Archives of Osteoporosis最新文献

{"title":"A comprehensive update on the cost-effectiveness of 10-year denosumab vs alendronate in postmenopausal women with osteoporosis in the United States.","authors":"Eric Yeh, Matia Saeedian, Jack Badaracco","doi":"10.1007/s11657-025-01564-x","DOIUrl":"10.1007/s11657-025-01564-x","url":null,"abstract":"<p><p>In postmenopausal women with osteoporosis, 10-year denosumab was estimated to be cost-effective vs 5 years of oral alendronate, a 2-year drug holiday, and subsequently 3-years of alendronate with an estimated incremental cost-effectiveness ratio of $97,574 per quality-adjusted life-years gained. Cost-effectiveness was demonstrated in most of the scenario simulations.</p><p><strong>Purpose: </strong>A previous economic analysis estimated that 5-year denosumab was cost-effective compared with 5-year alendronate in women with postmenopausal osteoporosis (PMO) in the United States (US). Emerging literature has provided data on the long-term clinical benefits of denosumab. Therefore, the cost-effectiveness analysis was updated to understand the potential implications of a longer treatment duration (10-year) with denosumab vs generic oral alendronate or no treatment from a US third-party payer perspective.</p><p><strong>Methods: </strong>A lifetime Markov cohort model was used to compare 10-year denosumab treatment to 5 years of alendronate, followed by a 2-year drug holiday and, then an additional 3 years of alendronate. The target population consisted of PMO women in the US with a starting age of 72 years. Recent publicly available data, including epidemiology, treatment efficacy, persistence, and costs, were used to inform model inputs. Scenario analyses and a probabilistic sensitivity analysis (PSA) were conducted to account for uncertainty.</p><p><strong>Results: </strong>Estimated mean total lifetime cost and quality-adjusted life years (QALYs), respectively, were $81,003 and 8.035 for denosumab, and $75,358 and 7.977 for alendronate, resulting in denosumab having an incremental cost-effectiveness ratio of $97,574 per QALY gained. At a threshold of $150,000 per QALY, the PSA demonstrated that denosumab was considered cost effective in 62.1% of simulations. Denosumab was dominant over no treatment.</p><p><strong>Conclusions: </strong>Ten-year denosumab treatment would be cost-effective compared with 5 years of alendronate, followed by a 2-year drug holiday and 3 years of alendronate at the threshold of $150,000. Cost-effectiveness was demonstrated across most scenarios with robust PSA results.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":"85"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526243","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 of Sarcopenic Obesity and Osteoporosis in Postmenopausal Women: Risk Factors and Protective Effects of Hormonal Therapy and Nutritional Status.","authors":"Oracha Chucherd, Orawin Vallibhakara, Sakda Arj-Ong Vallibhakara, Areepan Sophonsritsuk, Kitti Chattrakulchai, Makaramas Anantaburarana","doi":"10.1007/s11657-025-01573-w","DOIUrl":"10.1007/s11657-025-01573-w","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The cross-sectional study of postmenopausal Thai women discovered a strong association between both sarcopenia and sarcopenic obesity and osteoporosis. The risk of sarcopenic obesity was found to increase with poor nutritional status, while a history of menopausal hormone therapy was shown to offer protection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The study aims to investigate the association between sarcopenic obesity and osteoporosis in postmenopausal women and to identify risk factors for sarcopenic obesity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Our comprehensive cross-sectional study involved 248 Thai postmenopausal women aged 45-80. Osteoporosis was defined as a bone mineral density (BMD) T-score of less than -2.5 at the lumbar spine, total hip, or femoral neck, as measured by dual-energy X-ray absorptiometry (DXA). Sarcopenic obesity is defined as the co-existence of obesity and sarcopenia according to the criteria established by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO). Sarcopenia was defined as skeletal muscle mass adjusted by weight (SMM/W) &lt;35.6%, assessed via Bioelectrical Impedance Analysis (BIA), and compromised muscle function, which includes low hand grip strength (&lt;18 kg) or poor physical performance (chair-stand test time ≥17 seconds). Obesity was defined as a fat mass percentage &gt;41%, a body mass index (BMI) ≥25 kg/m&lt;sup&gt;2&lt;/sup&gt;, or a waist circumference ≥80 cm. Moreover, a questionnaire of baseline characteristics and the factor associated with sarcopenic obesity was collected, including age, years since menopause, history of menopausal hormone therapy, underlying diseases, medications, nutritional status assessed by the Mini Nutritional Assessment (MNA), and physical activity assessed by The Global Physical Activity Questionnaire (GPAQ). Univariate and multiple logistic regression analyses were used to examine the associated factors with sarcopenic obesity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The prevalence of sarcopenic obesity was 13.3%, and sarcopenia was present in 28.63%, while osteoporosis affected 39.91% of the participants. Sarcopenia and sarcopenic obesity were significantly associated with osteoporosis (odds ratio (OR) 3.05; 95% CI, 1.69-5.49; p &lt; 0.05 and OR 2.65; 95% CI, 1.23-5.68; p &lt; 0.05, respectively). In univariate and stepwise logistic regression analyses, a lower MNA score was significantly associated with an increased risk of sarcopenic obesity. Specifically, participants with an MNA score of 8-11 had an OR of 2.26; 95% CI,1.04-4.92; p &lt; 0.04, while those with a score &lt;8 exhibited a markedly elevated risk (OR 25.6; 95% CI, 1.04-4.92; p &lt; 0.05). Conversely, the use of menopausal hormone therapy (MHT) was identified as a significant protective factor against sarcopenic obesity (OR 0.29; 95% CI, 0.10-0.79; p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Both sarcopenia and sarcopenic obesity are linked to osteoporosis. Menopausal hormon","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":"83"},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493787","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":"The impact of biological age and age acceleration on 1-year mortality rates in elderly hip fracture patients: a prospective cohort study.","authors":"Zachary D Randall, Helena F Barber, Katherine E Buesser, Mitchel R Obey, Jenna-Leigh Wilson, Christopher M McAndrew, Marschall B Berkes","doi":"10.1007/s11657-025-01572-x","DOIUrl":"https://doi.org/10.1007/s11657-025-01572-x","url":null,"abstract":"<p><p>This study examines how biological age, calculated from routine lab tests, predicts 1-year mortality in elderly hip fracture patients better than chronological age. Our findings highlight that increased biological aging is linked to higher mortality, emphasizing its potential for improving preoperative risk assessment.</p><p><strong>Introduction: </strong>Geriatric hip fractures cause high morbidity and up to 30% 1-year mortality. Incorporating biological age and age acceleration into traditional assessments may improve predictions of outcomes and guide clinical interventions and perioperative counseling.</p><p><strong>Methods: </strong>In this prospective study, patients aged ≥ 50 with low-energy hip fractures had demographic data, chronological age, comorbidities, and nine laboratory parameters collected preoperatively. Biological age was computed per Levine et al. (2018), and age acceleration was defined as the difference between biological and chronological age. Patients were categorized by age acceleration (< 20 vs. ≥ 20 years) and into four subgroups (-15 to 5, 5-20, 20-30, and ≥ 30 years) for survival analysis.</p><p><strong>Results: </strong>Ninety-one patients were included. Mean chronological age was 76.6 (SD 9.2) years, biological age 90.5 (SD 15.0) years, and age acceleration 13.9 (SD 13.1) years; the mean Charlson Comorbidity Index was 4.1 (SD 3.1). One-year mortality was 25.3%. Those who died had higher CCI (6.0 vs. 3.5; p = 0.001), biological age (102.6 vs. 86.4; p < 0.001), and age acceleration (23.8 vs. 10.7; p < 0.001). Mortality increased from 7.7% in the lowest (-15 to 5 years) to 63.6% in the highest (≥ 30 years) age acceleration bracket. Cox regression-adjusted for ambulation, race, sex, CCI, and smoking-confirmed age acceleration ≥ 20 years as an independent predictor (HR 3.27; 95% CI 1.28-8.38; p = 0.014).</p><p><strong>Conclusion: </strong>Biological age and age acceleration outperform chronological age in predicting 1-year mortality, supporting their role in risk stratification for geriatric hip fracture patients.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":"84"},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493788","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":"Factors preventing early surgery for hip fractures in elderly patients: The osteoporosis liaison service (OLS)-Kashiwa study.","authors":"Yukihiro Kokubu, Aya Obi, Yuka Kimura, Aya Hattori, Hisanori Nemoto, Yujiro Matsuda, Yuho Oki, Ryo Amamiya, Keita Ogine, Masaru Misawa, Tomoko Shimaoka, Keisuke Hirose, Yoshiaki Ando, Toshinori Kurashige, Kiyoma Marusugi, Shuichi Kaneyama, Hiroshi Kawaguchi","doi":"10.1007/s11657-025-01567-8","DOIUrl":"https://doi.org/10.1007/s11657-025-01567-8","url":null,"abstract":"<p><p>Despite a recent reimbursement policy promoting early surgery for hip fractures in Japan, more than half of elderly patients experienced delays. Referral refusals, weekend admissions, comorbidity-related evaluations, and arthroplasty were key predictors. System-level reforms are needed to improve timely surgical access in Japan's aging population.</p><p><strong>Purpose: </strong>To identify pre-admission and post-admission factors associated with surgical delays for hip fractures in elderly patients, despite the recent implementation of the Japanese Ministry of Health, Labour and Welfare (MHLW) reimbursement policy incentivizing early surgery within 48 h.</p><p><strong>Methods: </strong>This retrospective cohort study included 366 patients aged ≥ 75 years who underwent surgery for hip fractures at a single acute-care hospital between January 2022 and December 2023. Patients were classified into early surgery (≤ 48 h) and delayed surgery (> 48 h) groups. Time to surgery was divided into pre-admission and post-admission intervals. Variables analyzed included age, sex, residence, referral refusal, admission day of the week, preoperative multi-specialty consultation, anticoagulant use, fracture type, and surgical procedure. Multivariate logistic regression identified independent predictors of delay.</p><p><strong>Results: </strong>Of all patients, 48.9% underwent early surgery. The delayed group had significantly longer pre- and post-admission times. Four factors were independently associated with delay: referral refusal (p = 0.027), admission later in the week (p = 0.004), preoperative multi-specialty consultation (p = 0.001), and arthroplasty rather than internal fixation (p = 0.028). In contrast, age, sex, residence, fracture type, and anticoagulant use were not significantly associated. Postoperative hospital stay was paradoxically longer in the early surgery group, primarily due to differences in discharge readiness between nursing home residents and community dwellers.</p><p><strong>Conclusion: </strong>Despite financial incentives, surgical delays persist due to both pre- and post-admission factors. System-level reforms-including improved referral systems, coordinated weekend surgical access, streamlined workflows, and adequate implant availability-are needed to enhance the effectiveness of early surgery initiatives in Japan's aging population.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":"82"},"PeriodicalIF":3.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473929","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":"Exploring the shared genetic architecture of type 2 diabetes mellitus and bone mineral density.","authors":"Xinran Feng, Hongbin Xu, Qian Guo, Zeying Wang, Ruikai Ba, Kun Xuan, Jinghao Ban","doi":"10.1007/s11657-025-01568-7","DOIUrl":"10.1007/s11657-025-01568-7","url":null,"abstract":"<p><p>There is a link between type 2 diabetes mellitus (T2DM) and bone mineral density (BMD), but the genetic reasons behind it are not yet clear. Our study found shared genetic markers and key genes connecting T2DM and BMD. This finding helps us understand their co-occurrence and may lead to new therapeutic strategies.</p><p><strong>Purpose: </strong>To explore the genetic correlation, causal relationships, and shared risk loci with potential functions between T2DM and BMD.</p><p><strong>Methods: </strong>Using data from genome-wide association studies (GWAS), we explored the genetic correlation and causality between T2DM and BMD through linkage disequilibrium score regression and bidirectional Mendelian randomization. The phenotype-cell-gene association (PCGA) platform was employed to investigate single-nucleotide polymorphism (SNP) enrichment at the tissue and cell-type levels. Shared risk SNPs were identified through cross-trait meta-analyses and Heritability Estimation from Summary Statistics. We further explored biologically relevant genes using summary-data-based Mendelian randomization (SMR).</p><p><strong>Results: </strong>Our study revealed a significant positive genetic correlation between T2DM and BMD (r_g = 0.0822, P = 3.84E - 06). The causality between T2DM and BMD was supported by our analyses, showing that T2DM affects BMD (IVW β = 0.035, P = 0.030; GSMR β = 0.107, P = 0.008) and BMD influences T2DM (IVW β = 0.085, P = 0.009; GSMR β = 0.094, P = 0.008). Cross-trait analysis identified 19 shared risk SNPs, including 3 novel pleiotropic SNPs. Tissue-specific SNP heritability enrichment for T2DM and BMD was observed in artery and adipose tissue. Additionally, cell-type-specific SNP heritability enrichment was found in macrophages, endothelial cells, fibroblasts, T cells, and mast cells. SMR identified three shared biologically relevant genes (BTBD16, RNF146, and CENPW) between T2DM and BMD.</p><p><strong>Conclusions: </strong>These discoveries elucidate the intertwined genetic structures of T2DM and BMD, enhancing our comprehension of the co-occurrence of T2DM and osteoporosis and paving the way for the innovation of targeted therapeutic strategies.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":"80"},"PeriodicalIF":3.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473928","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":"Distal forearm fracture risk in a cohort of female and male immigrants and Norwegian-born residents aged 20 to 79 years in Norway.","authors":"Reyhaneh Lashkari, Cecilie Dahl, Tove T Borgen, Åshild Bjørnerem, Jan-Erik Gjertsen, Torbjørn Wisløff, Jens-Meinhard Stutzer, Wender Figved, Ann Kristin Hansen, Lene B Solberg, Frede Frihagen, Espen Heen, Tone K Omsland","doi":"10.1007/s11657-025-01566-9","DOIUrl":"10.1007/s11657-025-01566-9","url":null,"abstract":"<p><p>The study investigated the risk of distal forearm fractures in adult Norwegian residents according to regions of birth. There were significant differences in fracture risk between the region of birth categories. Although the magnitude of the rates was different between the birth categories, similar sex and seasonal risk patterns were observed.</p><p><strong>Introduction: </strong>Worldwide, distal forearm fractures (DFFs) are the most common fractures in adults. This study compared incidence rates of first DFFs in women and men in Norway by region of birth, age, and season.</p><p><strong>Methods: </strong>We included Norwegian residents aged 20 to 79 years with a first DFF between 2010 and 2020 using data from the Norwegian Patient Registry and population estimates from Statistics Norway. Three countries of birth groups were compared: Norwegian-born, Global North (most of Europe, North America, Australia, and New Zealand), and Global South (Asia, Africa, Latin America, Oceania).</p><p><strong>Results: </strong>Compared to Norwegian-born residents in Norway, immigrants from Global North had 16% and 37% higher age-adjusted DFF incidence rates in women and men, respectively. Compared to Norwegian-born residents, female immigrants from Global South regions had 24% lower rates, whereas male immigrants from Global South regions did not have significantly lower rates. DFF rates were highest in winter for older men and women regardless of birth category, whereas rates in men younger than 50 years were highest during summer months.</p><p><strong>Conclusion: </strong>We observed significant differences in DFF rates by sex, region of birth, age, and season. Our findings might have important implications for public health efforts and fracture prevention strategies. Nonetheless, further research is necessary to investigate the underlying risk factors and mechanisms driving these differences.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":"81"},"PeriodicalIF":3.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473927","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":"Staging classification of atypical ulnar fractures.","authors":"Tetsushi Kinoshita, Fumihiro Isobe, Hiroshi Yamazaki, Koichi Nakamura, Shun Hashimoto, Teruki Shirayama, Hiroko Iwakawa, Masanori Hayashi, Jun Takahashi","doi":"10.1007/s11657-025-01569-6","DOIUrl":"10.1007/s11657-025-01569-6","url":null,"abstract":"<p><p>Atypical ulnar fractures (AUFs) are rare fractures associated with long-term bisphosphonate use; their progression pattern is not understood. This study classified AUFs based on imaging characteristics, revealing a progression from cortical bone thickening to complete fractures with osteosclerosis over time. This classification may assist in determining appropriate treatments for AUFs.</p><p><strong>Purpose: </strong>The progression and characteristics of AUFs remain unclear, and no definitive treatment method has been established. This study aimed to classify AUFs based on imaging findings to elucidate their characteristic progression patterns.</p><p><strong>Methods: </strong>We retrospectively reviewed 12 AUFs in 11 patients who had used bisphosphonates in the long term. Based on imaging characteristics, we classified the fractures into 3 stages: Stage I (incomplete fractures with cortical thickening or fracture lines only in the dorsal cortex), Stage II (complete fractures with fracture lines extending to the ventral cortex), and Stage III (complete fractures with osteosclerosis).</p><p><strong>Results: </strong>At the initial examination, 2 AUFs were classified as Stage I, 8 as Stage II, and 2 as Stage III. Two fractures progressed from Stage I to Stage II during follow-up. Our imaging analysis showed a consistent pattern, suggesting that AUFs begin with cortical thickening in the dorsal cortex, progress to fractures extending to the ventral cortex, and develop sclerosis resembling pseudoarthrosis.</p><p><strong>Conclusion: </strong>AUFs begin with cortical bone thickening and progress to complete fractures. Over time, these complete fractures can become sclerotic, resembling pseudoarthrosis.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":"79"},"PeriodicalIF":3.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324377","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":"Joint position on quality indicators for fragility hip fracture in Mexico.","authors":"J C Viveros-García, A Olascoaga-Gómez de León, J F Torres-Naranjo, R A Gómez-Mendoza, M A Buenrostro Ahued, G A Salas-Morales, A L Bremer-Aztudillo, P Clark, A Pérez-Santana, A T Ávila-García, R E López-Cervantes, J F Vilchez-Cavazos, M T Flores-Guzmán, J H Medina-Chávez, V Garzón-López, G Salmerón-Gudiño, J O Duarte-Flores","doi":"10.1007/s11657-025-01561-0","DOIUrl":"10.1007/s11657-025-01561-0","url":null,"abstract":"<p><p>A standardized framework for quality indicators (QIs) in fragility hip fracture care is lacking in Mexico, leading to variable treatment. This study proposes 33 QIs developed through literature review and expert consensus. These indicators aim to improve multidisciplinary care, reduce complications, and optimize resources, supporting national efforts for standardized management. Fragility hip fractures present a major public health challenge due to high mortality, complications, and healthcare costs. In Mexico, the absence of a standardized framework for quality indicators (QIs) for the management of fragility hip fractures has led to significant variability in care. This article aims to propose a comprehensive set of QIs tailored to the Mexican healthcare system. The proposal was developed through a three-phase process: a systematic review of international literature, a RAND/UCLA-type consensus approach involving experts from nine national medical societies, and the evaluation of QIs based on the opportunity and necessity criteria. The final consensus led to the identification of 33 QIs, covering preoperative, intraoperative, postoperative, and perioperative phases of care. Key indicators include timely surgery (within 48 h), early mobilization, orthogeriatric co-management, nutritional assessment, fall prevention, delirium detection, and secondary fracture prevention upon discharge. These indicators are designed to promote multidisciplinary care, improve functional outcomes, and reduce complications. The process also included operational definitions and measurement criteria to facilitate implementation in clinical settings, potentially contributing to the creation of national or regional hip fracture registries. This proposal represents the first multidisciplinary initiative in Mexico to address fragility hip fracture care with the goal of standardizing quality, optimizing resource use, and improving patient outcomes. Ongoing evaluation and adaptation of these indicators will be crucial to ensure their continued relevance and effectiveness in the evolving healthcare landscape.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":"77"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282283","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":"Joint position on vitamin D prescription in the adult Mexican population by AMMOM, AMEC, AMG, CMIM, CMO, CMR, CONAMEGER, FEMECOG, and FEMECOT.","authors":"Jose Francisco Torres-Naranjo, Hugo Gutierrez-Hermosillo, Pedro Alberto Garcia-Hernandez, Roberto E López Cervantes, Hilario E Avila Armengol, Rafael Bedoya Torres, Alhelí Lucía Bremer Aztudillo, Juan Humberto Medina Chávez, Rocio Morales Delgado, Eva M Perusquía Frías, Alan Rios Espinosa, Alejandro Vázquez Alanís","doi":"10.1007/s11657-025-01563-y","DOIUrl":"10.1007/s11657-025-01563-y","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D deficiency remains a critical health concern linked to skeletal disorders such as osteoporosis, osteomalacia, and fractures. Recent evidence highlights the broader role of vitamin D in preventing chronic conditions, including autoimmune diseases, diabetes, and cardiovascular events. However, inconsistencies in clinical practice across Mexico and limited population-specific data necessitate standardized guidelines to address diagnostic and therapeutic challenges.</p><p><strong>Objective: </strong>To establish evidence-based recommendations for diagnosing and prescribing vitamin D supplements tailored to the Mexican adult population, reducing practice variability while promoting optimal health outcomes.</p><p><strong>Methods: </strong>A multidisciplinary panel comprising specialists from nine leading Mexican medical organizations conducted a consensus process using the Delphi methodology. The recommendations were developed using a combined approach, integrating extensive literature reviews with expert consensus to address areas where empirical evidence is limited. The process informed guidelines for vitamin D supplementation, measurement criteria, and therapeutic monitoring.</p><p><strong>Results: </strong>Key recommendations include: Measuring 25(OH)D levels in adults with risk factors or conditions associated with hypovitaminosis D, avoiding routine screening in healthy individuals. Defining vitamin D deficiency as < 20 ng/mL, insufficiency as 20-29 ng/mL, and sufficiency as 30-100 ng/mL. Preferring cholecalciferol for supplementation, with calcifediol reserved for specific cases requiring rapid correction or compromised hepatic hydroxylation. Regularly monitor serum 25(OH)D concentrations to achieve and maintain levels between 30 and 60 ng/mL, ensuring safety and therapeutic efficacy.</p><p><strong>Conclusion: </strong>This joint position provides a comprehensive framework for managing hypovitaminosis D in Mexican adults. The recommendations aim to harmonize clinical practices, improve patient outcomes, and inform public health strategies for equitable resource allocation. Ongoing evaluation and stakeholder feedback will ensure adaptability and relevance as new evidence emerges.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":"78"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282284","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":"Recommendations for the prevention of fragility fractures: a consensus from international experts and Ibero-American scientific societies.","authors":"Pilar Sáez-López, César Aldecoa Álvarez-Santullano, Rosa Arboiro-Pinel, José Luis Baquero Úbeda, José Carlos Bastida Calvo, Francisco Baixaulí García, Concepción Cassinello Ogea, Patricia Ysabel Condorhuamán Alvarado, María Cortés Berdonces, Leonor Cuadra Llopart, Nuria Fernández Martínez, Mercé Giner García, Rafael Manuel Micó Pérez, Blanca Mur Molina, Antonio Naranjo Hernández, José Luis Neyro Bilbao, Cristina Ojeda-Thies, Santiago Palacios Gil Antuñano, Manuel Santiñá Vila, José Soto Bonel, Francisco José Tarazona-Santabalbina","doi":"10.1007/s11657-025-01551-2","DOIUrl":"10.1007/s11657-025-01551-2","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a multidisciplinary consensus outlining key recommendations to prevent fragility fractures and improve care through coordinated efforts across healthcare sectors.</p><p><strong>Methods: </strong>An international group of experts, coordinated by the Spanish National Hip Fracture Registry (RNFC), engaged over 300 professionals and 31 scientific societies. Using a nominal group technique, the committee reviewed scientific evidence and collaboratively developed ten core recommendations. The consensus was refined through multiple telematic reviews and finalized at the 7th RNFC Annual Meeting in March 2024.</p><p><strong>Results: </strong>The consensus presents ten actionable recommendations: (1) inclusion of osteoporosis and fragility fractures in health policies, (2) early detection and management of frailty and falls, (3) implementation of clinical practice guidelines, (4) promotion of fracture registries and audits, (5) support for Orthogeriatric Units and Fracture Liaison Services (FLS), (6) adoption of a \"Fragility Fracture Code,\" (7) empowerment of Primary Care in fracture prevention, (8) increased patient association involvement, (9) public awareness campaigns, and (10) promotion of research including patient-reported outcomes.</p><p><strong>Conclusions: </strong>Fragility fractures are a major public health issue with rising incidence, disability, and healthcare costs. This consensus offers unified, evidence-based guidance for policy makers, healthcare professionals, and patient organizations. Broad dissemination and implementation of these recommendations aim to reduce fracture rates and enhance patient outcomes through coordinated, multidisciplinary care.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"20 1","pages":"76"},"PeriodicalIF":3.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274106","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}