{"title":"The impact of osteoporosis virtual training course for general practitioners","authors":"Elahe Hesari, Fatemeh Hajivalizadeh, Mahnaz Sanjari, Kazem Khalagi, Noushin Fahimfar, Maryam Amini, Mahbobe Darman, Maryam Aalaa, Pardis Zarepour, Mohammad Javad Mansourzadeh, Sepideh Hajivalizadeh, Donya Sadeghi, Afshin Ostovar, Bagher Larijani","doi":"10.1007/s11657-025-01532-5","DOIUrl":"10.1007/s11657-025-01532-5","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>This study evaluated the impact of a virtual training program on osteoporosis management for general practitioners. Among 498 participants, knowledge scores significantly increased from 38 to 83 (<i>P</i> < 0.001). The findings highlight the effectiveness of targeted education in enhancing practitioners' understanding, ultimately improving patient care and reducing healthcare costs.</p><h3>Purpose</h3><p>Osteoporosis is a widespread global health concern. Training the general practitioners with updated treatment strategies can notably lessen patient discomfort (fracture and mobility limitation) and costs. So, this study aimed to assess the impact of a training course on osteoporosis management knowledge targeted at general practitioners.</p><h3>Methods</h3><p>A quasi-experimental study was conducted to train general practitioners about Osteoporosis. The study utilized a virtual education program accessible online and contained five key aspects of osteoporosis management. The impact of this program was evaluated by comparing pre-test and post-test scores across all 5 modules. Evaluation of Electronic Modules questionnaire was used to assess the quality of the osteoporosis virtual course. A linear regression analysis explored factors influencing physicians’ knowledge percent change in 5 modules.</p><h3>Results</h3><p>A total of 498 general practitioners participated in a virtual course on osteoporosis management. The average participant age was 35, and over 70% were women. The mean score for all five modules increased significantly, from 38 to 83, more than double the original score (<i>P</i> < 0.001). The analysis revealed that in Module 3 (Clinical Management), younger participants attained significantly higher post-test scores (<i>β</i>, − 0.28; 95% CI, − 0.55, − 0.01; <i>P</i>, 0.039). Also, most participants agreed or strongly agreed that the system is high-quality, offers valuable information, and services, and is both user-friendly and beneficial.</p><h3>Conclusion</h3><p>The virtual training course on osteoporosis management principles notably improved the participants’ knowledge.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809303","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}
Melkamu Tamir Hunegnaw, Jakub Mesinovic, Paul Jansons, Elena S. George, Belinda De Ross, Nicole Kiss, Peter R. Ebeling, Robin M. Daly, Eugene Gvozdenko, David Scott
{"title":"Feasibility and effectiveness of a digital voice assistant for improving anti-osteoporosis medication adherence, and osteoporosis knowledge and attitudes, in postmenopausal women with osteoporosis: A 12-month randomised controlled trial","authors":"Melkamu Tamir Hunegnaw, Jakub Mesinovic, Paul Jansons, Elena S. George, Belinda De Ross, Nicole Kiss, Peter R. Ebeling, Robin M. Daly, Eugene Gvozdenko, David Scott","doi":"10.1007/s11657-025-01529-0","DOIUrl":"10.1007/s11657-025-01529-0","url":null,"abstract":"<div><h3>Summary</h3><p>Digital voice assistants (DVAs) are feasible for delivering a digital health intervention designed to improve osteoporosis self-management in postmenopausal women with osteoporosis. However, the DVA intervention did not improve anti-osteoporosis drug adherence, nor did it enhance osteoporosis knowledge or attitudes in this population.</p><h3>Purpose</h3><p>To determine feasibility and effectiveness of a digital voice assistant (DVA) intervention for improving anti-osteoporosis medication adherence, and osteoporosis knowledge and attitudes, in postmenopausal women with osteoporosis.</p><h3>Methods</h3><p>This 12-month single-blinded, randomised controlled trial included 50 postmenopausal women with osteoporosis randomised to DVA (N = 25) or control (N = 25) for 6 months, followed by a 6-month follow-up period. DVA participants received an Amazon Alexa device that delivered osteoporosis education videos, medication reminders and interactive quizzes. Control participants received emails with links to osteoporosis information. Anti-osteoporosis medication possession ratio (MPR; acceptable adherence defined as ≥ 0.8) was determined using Pharmaceutical Benefits Schedule data. Osteoporosis knowledge was measured using the Osteoporosis Knowledge Assessment Tool (OKAT) and medication attitudes were measured using the Adherence Evaluation of Osteoporosis Treatment (ADEOS-12) questionnaire.</p><h3>Results</h3><p>The mean ± SD age of participants was 64.3 ± 6.1 years and 6-month DVA intervention adherence (number of DVA sessions accessed) was 79.5% (95%CI: 73.9, 84.9). The proportion of participants with acceptable 12-month MPRs was similar between groups (control: 86.4% [95%CI: 77.0, 93.6]; DVA: 95.0% [95%CI: 88.4, 100.0], <i>P</i> = 0.34). Mean OKAT scores improved in both groups after both 6- and 12 months, but there were no significance between groups. Changes in mean ADEOS-12 scores did not differ between baseline and 6 months in DVA compared to control (0.61 [95%CI: − 0.80, 2.03]) but worsened post-intervention from 6 to 12 months (net difference: − 1.42 [95%CI: − 2.80, − 0.06]).</p><h3>Conclusions</h3><p>This DVA-delivered intervention achieved good adherence but did not improve medication adherence, osteoporosis knowledge, or attitudes compared with control. Future studies should target populations with poor adherence to anti-osteoporosis medication.\u0000</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-025-01529-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809338","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}
Anna Spångeus, Tomas Bjerner, Maria Lindblom, Christoph Götz, Allan Hummer, Christoph Salzlechner, Mischa Woisetschläger
{"title":"Breaking the silence: AI’s contribution to detecting vertebral fractures in opportunistic CT scans in the elderly—a validation study","authors":"Anna Spångeus, Tomas Bjerner, Maria Lindblom, Christoph Götz, Allan Hummer, Christoph Salzlechner, 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, Keyi Li, Mingxuan Zheng, Xiaojun Chen, Yishan Yin, 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}
Jilmen Quintiens, Elena Paravisi, Piyush Uniyal, G. Harry van Lenthe
{"title":"Bone stiffness and strength at the distal radius can be determined using photon-counting CT","authors":"Jilmen Quintiens, Elena Paravisi, Piyush Uniyal, 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><sup>2</sup> > 0.911; <i>p</i> < 2e-4). Correlation and agreement were higher for density-based models (<i>R</i><sup>2</sup> > 0.977; <i>p</i> < 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}
Yuchen Zheng, Wenyu Zhou, Jian Zhang, Tao Lan, Rui Zhang
{"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, Wenyu Zhou, Jian Zhang, Tao Lan, 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}
Rogelio F. Jiménez-Ortega, Tania V. López-Pérez, Adriana Becerra‑Cervera, Diana I. Aparicio-Bautista, Nelly Patiño, Guadalupe Salas-Martínez, Jorge Salmerón, Rafael Velázquez‑Cruz, Berenice Rivera‑Paredez
{"title":"Impact of the dietary antioxidant index on bone mineral density gain among mexican adults: a prospective study","authors":"Rogelio F. Jiménez-Ortega, Tania V. López-Pérez, Adriana Becerra‑Cervera, Diana I. Aparicio-Bautista, Nelly Patiño, Guadalupe Salas-Martínez, Jorge Salmerón, Rafael Velázquez‑Cruz, 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/cm<sup>2</sup> 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}
Carmen Gómez-Vaquero, Marta Domínguez-Álvaro, Daniel Seoane-Mato, Pilar Peris Bernal, Santos Castañeda, Eduardo Kanterewicz Binstock, Ramón Mazzucchelli Esteban, Luis Arboleya Rodríguez, Miguel Bernard, Antonio Álvarez-Cienfuegos, Blanca Correa, Luis María Jiménez Liñán, Carmen Mateo Pascual, Ma Mercedes Molina del Rio, Mercedes Retamal Ortiz, Aida Fátima López Laguna, Ruth Molera Valero, Sara Alvar Pariente, Antonio Pascual-Vergara, Adolfo Arias Senso, Nuria Pérez Gutiérrez, Soledad García Frías, David Bouza Alvárez, Susana Sostrés, Daniel Suárez Hernandez, Ana Zamora Casal, Cristina García Ramírez, Enrique González-Dávila, on behalf of the OsteoSER Project Collaborative Group
{"title":"An update in bone mineral density status in Spain: the OsteoSER study","authors":"Carmen Gómez-Vaquero, Marta Domínguez-Álvaro, Daniel Seoane-Mato, Pilar Peris Bernal, Santos Castañeda, Eduardo Kanterewicz Binstock, Ramón Mazzucchelli Esteban, Luis Arboleya Rodríguez, Miguel Bernard, Antonio Álvarez-Cienfuegos, Blanca Correa, Luis María Jiménez Liñán, Carmen Mateo Pascual, Ma Mercedes Molina del Rio, Mercedes Retamal Ortiz, Aida Fátima López Laguna, Ruth Molera Valero, Sara Alvar Pariente, Antonio Pascual-Vergara, Adolfo Arias Senso, Nuria Pérez Gutiérrez, Soledad García Frías, David Bouza Alvárez, Susana Sostrés, Daniel Suárez Hernandez, Ana Zamora Casal, Cristina García Ramírez, Enrique González-Dávila, 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> < 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}
Andy K. O. Wong, Anthony Pokhoy, Ali M. Naraghi, Rakesh Mohankumar
{"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, Anthony Pokhoy, Ali M. Naraghi, 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/m<sup>2</sup>), 20.32% had moderate or high FRAX and showed lower subchondral bone density (− 0.12 to − 0.25 g/cm<sup>2</sup>), less intact trabeculae, and thinner cartilage (− 0.14 to − 0.47 mm) compared to low FRAX (<i>p</i> < 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> < 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}
Antoine Bouquegneau, François Jouret, Laurence Seidel, Catherine Bonvoisin, Laurent Weekers, Clio Ribbens, Olivier Bruyere, Etienne Cavalier, Pierre Delanaye, Olivier Malaise
{"title":"Trabecular bone score to assess bone microarchitecture in end-stage renal disease patients","authors":"Antoine Bouquegneau, François Jouret, Laurence Seidel, Catherine Bonvoisin, Laurent Weekers, Clio Ribbens, Olivier Bruyere, Etienne Cavalier, Pierre Delanaye, 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 < 1.370 were older and had a higher body mass index (BMI). In contrast to T-score-based classification (≤ -2.5 or > -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}