DOIUrl":"10.1007/s00198-026-08041-2","url":null,"abstract":"<p><p>Using highly precise measurements, we found obstructive sleep apnea (OSA) was linked to poorer bone health at most sites. Higher oxygen saturation, rather than sleep efficiency, was beneficial. Total sleep duration was partially nonlinearly related to bone health. Patients with chronic sleep problems should be screened for low BMD.</p><p><strong>Aim: </strong>Previous studies have shown associations between sleep characteristics and bone health, but findings are inconsistent. This study investigated the relationships between objectively measured sleep characteristics and bone mineral density (BMD) as well as bone mineral content (BMC) using dual-energy X-ray absorptiometry (DXA) measurements at various skeletal sites.</p><p><strong>Methods: </strong>The analysis included data from 4690 participants aged 40-70 years in the Human Phenotype Project (HPP) cohort. Associations between total sleep time, mean oxygen saturation (%), sleep efficiency, and obstructive sleep apnea (OSA) indices-respiratory disturbance index (RDI), apnea-hypopnea index (AHI), and oxygen desaturation index (ODI)-measured by a sleep apnea monitoring device, and BMD/BMC assessed by DXA imaging of various skeletal components were examined using multivariable linear regression models. All associations were tested for interactions with age.</p><p><strong>Results: </strong>OSA indices (AHI, ODI, RDI) showed linear or non-linear inverse associations with BMD or BMC at most bone sites. The negative associations of AHI and ODI with spine outcomes were non-linear, with stronger effects at higher index ranges. Total sleep time was inversely associated with BMC of the legs, femoral neck, and femoral shaft, with consistent estimates for BMD. U-shaped associations were observed between total sleep time and BMC of both arms and spine L2. Oxygen saturation was positively associated with BMD and BMC of the total body, arms, head, and spine. Sleep efficiency showed no association with any outcomes. Age-stratified analyses revealed stronger estimates in younger participants.</p><p><strong>Conclusions: </strong>OSA appears to be associated with reduced BMD and BMC, even in individuals without other major health conditions. These findings highlight the need for increased clinical awareness, including BMD screening for OSA patients, and, on the other hand, the detection of sleep problems in patients with osteoporosis or reduced BMD and BMC.</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":"2017-2026"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795677","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":"Biomechanical heterogeneity of Tai Chi styles may influence bone mineral density responses.","authors":"Chao-Chun Huang, Yi-Ching Chu","doi":"10.1007/s00198-026-08087-2","DOIUrl":"10.1007/s00198-026-08087-2","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":"2163-2164"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102172","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 \"Romosozumab versus teriparatide and risk of all-cause mortality in patients with osteoporosis: a real-world propensity score-matched cohort study\".","authors":"Jialin Yang, Dongdong Cao, Chao Du","doi":"10.1007/s00198-026-08092-5","DOIUrl":"10.1007/s00198-026-08092-5","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":"2165-2166"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166833","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 OSIN-D-26-01484: \"Clarifying statistical methods in a TriNetX analysis of statins and osteoporosis in CKD patients\".","authors":"Ping-Hsun Wu, Yi-Ting Lin, Jian-Chih Chen, Sung-Yen Lin, Li-Ting Kao, Yu-Ting Huang, Pei-Shan Ho, Chung-Hwan Chen, Tien-Ching Lee","doi":"10.1007/s00198-026-08167-3","DOIUrl":"10.1007/s00198-026-08167-3","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":"2151-2152"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623469","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 BMD in opportunistic screening: population-specific reporting and referral thresholds.","authors":"Changping Tian, Yapeng Xing, Ke Xue","doi":"10.1007/s00198-026-08217-w","DOIUrl":"10.1007/s00198-026-08217-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":"2157-2158"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820963","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":"Diagnostic performance of lumbar computed tomography Hounsfield unit thresholds for osteoporosis and osteopenia: a systematic review and meta-analysis.","authors":"Omar Lubbad, Akram Hagos, Laila Lubbad, Yahya El-Tahlawy, Giuseppe Lambros Morassi, Nektarios K Mazarakis","doi":"10.1007/s00198-026-07863-4","DOIUrl":"10.1007/s00198-026-07863-4","url":null,"abstract":"<p><p>Vertebral Hounsfield units (HU) measured on routine computed tomography (CT) have emerged as an accessible surrogate for bone mineral density (BMD), yet reported diagnostic thresholds vary widely. This meta-analysis aimed to define and test unified HU cut-offs for identifying osteopenia and osteoporosis. PubMed, EMBASE, MEDLINE, and Cochrane Library were searched to September 2025 for studies reporting vertebral HU referenced to dual-energy X-ray absorptiometry or quantitative CT. Continuous data were synthesised as standardised mean differences (SMD) and diagnostic accuracy using bivariate random-effects models. Reported thresholds were pooled to generate balanced, sensitivity-, and specificity-optimised cut-offs, tested through reconstructed 2 × 2 analyses. Twenty studies including 5016 patients met inclusion criteria. HU values were significantly lower in osteopenia and osteoporosis, with pooled SMD -2.78 for low BMD versus normal and -1.57 for osteoporosis versus non-osteoporotic bone (p < 0.001). Overall diagnostic performance was excellent (AUC 0.865; sensitivity 0.80; specificity 0.83). Pooled thresholds for osteopenia were 138.9 HU (balanced), 166.7 HU (high), and 111.2 HU (low); and for osteoporosis, 104.6 HU (balanced), 122.3 HU (high), and 86.8 HU (low). Decreasing HU was associated with stepwise increases in relative risk for low BMD. Vertebral HU strongly discriminate normal from low BMD, providing clinically applicable pooled thresholds for opportunistic CT-based screening and perioperative risk assessment. HU assessment could facilitate early detection and management of osteopenia and osteoporosis, particularly in surgical candidates.</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":"1899-1913"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648803","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":"Vertebral fractures identified on lateral DXA images by deep learning predict incident fractures in older women.","authors":"Mattias Lorentzon, Victor Wåhlstrand, Jennifer Alvén, Ida Häggström, Lisa Johansson","doi":"10.1007/s00198-026-08072-9","DOIUrl":"10.1007/s00198-026-08072-9","url":null,"abstract":"<p><p>XVFA is an AI-based method for identifying vertebral fractures on DXA images. In 423 women followed for 8 years, vertebral fractures identified by XVFA or manual assessment were associated with a twofold increased risk of incident fractures. XVFA predicted fracture risk comparably to manual assessment, supporting automated vertebral fracture detection.</p><p><strong>Purpose: </strong>Vertebral fractures (VFs), identified by vertebral fracture assessment (VFA) using dual-energy X-ray absorptiometry (DXA), predict incident fractures independently of clinical risk factors (CRFs) and bone mineral density (BMD). Most VFs remain clinically unrecognized. This study evaluated whether VFs identified using a deep learning-based method on lateral DXA images predict incident fractures comparably to manual VFA.</p><p><strong>Methods: </strong>Associations between prevalent VFs and incident fractures were investigated in 423 women from the population-based SUPERB study who were not included in development of the explainable deep learning model (XVFA). Vertebrae were classified by manual VFA and XVFA. Incident fractures were X-ray verified. Cox proportional hazards models assessed fracture risk adjusted for CRFs and femoral neck (FN) BMD.</p><p><strong>Results: </strong>Manual VFA reading and XVFA were used on baseline lateral images and classified 4563 and 5532 vertebrae, respectively, with numerical differences partly reflecting image quality limitations. VFs were identified in 102 women by manual VFA and 187 by XVFA. During 8 years of follow-up, incident fractures occurred in 48% of women with manual VFA VFs and 43% with XVFA VFs, vs 20% and 16% of women without VFs. Women with VFs had a higher fracture risk whether identified manually (HR 2.04; 95% CI, 1.35-3.07) or by XVFA (HR 2.32; 95% CI, 1.55-3.48), compared with women without VFs. Results remained significant after adjustment for CRFs and FN BMD.</p><p><strong>Conclusion: </strong>Automated XVFA predicted incident fractures similarly to manual assessment. These findings support the clinical utility of deep learning-based VF detection, which may enhance fracture risk assessment and management in routine practice.</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":"2073-2087"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877208","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":"Diabetes progression and its association with fracture risk in type 2 diabetes.","authors":"Bongsung Kim, Kyu-Na Lee, Kyungdo Han, Mee Kyoung Kim","doi":"10.1007/s00198-026-08079-2","DOIUrl":"10.1007/s00198-026-08079-2","url":null,"abstract":"<p><p>People with type 2 diabetes mellitus (T2DM) accumulate factors that weaken bone. In over two million adults, fracture risk rose stepwise as diabetes progressed, with the steepest increase for hip fractures. A simple progression score using routine clinical data may help flag patients who need earlier bone-protective care.</p><p><strong>Purpose: </strong>Patients with type 2 diabetes mellitus (T2DM) are often exposed to multiple factors contributing to bone fragility-such as poor glycemic control, long duration of exposure to hyperglycemia, and comorbidities. Because these factors often accumulate over time, we examined whether fracture risk increases with diabetes progression.</p><p><strong>Methods: </strong>We analyzed data from 2,069,920 patients with T2DM from the Korean National Health Information Database who underwent health examinations in 2015-2016. Patients with a prior history of fractures or who died within one year were excluded. Diabetes progression was scored from 0 to 6 based on the number of oral glucose-lowering drugs, disease duration, insulin use, and presence of chronic kidney disease, cardiovascular disease (CVD), or diabetic retinopathy. Incident fractures were tracked until 2023 using ICD-10 codes.</p><p><strong>Results: </strong>Over a median follow-up of 6.4 years, 169,595 fractures occurred, including 69,723 vertebral and 23,581 hip fractures. Each component of diabetes progression was independently associated with fracture risk (hazard ratios [HRs] ranging from 1.14 to 1.40). Insulin use (HR, 1.40; 95% confidence interval [CI]: 1.38-1.42) and CVD (HR, 1.26; 95% CI: 1.24-1.28) conferred notably higher risks. Fracture risk increased progressively with higher progression scores (HRs for score 4: 1.60; 95% CI: 1.56-1.64; HRs for score 5: 1.87; 95% CI: 1.78-1.96). The magnitude of increase was more pronounced for hip fractures.</p><p><strong>Conclusion: </strong>The risk of fractures increased incrementally in parallel with diabetes progression, most notably for hip fractures. Diabetes progression metrics may help identify patients at elevated fracture risk.</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":"2109-2119"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985092","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":"Fragility fractures of the pelvis and long-term outcomes among older adults with osteoporosis: a real-world cohort study.","authors":"Po-Chun Wang, Hung Su, Lien-Chen Wu, Yi-Jie Kuo, Yu-Pin Chen","doi":"10.1007/s00198-026-08060-z","DOIUrl":"10.1007/s00198-026-08060-z","url":null,"abstract":"<p><p>In this global real-world study, fragility fractures of the pelvis were associated with increased risks of mortality (HR 1.63; 95% CI 1.58-1.69) and subsequent fractures (HR 2.95) in older adults with osteoporosis. Subgroup analyses further indicated markedly higher relative fracture risks among patients aged 75-79 years (HR 4.94).</p><p><strong>Purpose: </strong>Fragility fractures of the pelvis (FFPs) are increasingly recognized in older adults with osteoporosis; however, their long-term prognostic impact remains incompletely defined. This study evaluated the risks of mortality, hospital readmission, subsequent fractures, and immobility-related complications associated with FFP in osteoporotic older adults.</p><p><strong>Methods: </strong>We conducted a global, retrospective cohort study using the TriNetX Research Network. Patients aged 65 years or older with osteoporosis were categorized into an FFP group and a non-FFP control group. Propensity score matching was performed in a 1:1 ratio to balance baseline covariates. Primary outcomes included mortality, hospital readmission, and subsequent fractures, assessed at 1-, 3-, and 5-year follow-up. Secondary outcomes comprised immobility-related complications. Age-stratified subgroup analyses were conducted to evaluate differential risk patterns.</p><p><strong>Results: </strong>After matching, 76,556 patients (38,278 per group) were included. Over 5 years of follow-up, patients with FFP exhibited significantly higher risks of mortality (HR 1.59; 95% CI 1.54-1.64), hospital readmission (HR 1.98; 95% CI 1.93-2.03), and subsequent fractures (HR 2.86; 95% CI 2.76-2.96) compared with controls. FFP was also associated with increased risks of immobility-related complications, including infections, thromboembolic events, and pressure ulcers. Analyses stratifying patients aged 65-79 years into three subgroups yielded consistent and highly elevated relative risks across all strata, whereas absolute event burdens were greatest among those aged 80 years or older.</p><p><strong>Conclusions: </strong>FFPs are associated with substantially increased long-term mortality, morbidity, and healthcare utilization in older adults with osteoporosis. These findings establish FFP as a high-risk condition warranting proactive, age-tailored secondary prevention, functional rehabilitation, and long-term care 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":"2027-2036"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864918","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":"Postpartum timing of teriparatide initiation and BMD response in pregnancy- and lactation-associated osteoporosis: an observational study.","authors":"Lauren K Lynch, Mafo Kamanda-Kosseh, Sanchita Agarwal, Elizabeth Shane, Stephanie Shiau, Jasmine Douglas, Dany El-Najjar, Ivelisse Colon, Mildense Del Orbe, Mariana Bucovsky, Adi Cohen","doi":"10.1007/s00198-026-08061-y","DOIUrl":"10.1007/s00198-026-08061-y","url":null,"abstract":"<p><p>This observational study of teriparatide-treated PLO documents a substantial effect of postpartum treatment timing on BMD response. Women who initiated teriparatide < 12 months (M) postpartum had two-threefold larger BMD increases than those initiating teriparatide ≥ 12M postpartum. This study provides important data to inform treatment response expectations in clinical care of teriparatide-treated PLO.</p><p><strong>Purpose: </strong>Pregnancy- and lactation-associated osteoporosis (PLO) describes an early-onset osteoporosis presentation with low- or no-trauma fractures associated with pregnancy/lactation; BMD at presentation is often extremely low. PLO fractures occur in the context of skeletal demineralization associated with pregnancy/lactation; natural BMD recovery is expected postpartum/postweaning, but BMD often remains quite low. Optimal management for PLO is uncertain. Teriparatide is the most common medication investigated. Observational studies document larger average BMD increases on teriparatide versus natural recovery-but individual response varies. Since treatment may overlap with the skeletally dynamic postweaning recovery period, we hypothesized that postpartum treatment timing would affect BMD response to teriparatide.</p><p><strong>Method: </strong>Within our PLO Registry, BMD was assessed at baseline, 6M, and 12M in 31 women with PLO who initiated teriparatide either < 12M postpartum (EarlyRx, n = 10, initiation 7 ± 3 M postpartum) or ≥ 12M postpartum (DelayedRx, n = 21, initiation 36 ± 29 M postpartum). Groups were similar in terms of age, BMI, parity, number of fractures, and breastfeeding duration.</p><p><strong>Results: </strong>As expected, based on known postpartum bone physiology, baseline BMD was lower in EarlyRx vs. DelayedRx. Teriparatide was associated with significant BMD increases in both timing groups-but response differed substantially. Increases at 12M in the EarlyRx group (LS:+ 21 ± 12%, TH:+ 9 ± 6%, and FN:+ 7 ± 6%, all p < 0.01) were two-threefold larger than the DelayedRx group (LS:+ 8 ± 5%, TH:+ 4 ± 4%, and FN:+ 2 ± 3%, all p < 0.05). This effect was reproduced after controlling for baseline BMD.</p><p><strong>Conclusion: </strong>These data highlight the complexity of assessing treatment response in the context of postpartum bone physiology and can inform treatment response expectations for women with PLO.</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":"2063-2072"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871368","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}