Archives of Osteoporosis最新文献

{"title":"Anti-osteoporosis medications in persons with and without Parkinson disease in Finland","authors":"Miriam T. Y. Leung,&nbsp;Marja-Leena Lamidi,&nbsp;Miia Tiihonen,&nbsp;Sirpa Hartikainen,&nbsp;J. Simon Bell,&nbsp;Justin P. Turner,&nbsp;Anna-Maija Tolppanen","doi":"10.1007/s11657-026-01780-z","DOIUrl":"10.1007/s11657-026-01780-z","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Contrary to reports on under-treatment in persons with Parkinson’s disease, our study found similar anti-osteoporosis medication usage before and after their hip fractures among Finns with and without Parkinson’s disease. Additional preventive measures may be needed to mitigate the high risk of hip fractures among persons with Parkinson’s disease.</p><h3>Purpose</h3><p>Parkinson’s disease (PD) is associated with a doubled risk of hip fracture. However, previous reports suggest under-recognition of osteoporosis among persons with PD. Our study aimed to assess the annual prevalence of anti-osteoporosis medications among persons with and without PD in relation to diagnosis of PD and hip fractures.</p><h3>Methods</h3><p>Our nationwide matched cohort design included 33,153 persons diagnosed with incident PD between 2000 and 2009 in Finland and 1:2 matched comparison cohort. Persons with previous hip fractures were excluded. Annual prevalences of anti-osteoporosis medications were calculated for each year between 5 years before and 10 years after diagnosis of PD, and between 5 years before and 5 years after the incident hip fractures.</p><h3>Results</h3><p>Prevalence of anti-osteoporosis medications was higher in persons with PD (3.62%, 95% confidence interval [CI] 3.28–3.98%) than those without PD (2.91%, 95% CI 2.70–3.14%), starting from 3 years before the diagnosis. Among individuals with incident hip fractures (1475 [13%] persons with PD and 1371 [6%] persons without PD), the annual prevalence were similar among persons with PD and without PD, peaking within 1 year after hip fractures (with PD: 20.3%, 95% CI 18.0–22.8%; without PD: 21.0%, 95% CI 18.5–23.6%).</p><h3>Conclusion</h3><p>Contrary to reports on under-treatment in persons with PD, our study found similar anti-osteoporosis medication usage before and after their hip fractures among Finns with and without PD. Additional preventive measures, such as regular review of fall risk, is needed to mitigate the doubled risk of hip fracture in PD.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103510","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":"Prevalence of vertebral osteoporosis in Thai postmenopausal women under 70","authors":"Nalina Orprayoon,&nbsp;Kanaungnit Kingpetch,&nbsp;Lalita Wattanachanya,&nbsp;Jirapa Champaiboon,&nbsp;Phanupong Phutrakool,&nbsp;Seangarun Surawong,&nbsp;Yupaporn Menorngwa,&nbsp;Sirarat Ittipuripat,&nbsp;Sasitorn Sirisalipoch,&nbsp;Sukanya Chaikittisilpa","doi":"10.1007/s11657-026-01775-w","DOIUrl":"10.1007/s11657-026-01775-w","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Osteoporosis is common in Thai postmenopausal women, with 14.4% having vertebral osteoporosis. Most affected women are under 65, highlighting the need for earlier screening. Findings support revising age-based screening strategies to prevent fractures in this at-risk population.</p><h3>Purpose</h3><p>Osteoporosis is a major public health concern, particularly among postmenopausal women. Updated prevalence data are crucial for informing screening and prevention strategies. This study aimed to determine the current prevalence and characteristics of vertebral osteoporosis in Thai postmenopausal women aged 50–70 years.</p><h3>Methods</h3><p>A cross-sectional study was conducted at a menopause clinic of King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from May 2024 to March 2025. A total of 730 postmenopausal women aged 50–70 years were enrolled; 721 completed bone mineral density (BMD) assessments. Osteoporosis was diagnosed by dual-energy X-ray absorptiometry (DXA) using Asian reference data, with vertebral fracture assessment (VFA) performed in women aged 60–70. Demographic, clinical, and lifestyle factors were recorded.</p><h3>Results</h3><p>The prevalence of vertebral osteoporosis was 14.4%, and osteoporosis at any site was 19.1%. Prevalence increased with age and time since menopause. Notably, 60% of vertebral osteoporosis cases were identified in women under 65 years. Asymptomatic vertebral fractures were detected in 4.4% of participants aged 60–70 years.</p><h3>Conclusions</h3><p>Osteoporosis, especially vertebral osteoporosis, is common among Thai postmenopausal women, with a significant proportion affected before age 65. These findings suggest that current age-based screening thresholds may underestimate at-risk women in this population. Earlier detection and targeted prevention strategies are warranted as Thailand transitions to an aged society.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073367","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":"An audit of the fracture liaison service at Helen Joseph Tertiary Hospital, Johannesburg, South Africa","authors":"C. Van der Meer,&nbsp;R. Daya,&nbsp;Z. Bayat,&nbsp;L. S. Greenstein","doi":"10.1007/s11657-026-01774-x","DOIUrl":"10.1007/s11657-026-01774-x","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;\u0000 &lt;i&gt;Summary&lt;/i&gt;\u0000 &lt;/h3&gt;&lt;p&gt;Fragility fractures are increasing worldwide, yet osteoporosis often remains underdiagnosed and untreated. This study found a high burden of osteoporosis risk factors among patients enrolled in a South African fracture liaison service, highlighting the need for structured secondary prevention. These findings support expansion of fracture liaison services to improve long-term patient outcomes in resource-limited settings.&lt;/p&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Fragility fractures (FF) driven by osteoporosis result in high morbidity and mortality and are a global health concern. Fracture liaison services (FLSs) are the gold standard for secondary prevention, yet data on their implementation and patient profiles in South Africa remain sparse. The Helen Joseph Tertiary Hospital (HJH) FLS was established to improve this care gap.&lt;/p&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;p&gt;To describe the clinical and demographic characteristics, risk factors for osteoporosis and falls, osteoporosis risk scores, and management of patients enrolled in the FLS at HJH.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;This retrospective audit included 247 patients admitted to the orthopaedic ward and enrolled in the FLS between 03 October 2022 and 04 June 2024. Data on demographics, osteoporosis risk factors, investigations and management were analysed. Statistical significance was set at &lt;i&gt;p&lt;/i&gt; &lt; 0.05.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;The majority of patients were female (74.5%), aged 60–89 years (81.4%). Hip fractures predominated (59.9%), specifically neck of femur (38.8%) and intertrochanteric fractures (21.1%). Although 82.5% of patients received calcium and vitamin D supplementation, only 27.8% received in-hospital bisphosphonate therapy (Zoledronic acid). Medication shortages accounted for 60% of cases in which Zoledronic acid was not administered, while 12.4% were ineligible due to advanced chronic kidney disease. In-hospital mortality was 5%, and median length of stay was 18 days (IQR 11–28). Vitamin D insufficiency was prevalent (41.1%) and did not differ by ethnicity. Significant gender differences were observed: men had substantially higher rates of smoking (73% vs 46%) and alcohol use (48% vs 23%). Inadequate physical activity was a risk factor in both genders. Fall risks included a history of previous falls (42.0%) and cognitive impairment (Mini-Cog &lt;3; 39.6%). Patients with hip fractures had significantly higher FRAX scores than those with fractures at other sites (&lt;i&gt;p&lt;/i&gt; &lt; 0.05).&lt;/p&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;This is the first South African Fracture Liaison Service study to report on fall risk, osteoporosis risk, and post-fracture management. Fragility fractures at Helen Joseph Hospital represent a substantial burden, with a high prevalence of clinical risk factors and notable gender-specific contributors, particularly alcohol use in men. While the FLS helps close the treatment gap, its impact is limited by inconsistent access to oste","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073432","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":"Baseline survey on the scope of education and training for rare bone and mineral diseases","authors":"Neveen A. T. Hamdy,&nbsp;Violeta Iotova,&nbsp;Lorena Casareto,&nbsp;Edoardo Gallerani,&nbsp;Alberto Pereira,&nbsp;Luca Sangiorgi,&nbsp;for the ERN BOND Education & Training Working Group","doi":"10.1007/s11657-026-01773-y","DOIUrl":"10.1007/s11657-026-01773-y","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Survey findings from 69 ERN BOND and Endo-ERN health care providers, main stakeholders in advancing the care of patients with rare bone and mineral disorders, reveal the need to develop an accredited, structured, harmonised and accessible cross-border Educational and Training programme in this field.</p><h3>Purpose</h3><p>There are disparities in Education and Training (ET) in Rare Bone and Mineral Disorders (RBMDs) among European Member States (MSs). Health care providers (HCPs) from two European Reference Networks play pivotal roles in advancing RBMDs care: ERN BOND for rare bone diseases, and Endo-ERN for rare endocrine diseases. The purpose of this study was to map the ET landscape and identify gaps and unmet needs in this field.</p><h3>Methods</h3><p>A 56-questions online survey developed by ERN BOND addressed educational activities, undergraduate and postgraduate ET, competence assessment, and future perspectives in RBMDs. Dissemination was via SurveyMonkey to all ERN BOND (38) and Endo-ERN (78) HCPs.</p><h3>Results</h3><p>Collectively, 69 HCPs (60%) representing 20 MSs responded. Most worked in academic institutions, were aged &gt;50 yrs, and had &gt;20 yrs experience. Educational tools most frequently used were PubMed Central searches, phone/email a colleague and attendance of “Meet the expert” sessions and RBMD-related courses. RBMDs were in the undergraduate curriculum of &gt;60% of HCPs. The most popular postgraduate educational tools were formal lectures and learning on the job. Major gaps were specialist ET, and unmet needs were mainly for training workshops/seminars. Nearly all supported the creation of a common educational platform to develop a cross-border educational programme.</p><h3>Conclusion</h3><p>Findings from this survey among two ERNs representing the main stakeholders in the excellence of care for patients with RBMDs highlight the need for an accredited, structured, harmonized and accessible cross-border ET programme in this field and inform future initiatives for its development.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01773-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023709","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":"Polycystic ovary syndrome, insulin resistance, and bone health in Saudi women: a cross-sectional study","authors":"Mai Albaik,&nbsp;Fiona E. A. McGuigan,&nbsp;Ahmed E. Altyar,&nbsp;Jalaluddin A. Khan,&nbsp;Kristina E. Akesson","doi":"10.1007/s11657-026-01707-8","DOIUrl":"10.1007/s11657-026-01707-8","url":null,"abstract":"<div><h3>Summary</h3><p>Insulin resistance is common in Saudi women with PCOS and linked to hormonal imbalances. While bone health differences were not significant, trends suggest obesity and vitamin D may influence future risk. Early detection and management of insulin resistance could help reduce long-term health complications in affected women.</p><h3>Background</h3><p>Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by hormonal, metabolic, and reproductive dysfunction. Insulin resistance (IR), a hallmark feature of PCOS, is associated with long-term health complications, including adverse effects on bone metabolism.</p><h3>Objective</h3><p>This study aimed to explore the prevalence of IR in Saudi women with PCOS and investigate its associations with hormonal, metabolic, and bone health parameters.</p><h3>Methods</h3><p>A cross-sectional study was conducted at the Center of Excellence for Osteoporosis Research, King Abdulaziz University, Jeddah, Saudi Arabia, between December 2018 and June 2019. A total of 144 participants were enrolled, comprising 72 women with PCOS and 72 age- and BMI-matched healthy controls. Anthropometric measurements, biochemical analysis, and bone mineral density (BMD) assessments were performed. IR was evaluated using fasting serum insulin, homeostasis model assessment (HOMA), and glucose-to-insulin ratio (GIR). Statistical analyses included group comparisons and correlation analyses to identify associations.</p><h3>Results</h3><p>IR was significantly higher in women with PCOS compared to controls across all diagnostic criteria (<i>P</i> &lt; 0.01). PCOS women had higher luteinizing hormone (LH) levels and LH/FSH ratios (<i>P</i> &lt; 0.001), particularly in insulin-resistant subgroups. No significant differences in BMD or T-scores were observed between groups; however, stratified analyses suggested trends toward higher T-scores in obese PCOS women. Vitamin D deficiency was similarly prevalent in both groups.</p><h3>Conclusion</h3><p>This study highlights the substantial metabolic burden of IR in Saudi women with PCOS and its association on hormonal profiles. While no differences in bone health were observed, trends suggest that factors such as BMI and vitamin D status may be associated with skeletal outcomes at later stages. These findings underscore the importance of early IR identification and management to mitigate long-term health complications in PCOS.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01707-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975565","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":"Quantifying impact loading for osteoporosis prevention: a study on the relationship between ground reaction forces and wearable impact data","authors":"Gonzalo Reverte-Pagola,&nbsp;Horacio Sánchez-Trigo,&nbsp;Carlos Rangel,&nbsp;Sergio Tejero,&nbsp;Borja Sañudo","doi":"10.1007/s11657-026-01715-8","DOIUrl":"10.1007/s11657-026-01715-8","url":null,"abstract":"<div><h3>Summary</h3><p>High-impact exercise can strengthen bones, but clinical use is limited because mechanical loading is difficult to measure outside laboratories. We validated a wrist-worn accelerometer against force-plate ground reaction forces and found that wearable data reliably reflect impact loading. This approach may enable practical monitoring of bone-stimulating exercise in real-world settings.</p><h3>Purpose</h3><p>Mechanical loading must surpass a minimum intensity threshold to stimulate osteogenic adaptation, yet clinicians lack practical tools to quantify impact dose outside laboratory settings. Wearable accelerometers could enable safe, scalable monitoring of bone-strengthening exercise, but their validity for estimating osteogenic loading remains uncertain. This study examined whether wrist-worn accelerometry can support approximate estimation and coarse classification of platform-derived impact loading during maximal countermovement jumps in postmenopausal women.</p><h3>Methods</h3><p>Thirty-eight women were enrolled; 37 contributed 125 valid CMJs with concurrent force-platform and wrist-accelerometer recordings. The primary model predicted peak platform-derived vertical acceleration from peak wrist vector-magnitude acceleration and body mass. Coefficient inference used linear regression with participant-clustered robust standard errors. Predictive performance and four-class osteogenic classification (&lt; 2 g, 2– &lt; 3 g, 3– &lt; 3.9 g, ≥ 3.9 g) were evaluated using leave-one-subject-out cross-validation. Fuller anthropometric models and residual-based outlier filtering were examined as sensitivity analyses.</p><h3>Results</h3><p>In the primary reduced model, wrist vector magnitude and body mass were both independently associated with peak platform acceleration. In leave-one-subject-out validation, the model explained 44.3% of the variance (<i>R</i>² = 0.443), with MAE = 5.83 and RMSE = 7.99 m·s⁻². Mean bias was 0.05 m·s⁻², with 95% limits of agreement from − 15.66 to 15.77 m·s⁻². Four-class classification accuracy was 0.544, with quadratic weighted <i>κ</i> = 0.639; misclassifications occurred predominantly between adjacent bins. The fuller anthropometric model did not improve out-of-sample performance.</p><h3>Conclusions</h3><p>Wrist-worn accelerometry provided limited precision for per-jump estimation of platform-derived loading, even under constrained laboratory conditions. However, it retained moderate utility for coarse, bin-based classification of impact intensity during maximal CMJs performed with hands on hips. Its most defensible application is session-level monitoring and conservative progression in home- and community-based osteogenic exercise programs, rather than replacement of laboratory force-platform measurement.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886136","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":"Abdominal aortic calcification and skeletal outcomes in hospitalized patients with surgically treated fragility fractures: a retrospective cohort study","authors":"Bing‑Hao Lu,&nbsp;Wei-Han Lin,&nbsp;Kuo‑Yuan Huang","doi":"10.1007/s11657-026-01755-0","DOIUrl":"10.1007/s11657-026-01755-0","url":null,"abstract":"<div><h3>Summary</h3><p>Abdominal aortic calcification was associated with lower femoral neck BMD in unadjusted analyses, but its independent skeletal stratification value was limited in hospitalized patients with surgically treated fragility fractures. AAC was not independently associated with fracture severity or refracture risk in this cohort.</p><h3>Purpose</h3><p>Abdominal aortic calcification (AAC) has been linked to lower bone mineral density (BMD) and fracture risk in community-based populations, but its relevance for skeletal stratification after surgically treated fragility fracture is unclear. We examined associations between AAC burden and BMD, FRAX-estimated fracture probabilities, fracture severity, and refracture risk.</p><h3>Methods</h3><p>We retrospectively studied 230 hospitalized adults with surgically treated fragility hip or vertebral fractures. AAC was quantified on lateral spine radiographs using the 24-point Kauppila score. Associations with BMD, FRAX probabilities, and fracture severity were assessed using correlation and multivariable regression. Refracture was analyzed using Kaplan–Meier and Cox models from a common baseline defined as the latest of the index operation, DXA, and AAC assessment dates.</p><h3>Results</h3><p>Higher AAC burden was associated with lower femoral neck BMD in unadjusted analyses (Spearman <i>ρ</i> = − 0.230, <i>p</i> &lt; 0.001), but this association was attenuated after adjustment. AAC showed weak positive correlations with FRAX-estimated probabilities but was not independently associated with vertebral or hip fracture severity. In common-baseline refracture analysis, 24/224 patients had a first refracture. Refracture-free survival did not differ by AAC group (log-rank <i>p</i> = 0.982), and high AAC was not associated with refracture risk (HR 0.90, 95% CI 0.38–2.15; <i>p</i> = 0.809).</p><h3>Conclusion</h3><p>In this fracture-selected inpatient cohort, AAC showed limited independent value for skeletal stratification beyond shared demographic and body-composition factors. AAC was not independently associated with fracture severity, and refracture analyses should be interpreted as exploratory because of the limited number of events.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886155","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":"Teriparatide treatment of osteoporosis in solid organ transplant recipients—a single-center experience","authors":"Talia Diker Cohen,&nbsp;Ilana Shraga-Slutzky,&nbsp;Keren Kaminer,&nbsp;Alexander Gorshtein,&nbsp;Idit Dotan,&nbsp;Gloria Tsvetov","doi":"10.1007/s11657-026-01751-4","DOIUrl":"10.1007/s11657-026-01751-4","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Solid organ transplant recipients face high fracture risk with limited evidence guiding anabolic therapy. In this real-world cohort, teriparatide was associated with significant improvements in bone mineral density and acceptable safety without adverse graft effects. These findings support selective anabolic treatment in high-risk transplant recipients and highlight the need for prospective studies.</p><h3>Purpose</h3><p>Solid organ transplant (SOT) recipients are at high risk for osteoporosis and fragility fractures due to pre-existing organ dysfunction and long-term immunosuppressive therapy, particularly glucocorticoids. However, evidence supporting the use of anabolic osteoporosis therapy in this population remains limited.</p><h3>Methods</h3><p>We conducted a retrospective cohort study at a large transplant center including adult kidney, lung, and liver transplant recipients selected for teriparatide treatment based on clinical indications for severe post-transplant osteoporosis for at least 3 months. Bone mineral density (BMD), incident fractures, biochemical parameters, renal function, and adverse events were evaluated during treatment and follow-up.</p><h3>Results</h3><p>Thirty-nine SOT recipients (33% men; mean age 61.3 ± 11.6 years) were included, comprising kidney (<i>n</i> = 10), lung (<i>n</i> = 20), and liver (<i>n</i> = 9) transplant recipients. Prior fragility fractures were present in 90% of patients, and 79% had multiple fractures. Median teriparatide treatment duration was 22.3 months. Significant increases in BMD were observed at the lumbar spine (+11 ± 15%, <i>p</i> = 0.01), femoral neck (+8 ± 14%, <i>p</i> = 0.05), and total hip (+11 ± 16%, <i>p</i> = 0.05). Six patients sustained fractures after teriparatide initiation; only two occurred during active therapy, whereas four occurred after treatment discontinuation. Hypercalcemia occurred in one patient and led to treatment cessation. The estimated glomerular filtration rate declined modestly during the first 6 months and stabilized thereafter; a broadly similar pattern was observed in contemporaneous matched transplant controls. No episodes of graft rejection were observed.</p><h3>Conclusions</h3><p>In this real-world cohort of SOT recipients with severe osteoporosis, teriparatide therapy was associated with significant improvements in BMD, acceptable safety, and no apparent excess risk to graft function. These findings support the selective use of anabolic therapy in high-risk transplant recipients and highlight the need for prospective studies to define optimal treatment strategies.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879160","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":"High-resolution peripheral quantitative computed tomography imaging and bone biomarker characteristics of patients with ischemic stroke or transient ischemic attack—baseline analysis of the Post-stroke Osteopathy study","authors":"Benjamin Dejakum,&nbsp;Johannes Bereiter-Payr,&nbsp;Silvia Felicetti,&nbsp;Kurt Moelgg,&nbsp;Anel Karisik,&nbsp;Gerald Degenhart,&nbsp;Thomas Toell,&nbsp;Christian Boehme,&nbsp;Lukas Mayer-Suess,&nbsp;Raimund Pechlaner,&nbsp;Anna-Maria Liphardt,&nbsp;Gabriela Berg,&nbsp;Georg Schett,&nbsp;Stefan Kiechl,&nbsp;Michael Knoflach","doi":"10.1007/s11657-026-01767-w","DOIUrl":"10.1007/s11657-026-01767-w","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Stroke or transient ischemic attack (TIA) leads to unfavorable structural changes in the bones. The underlying pathophysiological process is unclear. We provide a detailed characterization of the structural and biochemical properties of bone in a stroke/TIA cohort. Our findings lay the foundation for a comprehensive understanding of post-stroke osteopathy and its clinical implications.</p><h3>Purpose</h3><p>Patients who have suffered a stroke or transient ischemic attack are at high risk of fractures, which increase mortality and reduce health-related quality of life. Previous studies showed that ischemic stroke leads to unfavorable structural changes in the bones, but the underlying pathophysiological process is still unclear. Our aim was to analyze biomarkers and bone structure with high-resolution peripheral quantitative computed tomography (HR-pQCT) in a stroke/TIA cohort.</p><h3>Methods</h3><p>This cross-sectional study analyzes the baseline data of a prospective cohort. Patients underwent HR-pQCT scans of the radius and tibia, alongside biochemical bone marker evaluation, within the first days after the acute cerebrovascular event.</p><h3>Results</h3><p>Women had lower total, cortical, and trabecular volumetric bone mineral density (vBMD) and lower values for most other HR-pQCT parameters. Patients with increasing age had lower total and cortical vBMD, but no difference in trabecular parameters. Active or former smokers had lower total and trabecular vBMD. Higher BMI was associated with greater cortical and trabecular bone areas and higher trabecular density. A positive correlation was found between sclerostin levels and trabecular parameters. Higher osteoprotegerin levels were associated with lower cortical area and thickness. Osteocalcin showed a negative correlation with total vBMD and cortical thickness.</p><h3>Conclusions</h3><p>This study is the first to combine HR-pQCT imaging with bone biomarkers to provide a detailed characterization of the structural and biochemical properties of bone in a stroke/TIA cohort. Our findings lay the foundation for a comprehensive understanding of post-stroke osteopathy and its clinical implications.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01767-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838190","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":"Actionable osteoporosis alerts in musculoskeletal radiology reports improve secondary fracture prevention after orthopaedic fragility fractures","authors":"Farid Pakizeh,&nbsp;Keyvan Mansouri","doi":"10.1007/s11657-026-01770-1","DOIUrl":"10.1007/s11657-026-01770-1","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;\u0000 &lt;i&gt;Summary&lt;/i&gt;\u0000 &lt;/h3&gt;&lt;p&gt;A standardized osteoporosis alert in fracture radiology reports boosted osteoporosis care from 17 to 57% in 500 patients. This low-cost, scalable intervention bridges a critical communication gap between radiologists and clinicians, substantially improving secondary fracture prevention after fragility fractures.&lt;/p&gt;&lt;h3&gt;Background\u0000&lt;/h3&gt;&lt;p&gt;Fragility fractures in adults aged 50 years or older are sentinel events for osteoporosis, but post-fracture evaluation and treatment remain inconsistent. Radiology reports are a scalable point of clinical communication, yet conventional fracture reports often describe morphology without explicitly recommending secondary fracture prevention.&lt;/p&gt;&lt;h3&gt;Purpose\u0000&lt;/h3&gt;&lt;p&gt;To evaluate whether an actionable osteoporosis alert embedded in musculoskeletal radiology reports improves downstream osteoporosis care after low-energy orthopaedic fractures.&lt;/p&gt;&lt;h3&gt;Methods\u0000&lt;/h3&gt;&lt;p&gt;This multicenter interrupted time-series study included 500 adults aged 50 years or older with low-energy fractures treated across three centers: one academic trauma center, one academic general hospital, and one public community hospital. The pre-alert period included 250 patients from January to December 2024; the post-alert period included 250 patients from January to December 2025. The primary cohort included hip/proximal femur, clinical vertebral compression, distal radius/forearm, and proximal humerus fractures. Pelvic/sacral insufficiency fractures were retained only as an expanded secondary cohort. Low-energy fracture status was adjudicated from emergency, orthopaedic, and radiology documentation and defined as a fall from standing height or less without malignancy, periprosthetic fracture, atypical femoral fracture, or high-energy trauma. The intervention was a standardized report impression sentence recommending osteoporosis evaluation and secondary fracture prevention. The primary outcome was osteoporosis care initiation within 90 days, defined as DXA order, specialist/FLS referral, fracture-risk assessment, or anti-osteoporosis medication initiation.&lt;/p&gt;&lt;h3&gt;Results\u0000&lt;/h3&gt;&lt;p&gt;In the expanded 500-patient cohort, actionable report wording increased from 6.8 to 82.4%. Overall radiologist adherence in the post-alert period was 206/250 reports (82.4%), varying by center from 71.7 to 88.4% and by fracture site from 66.7 to 91.4%. Osteoporosis care initiation increased from 16.8% before implementation to 56.8% after implementation. Segmented regression of 24 monthly observations demonstrated an immediate post-intervention level increase of 40.0 percentage points (95% CI, 33.0 to 47.0; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), with no significant pre-intervention trend, no significant seasonality, and no evidence of positive autocorrelation (Durbin-Watson, 2.85). In multivariable analysis, the post-alert period remained associated with care initiation after adjustment for age, sex, fracture si","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856874","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}