Archives of Osteoporosis最新文献

{"title":"Breaking the silence: AI’s contribution to detecting vertebral fractures in opportunistic CT scans in the elderly—a validation study","authors":"Anna Spångeus,&nbsp;Tomas Bjerner,&nbsp;Maria Lindblom,&nbsp;Christoph Götz,&nbsp;Allan Hummer,&nbsp;Christoph Salzlechner,&nbsp;Mischa Woisetschläger","doi":"10.1007/s11657-025-01524-5","DOIUrl":"10.1007/s11657-025-01524-5","url":null,"abstract":"<div><h3>Summary</h3><p>Vertebral fractures frequently go undetected in clinical practice. AI-assisted detection on CT scans demonstrates considerable promise, with a sensitivity of 86% and a specificity of 99%. The performance varied based on sex, and CT kernel, showing superior results in females and in scans using non-bone kernel protocols.</p><h3>Purpose</h3><p>Vertebral fractures (VFs) are highly underdiagnosed, necessitating the development of new identification methods for opportunistic screening in computed tomography (CT) scans. This study validated an AI algorithm (ImageBiopsy Lab [IBL], FLAMINGO) for detecting VFs in a geriatric cohort, with various subgroup analyses including different CT protocols.</p><h3>Methods</h3><p>The performance of the AI in detecting VFs was compared to assessments by two experienced radiologists. A total of 246 thoracic or abdominal CT scans, primarily conducted for purposes other than skeletal examination, were included in the study.</p><h3>Results</h3><p>The patients had a mean age of 84 years (range 62 to 103), with 42% being female. The AI demonstrated high accuracy (0.93), sensitivity (0.86), and specificity (0.99) in detecting moderate to severe VFs. Subgroup analysis revealed accuracy ranging from 0.88 to 0.96, with higher accuracy in females compared to males (0.96 vs. 0.89, <i>p</i> = 0.03) and in scans performed with non-bone kernel versus bone kernel protocols (0.96 vs. 0.88, <i>p</i> = 0.02). No significant differences were found for age, contrast phase, or spinal region.</p><h3>Conclusion</h3><p>The results indicate that the AI algorithm exhibits high performance in a geriatric setting. If effectively integrated with a fracture liaison service, this could enhance VF detection considerable in the future.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-025-01524-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143688524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between dietary protein intake and bone mineral density in adolescents: a cross-sectional study","authors":"Chunhong Guo,&nbsp;Keyi Li,&nbsp;Mingxuan Zheng,&nbsp;Xiaojun Chen,&nbsp;Yishan Yin,&nbsp;Shaohua Chen","doi":"10.1007/s11657-025-01526-3","DOIUrl":"10.1007/s11657-025-01526-3","url":null,"abstract":"<div><h3>Summary</h3><p>Elevated daily protein consumption was significantly correlated with enhanced bone mineral density (BMD) across multiple skeletal sites in adolescents, as observed in the National Health and Nutrition Examination Survey. These results highlight the pivotal role of dietary protein in fostering bone health in the youth.</p><h3>Background</h3><p>The relationship between dietary protein intake and bone mineral density (BMD) remains inconclusive, particularly among adolescents. This study aimed to investigate the association between dietary protein intake and BMD in adolescents.</p><h3>Methods</h3><p>This cross-sectional study utilized data from 12–19-year-old participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2010. Average daily protein intake was calculated from two consecutive 24-h dietary recalls. Dual-energy X-ray absorptiometry (DXA) was used to evaluate the BMD of the total femur, femoral neck, total spine, and lumbar spine. Multivariate linear regression was used to evaluate the association between dietary protein intake and BMD, adjusted for dietary protein intake per 10 g/day and multiple covariates. Stratified analysis, interaction analysis, and sensitivity analysis were performed to assess the consistency of this relationship and identify potential modifiers.</p><h3>Results</h3><p>After excluding missing data, the analysis included 2,640 adolescents. In the fully adjusted model, dietary protein intake showed a significant positive association with both total femur BMD (per 10 g/d: <i>β</i> = 5.25, 95% Cl = 1.69 ~ 8.82) and femoral neck BMD(per 10 g/d: <i>β</i> = 5.23, 95% Cl = 1.56 ~ 8.89). This positive association between dietary protein intake and BMD persisted in sensitivity analyses after multiple interpolation with all covariates missing. Subgroup analyses found no interaction between subgroups, or interaction results showed no clinical significance.</p><h3>Conclusion</h3><p>This study suggests that higher dietary protein intake is associated with increased BMD in US adolescents, highlighting the potential role of protein in adolescent bone health.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone stiffness and strength at the distal radius can be determined using photon-counting CT","authors":"Jilmen Quintiens,&nbsp;Elena Paravisi,&nbsp;Piyush Uniyal,&nbsp;G. Harry van Lenthe","doi":"10.1007/s11657-025-01527-2","DOIUrl":"10.1007/s11657-025-01527-2","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Estimating bone strength aids in osteoporotic fracture risk assessment. Bone strength is usually calculated with a high-resolution CT; however, this modality has limited clinical utility. We demonstrated that clinical photon-counting CT can also be used for bone strength quantification, which facilitates the use of this information in clinical decision-making.</p><h3>Purpose</h3><p>Quantification of bone strength and microarchitecture at the distal radius with high-resolution peripheral quantitative computed tomography (HR-pQCT) can predict osteoporotic fracture risk independently of dual-energy X-ray absorptiometry. Photon-counting CT (PCCT) is a novel imaging technique with larger fields of view, shorter acquisition times, and similar resolution when compared to HR-pQCT. This study aimed to compare the stiffness and strength of the distal radius computed from PCCT and HR-pQCT images.</p><h3>Methods</h3><p>We evaluated a 10.2 mm section of the distal radius from eight cadaveric forearms scanned with PCCT and HR-pQCT at 0.11 mm and 0.061 mm voxel size, respectively. All CT images were converted to voxel-based linear finite element models. Two material models were used: a segmentation-based model with a fixed Young’s modulus of 10 GPa for bone elements, and a density-based model where Young’s modulus was assigned on a voxel-by-voxel basis, based on its gray value. Poisson’s ratio was set to 0.3 for all elements. Axial compression at 1% apparent strain was applied to quantify stiffness; strength was quantified with the Pistoia criterion. In addition, load sharing between cortical and trabecular bone was quantified.</p><h3>Results</h3><p>We found strong correlations between PCCT and HR-pQCT-derived bone stiffness, strength, and cortical and trabecular proportion for segmentation-based models (<i>R</i>² &gt; 0.911; <i>p</i> &lt; 2e-4). Correlation and agreement were higher for density-based models (<i>R</i>² &gt; 0.977; <i>p</i> &lt; 4e-6).</p><h3>Conclusion</h3><p>We demonstrated that PCCT can estimate bone strength with high accuracy and agreement when compared to HR-pQCT. These findings highlight PCCT’s potential in assessing fracture risk in osteoporosis. At the same time, PCCT’s large field of view enables broader usage, at sites different from peripheral limbs.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143667908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between dietary carotenoid intake and vertebral fracture in people aged 50 years and older: a study based on the National Health and Nutrition Examination Survey","authors":"Yuchen Zheng,&nbsp;Wenyu Zhou,&nbsp;Jian Zhang,&nbsp;Tao Lan,&nbsp;Rui Zhang","doi":"10.1007/s11657-025-01508-5","DOIUrl":"10.1007/s11657-025-01508-5","url":null,"abstract":"<div><h3>Summary</h3><p>This study discussed the association between dietary intake of carotenoids and vertebral fractures by analyzing the target data, concluding a result of negative association and providing valuable information on vertebral fracture.</p><h3>Objective</h3><p>This study is to explore the association between dietary intake of carotenoids and vertebral fractures.</p><h3>Methods</h3><p>Data of individuals aged ≥ 50 years from the 2013–2014 National Health and Nutrition Examination Survey (NHANES) database were used in this cross-sectional study. Information on dietary carotenoid intake was obtained from the first 24-h dietary recall interview. Vertebral fractures were assessed using dual-energy x-ray absorptiometry (DXA). The weighted multivariable logistic regression model was established to assess the association between dietary carotenoid intake and risk of vertebral fracture. Subgroup analysis of fracture history and menopausal status was performed for further analysis of this relationship.</p><h3>Results</h3><p>Of the 2053 eligible study subjects, there were 1021 men and 1032 women. Increased β-carotene intake was associated with decreased odds of vertebral fracture in women (odds ratio (OR) = 0.77, 95% confidence interval (CI) 0.60–0.99, <i>P</i> = 0.047), after adjusting for covariates. In men without a history of fracture, lutein and zeaxanthin intake was negatively associated with increased odds of vertebral fracture (OR = 0.70, 95% CI 0.50–0.99, <i>P</i> = 0.048). In women without a history of fracture, increased β-carotene intake was associated with decreased odds of vertebral fracture (OR = 0.78, 95% CI 0.61–0.99, <i>P</i> = 0.047). In postmenopausal women, β-carotene intake was also negatively associated with increased odds of vertebral fracture (OR = 0.77, 95% CI 0.60–0.99, <i>P</i> = 0.048).</p><h3>Conclusion</h3><p>This research concludes a negative association between dietary carotenoid intake, especially β-carotene, and vertebral fractures in women, revealing a potential dietary prevention tactic for vertebral fractures in the future.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-025-01508-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the dietary antioxidant index on bone mineral density gain among mexican adults: a prospective study","authors":"Rogelio F. Jiménez-Ortega,&nbsp;Tania V. López-Pérez,&nbsp;Adriana Becerra‑Cervera,&nbsp;Diana I. Aparicio-Bautista,&nbsp;Nelly Patiño,&nbsp;Guadalupe Salas-Martínez,&nbsp;Jorge Salmerón,&nbsp;Rafael Velázquez‑Cruz,&nbsp;Berenice Rivera‑Paredez","doi":"10.1007/s11657-025-01518-3","DOIUrl":"10.1007/s11657-025-01518-3","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>In the Mexican population, low dietary antioxidant intake (DAI) is associated with reduced bone mineral density (BMD). A decline in DAI over time further contributes to BMD loss, particularly at the total hip, femoral neck, and lumbar spine, with a more pronounced effect in women over 45 years old.</p><h3>Purpose</h3><p>Bone remodeling, balancing resorption and formation, is crucial for bone health. Aging shifts this balance, reducing BMD and increasing osteoporosis risk. Reactive oxygen species (ROS) contribute to bone loss through oxidative stress. Antioxidants may help mitigate this damage, but their impact on BMD in populations with inadequate nutrient intake, like Mexicans, needs to be better understood. This study explores the association between DAI changes and BMD in a Mexican population.</p><h3>Methods</h3><p>Data were sourced from the Health Worker Cohort Study (HWCS), including 1,318 participants (aged ≥ 20) with BMD measurements and complete dietary information at two time points. The study employed a longitudinal design was used, whit data from two waves of the study (2010–2012 and 2017–2019), providing a median follow-up time of 6.4 years for men and 6.8 years for women. Dietary antioxidant intake was assessed using a validated Food Frequency Questionnaire for the Mexican diet. BMD was measured at the femoral neck, total hip, and lumbar spine using dual-energy X-ray absorptiometry (DEXA). Fixed-effects regression models were applied to analyze the association between DAI and BMD at different sites, adjusting for time-varying covariates.</p><h3>Results</h3><p>Changes in DAI scores were associated with lower BMD at various sites. Each unit decrease in DAI over time was associated with a BMD loss of -0.002,-0.004 g/cm² at the total hip, femoral neck, and lumbar spine. Notable declines were observed in women, particularly those over 45 years old, where specific antioxidant components, like zinc, magnesium, and selenium, were linked to lower BMD.</p><h3>Conclusion</h3><p>This study underscores the role of reduced dietary antioxidant intake in contributing lower BMD, particularly among older adults. Diets low in antioxidant may increase the risk of osteoporosis, especially in populations with insufficient nutrient intake.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-025-01518-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An update in bone mineral density status in Spain: the OsteoSER study","authors":"Carmen Gómez-Vaquero,&nbsp;Marta Domínguez-Álvaro,&nbsp;Daniel Seoane-Mato,&nbsp;Pilar Peris Bernal,&nbsp;Santos Castañeda,&nbsp;Eduardo Kanterewicz Binstock,&nbsp;Ramón Mazzucchelli Esteban,&nbsp;Luis Arboleya Rodríguez,&nbsp;Miguel Bernard,&nbsp;Antonio Álvarez-Cienfuegos,&nbsp;Blanca Correa,&nbsp;Luis María Jiménez Liñán,&nbsp;Carmen Mateo Pascual,&nbsp;Ma Mercedes Molina del Rio,&nbsp;Mercedes Retamal Ortiz,&nbsp;Aida Fátima López Laguna,&nbsp;Ruth Molera Valero,&nbsp;Sara Alvar Pariente,&nbsp;Antonio Pascual-Vergara,&nbsp;Adolfo Arias Senso,&nbsp;Nuria Pérez Gutiérrez,&nbsp;Soledad García Frías,&nbsp;David Bouza Alvárez,&nbsp;Susana Sostrés,&nbsp;Daniel Suárez Hernandez,&nbsp;Ana Zamora Casal,&nbsp;Cristina García Ramírez,&nbsp;Enrique González-Dávila,&nbsp;on behalf of the OsteoSER Project Collaborative Group","doi":"10.1007/s11657-025-01520-9","DOIUrl":"10.1007/s11657-025-01520-9","url":null,"abstract":"<div><h3>Summary</h3><p>Bone mineral density (BMD) reference data for the Spanish population come from the Multicenter Research Project on Osteoporosis (MRPO) in 1989. The OsteoSER study updated Spanish BMD reference data, showing similarities with MRPO and NHANES III. Peak bone mass occurred at 20–39 years, positively associated with physical activity and negatively with smoking. Osteopenia affected 54.4%, and osteoporosis 10.7% of adults ≥ 50 years, with higher prevalence in women and increasing with age.</p><h3>Purpose</h3><p>This study aimed to estimate the distribution of BMD in lumbar spine, femoral neck, and total hip in the Spanish population aged ≥ 20 years and compare it with MRPO and NHANES III data.</p><h3>Methods</h3><p>A multicenter cross-sectional observational study was conducted in a White Spanish population aged 20–80 years across 12 urban and rural municipalities. Participants were selected by primary care physicians based on inclusion criteria (stratified by sex, age, and BMI) and exclusion criteria (artifacts in BMD imaging in participants of all ages and conditions affecting bone density in younger participants). A vehicle with a Hologic® Horizon W densitometer traveled to each municipality.</p><h3>Results</h3><p>A total of 1522 participants underwent densitometry (51.8% men). Peak bone mass is reached at ages 20–39 years in both sexes at all sites. BMD was positively associated with height, BMI, and physical activity and negatively with smoking (<i>p</i> &lt; 0.05). The distribution of BMD by age and sex was comparable to MRPO and NHANES III. We found that 54.4% of postmenopausal women and men ≥ 50 years had osteopenia, while osteoporosis was observed in 10.7%, with higher prevalence in women (18.6% vs. 2.6%) and increasing with age. Using MRPO criteria, osteoporosis prevalence rose to 14.8%.</p><h3>Conclusion</h3><p>The BMD of the OsteoSER study population is similar to that of MRPO and NHANES III. Physical activity positively influences peak bone mass, while smoking has detrimental effects.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weaker subchondral bone and thinner articular cartilage of the knee are associated with elevated baseline fracture risk independently of osteoarthritis risk factors","authors":"Andy K. O. Wong,&nbsp;Anthony Pokhoy,&nbsp;Ali M. Naraghi,&nbsp;Rakesh Mohankumar","doi":"10.1007/s11657-025-01517-4","DOIUrl":"10.1007/s11657-025-01517-4","url":null,"abstract":"<div><h3>Summary</h3><p>Knee osteoarthritis involves damaged bones beneath joint surfaces but how current bone health predicts future disease state is unclear. We discovered higher osteoporotic fracture risk (FRAX) was linked to compromised knee bone quality and thinner cartilage. Integrating FRAX into osteoarthritis care could identify who may develop worse disease outcomes.</p><h3>Objectives</h3><p>To examine how well fracture risk predicts subchondral bone and cartilage morphometry independently of osteoarthritis (OA) clinical risk factors.</p><h3>Methods</h3><p>Male and female participants in the Osteoarthritis Initiative (OAI) at visit 5 (36 months) were evaluated for fracture risk using FRAX and categorized into low-, moderate-, or high-risk groups. These groups were compared for bone marrow lesion (BML) size, number and effusion, subchondral bone structure, density, and cartilage morphometry in the most affected knee at either same time point, 1 or 2 years later, using general linear models. Sex interactions were examined in each case and probed if significant.</p><h3>Results</h3><p>Among 1240 participants (58.8% female, age: 63.7 ± 8.8 years, and BMI: 30.1 ± 4.9 kg/m²), 20.32% had moderate or high FRAX and showed lower subchondral bone density (− 0.12 to − 0.25 g/cm²), less intact trabeculae, and thinner cartilage (− 0.14 to − 0.47 mm) compared to low FRAX (<i>p</i> &lt; 0.05). Males showed larger positive FRAX correlations with bone density, and females had protective effects of FRAX against BML numbers, although the effects were small (sex interaction, <i>p</i> &lt; 0.05). All FRAX models adjusting for OA risk factors yielded better model fit than OA risk factors alone. Having moderate/high versus low FRAX at baseline predicted a 1.36 (1.00, 1.86)-fold higher odds of reaching a Kellgren-Lawrence score of 3 or 4 within a year.</p><h3>Conclusions</h3><p>High FRAX predicts thinner cartilage and weaker subchondral bone within a year. Complementing standard OA clinical risk factors with FRAX calculation could help identify individuals likely to develop worse knee OA radiologic outcomes.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trabecular bone score to assess bone microarchitecture in end-stage renal disease patients","authors":"Antoine Bouquegneau,&nbsp;François Jouret,&nbsp;Laurence Seidel,&nbsp;Catherine Bonvoisin,&nbsp;Laurent Weekers,&nbsp;Clio Ribbens,&nbsp;Olivier Bruyere,&nbsp;Etienne Cavalier,&nbsp;Pierre Delanaye,&nbsp;Olivier Malaise","doi":"10.1007/s11657-025-01519-2","DOIUrl":"10.1007/s11657-025-01519-2","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p><b>Rationale</b>: This study evaluates TBS for estimating bone microarchitecture in ESRD patients using HR-pQCT as the reference technique. <b>Main results</b>: TBS correlates significantly with vBMD and bone microarchitecture, unlike aBMD. <b>Significance</b>: TBS may complement bone health assessment in ESRD patients by offering additional information alongside aBMD.</p><h3>Purpose</h3><p>Given the high fracture risk, non-invasive techniques for assessing bone fragility in chronic kidney disease (CKD) remain important. Trabecular bone score (TBS) may provide additional information that could help guide treatment and follow-up decisions. The aim of this study is to investigate whether TBS reflects bone microarchitecture in end-stage renal disease (ESRD) patients, using high-resolution peripheral quantitative computed tomography (HR-pQCT) as the reference technique. Additionally, we aim to identify parameters associated with a low TBS.</p><h3>Methods</h3><p>Seventy-five ESRD patients were included at the time of kidney transplantation (KTx). Areal bone mineral density (aBMD) was analyzed using dual-energy X-ray absorptiometry (DXA). TBS was assessed from the L1-L4 area during DXA. Volumetric BMD (vBMD) and bone microarchitecture at tibia and radius sites were analyzed using HR-pQCT.</p><h3>Results</h3><p>In ESRD patients, those with TBS &lt; 1.370 were older and had a higher body mass index (BMI). In contrast to T-score-based classification (≤ -2.5 or &gt; -2.5), low TBS was linked to significantly lower trabecular and cortical vBMD, reduced trabecular bone volume fraction (BV/TV) and trabecular number (Tb.N), and increased trabecular separation (Tb.Sp). In multivariate analysis, older age, higher BMI, and lower Tb.N remained independently associated with low TBS, while no HR-pQCT parameters were linked to low aBMD (T-score ≤ -2.5).</p><h3>Conclusion</h3><p>TBS correlates with both trabecular and cortical parameters measured by HR-pQCT, potentially offering a complementary perspective on bone microstructure compared to aBMD. At the time of KTx, a low TBS appears to better discriminate patients with significantly lower vBMD than aBMD alone.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the FLS model on patients with major fracture in Gran Canaria: 2018–2022 experience","authors":"Antonio Naranjo,&nbsp;Cristian Sarmiento,&nbsp;Amparo Molina,&nbsp;Sonia Fuentes,&nbsp;Laura Cáceres,&nbsp;Soledad Ojeda","doi":"10.1007/s11657-025-01514-7","DOIUrl":"10.1007/s11657-025-01514-7","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>We analyzed 5396 patients with fragility fracture, their inclusion by the FLS, and prescription of treatment. Thirty-four percent of potential cases were attended by the FLS, and at the healthcare level, the impact of FLS model resulted in an increase of treated patients from 20% in standard care to 41%.</p><h3>Introduction</h3><p>Patients with fragility fractures are at high risk of new fractures, with a negative impact on their quality of life, as well as higher mortality and costs for the health system, especially for hip fractures. Less than 20% of patients receive treatment (lifestyle advice, calcium, vitamin D, and bisphosphonate) after a fracture. The fracture liaison service (FLS) is the most effective model for secondary prevention.</p><h3>Objectives</h3><p>To analyze the incidence of fragility fractures in the area of Gran Canaria North and the impact of the FLS unit on the prevention of new fractures.</p><h3>Methods</h3><p>Patients &gt; 50 years were attended at the emergency department for fractures of the proximal femur, proximal humerus, distal forearm, pelvis, or vertebra during the period 2018–2022 were included. A file was constructed containing demographic data, type of fracture, inclusion in the FLS, and the initiation of treatment to prevent new fractures. A sample of patients not treated at the FLS was selected for estimating the prophylaxis of fractures under standard care management.</p><h3>Results</h3><p>A total of 5396 patients were included, 74.2% women, with a mean age of 74 years. After excluding 558 traumatic fractures (10.3%), 318 (5.9%) deaths, and 167 (3.1%) cases due to a lack of criteria, the sample of potential patients who were candidates for FLS was 4353. This represented 80.6% of the initial sample, of which 1497 patients (34.4%) were attended at the unit. Factors independently associated with referral to the FLS were younger age (OR 0.97; 95% CI 0.97–0.98), female sex (OR 2.24; 95% CI 1.91–2.61), and humerus fracture (OR 1.34; 95% CI 1.16–1.55). Treatment to prevent fractures was verified in 1189 patients (79.4%) in the FLS group and in 585 (20.4%) of those with fragility fractures who were not included. At the healthcare level, the services provided by the FLS resulted in an increase in treated patients from 20% in standard care to 41% with the FLS model.</p><h3>Conclusions</h3><p>In terms of treatment initiation to new fracture prevention at the healthcare level, the FLS achieved a twofold increase. The high incidence of fractures and the progressive aging of the population underline the effectiveness of the FLS secondary prevention model.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-025-01514-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing bone health with bisphosphonate therapies in pediatric osteogenesis imperfecta: a network meta-analysis of randomized trials","authors":"Ying-Yu Wang,&nbsp;Yu-Cheng Su,&nbsp;Pei-Chun Lai,&nbsp;Yen-Yin Chou,&nbsp;Po-Ting Wu,&nbsp;Meng-Che Tsai,&nbsp;Ta-Wei Tai,&nbsp;Chih-Hsing Wu,&nbsp;Yin-Fan Chang,&nbsp;Yu-Kang Tu,&nbsp;Ching-Ju Fang,&nbsp;Chii-Jeng Lin,&nbsp;Fa-Chuan Kuan,&nbsp;Kai-Lan Hsu,&nbsp;Chih-Kai Hong,&nbsp;Wei-Ren Su,&nbsp;Ming-Tung Huang,&nbsp;Chien-An Shih","doi":"10.1007/s11657-025-01515-6","DOIUrl":"10.1007/s11657-025-01515-6","url":null,"abstract":"<div><h3>Summary</h3><p>This study compares the efficacy of various bisphosphonate treatments for pediatric osteogenesis imperfecta (OI) in terms of lumbar spine areal bone mineral density (LS-aBMD), Z-scores, bone turnover markers (BTMs), fracture rates, and adverse events.</p><h3>Purpose</h3><p>The optimal bisphosphonate treatment for pediatric OI remains uncertain. This study aims to analyze the comparative effectiveness of different bisphosphonate therapies for children with OI.</p><h3>Methods</h3><p>A network meta-analysis (NMA) was conducted following PRISMA guidelines, screening clinical trials involving oral or intravenous bisphosphonate therapy in pediatric OI. The primary outcomes included changes in LS-aBMD and Z-scores over 1 and 2 years and fracture events. Secondary outcomes included BTM (uNTX/Cr) over 1 and 2 years and adverse event rates.</p><h3>Results</h3><p>The NMA included 9 RCTs with 595 children. For LS-aBMD changes, no bisphosphonates showed differences at 1 year; at 2 years, all active treatments improved LS-aBMD compared to placebo, with pamidronate showing greatest improvement (208.73 mg/cm², 95% CI 60.48, 356.98; CoE, moderate). Zoledronic acid demonstrated superior LS Z-scores at both 1 year (1.63 points, 95% CI 0.07, 3.19; CoE, low) and 2 years (1.37 points, 95% CI 0.95, 1.79; CoE, low). In the limited fracture analysis, only olpadronate reduced total fracture numbers compared to placebo (− 1.65, 95% CI − 3.05, − 0.26; CoE, moderate). For BTMs, all treatments reduced 1-year uNTX/Cr versus placebo, with only alendronate maintaining reduction at 2 years (− 182.38 nmol/mmol, 95% CI − 283.67, − 81.09; CoE, moderate). Zoledronic acid showed higher adverse event rates versus placebo (5.49, 95% CI 1.66, 18.19; CoE, low).</p><h3>Conclusion</h3><p>Among various bisphosphonates, pamidronate demonstrated superior improvements in LS-aBMD, while zoledronic acid achieved the most substantial Z-score gains but exhibited increased adverse event rates. Evidence gaps, particularly in direct comparative trials, limit definitive conclusions regarding fracture prevention and bone turnover markers. Future large-scale head-to-head trials comparing oral and intravenous formulations are essential to establish evidence-based treatment protocols for pediatric osteogenesis imperfecta.</p><p>Trial registration.</p><p>This research is registered with PROSPERO, registration number CRD42024571408.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143553830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}