Calcified Tissue International最新文献

{"title":"Exploring the Role of FGF7 in Tumor-Induced Osteomalacia. Clinic-Pathologic Analysis in a Patient with a Sino-Nasal Phosphaturic Mesenchymal Tumor.","authors":"L Colangelo, F R Di Ciommo, B Palmisano, R Scrivo, M Della Monaca, J Pepe, C Cipriani, C Alessandri, V Valentini, M Riminucci, S Minisola, F Conti, A Corsi","doi":"10.1007/s00223-025-01394-6","DOIUrl":"10.1007/s00223-025-01394-6","url":null,"abstract":"<p><p>Tumor-induced osteomalacia (TIO) is an ultrarare paraneoplastic syndrome due to the overproduction of Fibroblast Growth Factor 23 (FGF23). Although other phosphate-regulating substances (i.e., \"phosphatonins\") have been demonstrated to be expressed in tumors associated with TIO, very limited information is available about their circulating levels and clinical significance. Here, we report a patient with a long-standing history of low serum phosphate values due to a sino-nasal phosphaturic mesenchymal tumor (PMT), in which the co-expression of FGF23 and FGF7 was detected in the neoplastic tissue and their serum levels determined before and after surgical tumor excision. The serum level of FGF23 was increased (312.0 pg/mL) before surgery and promptly normalized 24 h after tumor excision. In contrast, the value of FGF7 was high (202.6 pg/mL) before surgery, fell at 24 h after surgery (108.6 pg/mL), increased again after one week (252.0 pg/mL), and finally normalized (33.4 pg/mL) one year later, when also serum phosphate was in the normal range. This is the first sino-nasal PMT in which expression of FGF7 was observed and the first case of TIO in which the serum levels of FGF7 were monitored during the course of the disease (i.e., before and after tumor excision). Even though \"phosphatonins\" in addition to FGF23 are thought to contribute to the phosphate wasting leading to TIO, the observed increase in FGF7 levels one week after surgery (+ 31.66% compared to the preoperative value), when phosphate levels tended to normalize, may suggest a mild, if ever, phosphaturic effect of FGF7. Further studies are needed to define the mechanisms underlying the different post-surgical time-dependent decrease in the serum levels of FGF23 and FGF7 and the role of FGF7 in patients with TIO and more in general in phosphate homeostasis.</p>","PeriodicalId":9601,"journal":{"name":"Calcified Tissue International","volume":"116 1","pages":"82"},"PeriodicalIF":3.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246580","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":"Mineral Content and Extracellular Matrix Protein Expression in Mouse Growth Plates During Epiphyseal Fusion: An Observational Study.","authors":"Xinhang Yu, Megumi Nakamura, Miyuki Mayanagi, Itaru Mizoguchi, Yasuyuki Sasano","doi":"10.1007/s00223-025-01391-9","DOIUrl":"10.1007/s00223-025-01391-9","url":null,"abstract":"<p><p>In humans, the growth plate cartilage is completely replaced by bone in late puberty, resulting in epiphyseal fusion. However, in rats and mice, commonly used experimental model systems, the growth plate does not fuse completely even after sexual maturation, making it difficult to elucidate mechanisms involved in epiphyseal fusion. In this study, we investigated age-related changes in the mouse growth plate to better understand the process of epiphyseal fusion. We used scanning electron microscopy and energy-dispersive X-ray spectroscopy (SEM/EDS) to examine the distributions and concentrations of minerals in the growth plate. In SEM images, the hypertrophic zone was observed as a bright area and other zones as dark areas at 10 weeks of age (W10). The bright area was further expanded at W55 than at W10. EDS analysis showed that P and Ca concentrations were high in this area, while C and O concentrations were low, indicating that the growth plate had calcified during aging. Alcian blue histochemistry revealed that the glycosaminoglycans of aggrecan were distributed in the growth plate at both W10 and W55. Immunohistochemistry showed that aggrecan and type II collagen were expressed throughout the growth plate at W10, but sparsely at W55. Type I collagen was expressed weak at both W10 and W55. Type X collagen and MMP-13 expression were observed in the hypertrophic zone at W10 but not at W55. This study demonstrated that although the mouse growth plate calcifies with age, it remains calcified cartilage for an extended period without being replaced by bone.</p>","PeriodicalId":9601,"journal":{"name":"Calcified Tissue International","volume":"116 1","pages":"81"},"PeriodicalIF":3.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233268","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":"Patterns of Bone Mineral Density Loss at Multiple Skeletal Sites Following Recent Menopause in Users and Non-Users of Menopausal Hormone Therapy.","authors":"Kara L Holloway-Kew, Amelia G Morse, Kara B Anderson, Mark A Kotowicz, Julie A Pasco","doi":"10.1007/s00223-025-01392-8","DOIUrl":"10.1007/s00223-025-01392-8","url":null,"abstract":"<p><p>Post-menopausal bone loss has been well described, however fewer studies have focussed on changes around the time of menopause. This study describes bone mineral density (BMD) loss following recent menopause, stratified by hormone replacement therapy (HT) use. Women (n = 287) who self-reported recent menopause (≥ 12 months to < 5 yr since last menstrual period) for at least one assessment phase of the Geelong Osteoporosis Study were included. BMD was measured using Lunar DPX-L and GE-Prodigy machines. Time since menopause was calculated for each participant at each assessment phase and divided into three categories: < 5 yr, 5-10 yr and ≥ 10 yr. BMD loss was expressed as: (i) cumulative loss over time, (ii) absolute value per year and (iii) percentage loss per year. Proportions of women with normal BMD, osteopenia and osteoporosis were also calculated. Cumulative BMD loss was lower among HT users than non-users at all sites and time categories, except the femoral neck. Compared to the other time categories, HT non-users had a greater rate of BMD loss (expressed as an absolute value or percentage per year) during the first five years postmenopause at the ultra-distal forearm and lumbar spine. No differences were observed between the time categories for HT users. The proportions of women with osteopenia and osteoporosis increased across each of the time categories, but patterns differed by skeletal site, being more pronounced for the femoral neck and mid-forearm sites. Rates of bone loss were greater at the lumbar spine and ultra-distal forearm during the first five years following menopause.</p>","PeriodicalId":9601,"journal":{"name":"Calcified Tissue International","volume":"116 1","pages":"80"},"PeriodicalIF":3.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224402","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":"Comparison of Type 2 Diabetes Risk in Osteoporosis Patients Treated with Denosumab or Alendronate: A Nationwide Cohort Study.","authors":"Kyoung Jin Kim, Seol A Jang, Su Jin Kwon, Gi Hyeon Seo, Kyoung Min Kim","doi":"10.1007/s00223-025-01385-7","DOIUrl":"https://doi.org/10.1007/s00223-025-01385-7","url":null,"abstract":"<p><p>Recent studies have suggested potential metabolic effects of anti-osteoporotic medications, but their impact on type 2 diabetes mellitus (T2D) risk remains unclear. This study investigated the incidence of T2D in patients with osteoporosis treated with denosumab or alendronate. Using the Korean Health Insurance Review and Assessment Service database, we identified 316,026 patients who received either denosumab or alendronate between October 2017 and June 2022. After 1:3 propensity score matching, 1136 denosumab users and 3303 alendronate users were included. The primary outcome was incident T2D, defined as a new diagnosis followed by an antidiabetic medication prescription within six months. Over a median follow-up of 4.7 years, 57 (5.0%) denosumab users and 196 (5.9%) alendronate users developed T2D, with incidence rates of 10.7 and 12.4 per 1000 person-years, respectively. Denosumab use was not significantly associated with reduced T2D risk (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.64-1.15). Additional adjustment for chronic kidney disease and fractures during follow-up yielded an HR of 0.84 (95% CI 0.62-1.13; P = 0.25). Fine-Gray competing risk analysis considering death produced similar results (HR 0.84, 95% CI 0.62-1.13; P = 0.24). Subgroup analyses showed consistent findings across sex, age groups, comorbidities, and concurrent medication use. These findings suggest no significant difference in T2D risk between denosumab and alendronate users in osteoporosis patients. Both medications appear to have comparable metabolic effects. Further large-scale studies with longer follow-up are warranted to clarify the long-term impact of osteoporosis treatments on diabetes risk.</p>","PeriodicalId":9601,"journal":{"name":"Calcified Tissue International","volume":"116 1","pages":"78"},"PeriodicalIF":3.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186648","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":"Stress During Lactation: A Hidden Link to Offspring Bone Health.","authors":"Ranjitha Chandrashekar, Bharath K Mulakala, Manoj Gurung, Geetanjali Venna, Jolene R Rearick, Brenda Onyekweli, Meghan L Ruebel, Jasmine Dada-Fox, Jasmina A Zeledon, Rachelanne Talatala, Kayleigh Rodriguez, Laura R Osborn, Mary Grace Bishop, Brenda Smith, Kimberly E Stephens, Edralin A Lucas, Laxmi Yeruva","doi":"10.1007/s00223-025-01378-6","DOIUrl":"10.1007/s00223-025-01378-6","url":null,"abstract":"<p><p>Early-life resource limitation is one factor that could have a major impact on child health and development. Thus, using a rat model of limited bedding and nesting (LBN), we investigated the postnatal bone development, mineralization, and microarchitecture. Pregnant Sprague-Dawley rats were subjected to a LBN model to induce chronic early-life stress (CES), while a control group was maintained under standard conditions. The offspring were assessed at postnatal day (PND) 10, 21, and 35. Tibial length was measured, and tibial and lumbar vertebral bone mineral density (BMD), content (BMC), and area (BMA) were assessed using dual-energy X-ray absorptiometry (DXA). Bone microarchitecture was examined using microcomputed tomography (μCT). Changes in gene expression from the lumbar vertebrae were analyzed by transcriptome. At PND 10, there were no significant differences in BMD and BMC between the treatment groups, but tibial length was significantly decreased by CES. By PND 21, tibial BMC and BMA were significantly reduced in the CES group, indicating impaired bone mineral accumulation. At PND 35, tibial length remained significantly reduced by CES, while BMD and BMC differences were less affected. Vertebral BMA and BMC were reduced by CES. μCT analysis of tibial cortical bone showed significant changes in cortical thickness and bone volume at PND 10 and 21, respectively. For the lumbar vertebrae, μCT data indicated significant increases in the degree of anisotropy and structural model index at PND 21 and 35, respectively. Transcriptome analyses revealed significant differential expression of genes involved in immune response, cellular repair, and stress adaptation at PND 21 but not at PND 10 and PND 35. CES significantly disrupts BMC, BMD, length, and microarchitecture differently at various stages of postnatal development. Transcriptome analyses suggest that these changes are mediated by alterations in gene expression related to immune function and cellular repair. Future research should focus on tracking the longitudinal impacts of CES on bone health from infancy into adulthood, and exploring nutritional interventions, stress reduction programs, and molecular studies that can mitigate the negative effects of CES on bone.</p>","PeriodicalId":9601,"journal":{"name":"Calcified Tissue International","volume":"116 1","pages":"79"},"PeriodicalIF":3.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186649","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":"Geraniin Promotes Osteoblast Proliferation, Bone Formation, and Autophagy by Regulating the PI3K/Akt/mTOR Cascade to Improve Glucocorticoid-Induced Osteoporosis.","authors":"XueGang Liang, QianPeng Ma, LiJuan Wang, XianRui Xu, WenHui Jiang, Long Bao, Fei Liu","doi":"10.1007/s00223-025-01387-5","DOIUrl":"https://doi.org/10.1007/s00223-025-01387-5","url":null,"abstract":"<p><p>Geraniin is a plant natural product that has been testified to perfect osteoporosis (OP). However, Geraniin's impacts on osteoblast autophagy and its latent molecular mechanisms remain uncertain. In this study, Geraniin's impacts on autophagy in osteoblasts were figured out and its molecular mechanism was uncovered. We established in vivo and in vitro models of OP using glucocorticoids and administered Geraniin. The results manifested that Geraniin dose-dependently promoted the phosphorylation of PI3K/Akt/mTOR in OP rats and osteoblasts, increased the bone mineral density, bone surface area/bone volume, Trabecular number and trabecular bone thickness of rat femurs, enhanced alkaline phosphatase activity in OP rats and osteoblasts, elevated osteogenesis-linked proteins RUNX2, OSX and OCN, facilitated autophagosome formation in osteoblasts, elevated Beclin-1 and ACTG5 expression levels and LC3II/LC3I ratio and downregulated p62. However, these effects of Geraniin were attenuated by PI3K/Akt/mTOR inhibitors. All in all, the results of this study indicate Geraniin can perfect glucocorticoid-induced OP by motivating autophagy in osteoblasts through PI3K/Akt/mTOR cascade, which offers strong data support for the future development of Geraniin as a drug for OP cure.</p>","PeriodicalId":9601,"journal":{"name":"Calcified Tissue International","volume":"116 1","pages":"77"},"PeriodicalIF":3.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of a Body Shape Index with Bone Mineral Density and Osteoporosis Among U.S. Adults: Evidence from NHANES.","authors":"He-Gang Niu, Gao-Kai Hu, Tong Li, Zhao Guo, Yang Hu, Yu-Kang Gong, Gao-Qi Ye, De-Jin Chen, Ji-Long An, Wen-Shan Gao","doi":"10.1007/s00223-025-01386-6","DOIUrl":"https://doi.org/10.1007/s00223-025-01386-6","url":null,"abstract":"<p><p>Obesity significantly impacts bone health. The ABSI is an innovative metric for assessing obesity, offering greater accuracy than traditional measures such as body mass index and waist circumference in reflecting visceral fat accumulation. This study aims to investigate the relationship between ABSI and BMD as well as its association with osteoporosis among U.S. adults, utilizing data from the NHANES. This cross-sectional study analyzed data from adults aged 18 years and older, collected during the 2005-2006, 2013-2014, and 2017-2018 cycles of the NHANES. Multivariate linear regression models were used to evaluate the association between ABSI and BMD. Multivariate logistic regression models were applied to assess the relationship between ABSI and osteoporosis. Restricted cubic spline models were employed to evaluate potential nonlinear associations between ABSI and BMD as well as osteoporosis. Additionally, subgroup analyses and sensitivity analyses were conducted to ensure the robustness of the findings. A total of 5487 participants were included in the analysis, with a mean age of 47.04 years. ABSI was found to be negatively associated with BMD at the femoral neck, total femur, and lumbar spine. Participants in the highest ABSI quartile exhibited a significantly higher prevalence of osteoporosis compared to those in the lowest quartile (OR = 1.95; 95% CI 1.61-2.26). Nonlinear relationships were observed between ABSI and BMD at the femoral neck, total femur, lumbar spine, and osteoporosis, with inflection points at 8.84, 8.56, 9.23, and 8.14, respectively. Sensitivity analyses confirmed the robustness of these associations. Subgroup analyses revealed significant interactions between ABSI and BMD in smokers (P < 0.05). This study identifies a significant negative association between ABSI and BMD and a positive association with osteoporosis. The nonlinear relationship observed between ABSI and both BMD and osteoporosis underscores the importance of maintaining an optimal ABSI to promote bone health. These findings support the utility of ABSI as a valuable marker for early identification and prevention of osteoporosis, offering actionable insights for clinical and public health strategies. Future longitudinal research is warranted to validate these results and further elucidate the underlying mechanisms.</p>","PeriodicalId":9601,"journal":{"name":"Calcified Tissue International","volume":"116 1","pages":"76"},"PeriodicalIF":3.3,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141376","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":"The Association Between Two Different Non-invasive Advanced Glycation End Products and Osteoporosis in the Non-diabetic Population: A Cross-Sectional Study.","authors":"Yu-Yi Tian, Lu-Lu Xu, Ya-Qian Fu, Shan Zhou, Chun Yue, Li Hu, Yan-Yi Yang, Yu-Qi Lu, Zhi-Feng Sheng, Li-Hong Liu","doi":"10.1007/s00223-025-01384-8","DOIUrl":"https://doi.org/10.1007/s00223-025-01384-8","url":null,"abstract":"<p><p>Advanced glycation end products (AGEs) are associated with osteoporosis (OP) in the diabetic population. However, their relationship with OP in the non-diabetic population remains unclear. This study aimed to investigate cross-sectional associations of AGEs levels in the skin and lens with OP in the non-diabetic population. A retrospective analysis of clinical data of 652 participants was conducted. Bone mineral density (BMD) was quantified by dual-energy X-ray absorptiometry. Lens and skin AGEs were assessed by lens and skin autofluorescence (LAF and SAF). This study included 652 individuals, 280 males (42.9%) and 372 females (57.1%), with a mean age of (55.5 ± 6.9) years. The population with osteopenia exhibited significantly higher levels of SAF-AGEs than those with normal BMD, while the population with OP had significantly higher levels of both SAF- and LAF-AGEs. After adjusting for age and body mass index, LAF-AGEs were negatively correlated with BMD at the femoral neck and total hip. In contrast, SAF-AGEs were negatively correlated with BMD at the lumbar1-4 spine. Furthermore, multiple linear stepwise regression analysis demonstrated that LAF-AGEs were negatively associated with BMD at both the femoral neck and total hip. However, SAF-AGEs showed no association with BMD at any of the three measured sites. Additionally, after adjusting for other covariates, the logistic regression analysis emphasized that LAF-AGEs were associated with OP in the non-diabetic population, but SAF-AGEs do not. The results revealed a significant correlation between LAF-AGEs and OP in the non-diabetic population and their potential clinical utility warrants further validation. Therefore, we urge for larger longitudinal analyses and experimental research to validate and extend these cross-sectional findings.</p>","PeriodicalId":9601,"journal":{"name":"Calcified Tissue International","volume":"116 1","pages":"75"},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118970","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":"Grading Pseudo Fractures.","authors":"Sudhaker D Rao","doi":"10.1007/s00223-025-01383-9","DOIUrl":"https://doi.org/10.1007/s00223-025-01383-9","url":null,"abstract":"","PeriodicalId":9601,"journal":{"name":"Calcified Tissue International","volume":"116 1","pages":"74"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979206","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":"Transition Care for Young Persons with Rare Bone Mineral Conditions: A Consensus Recommendation from the ECTS Rare Bone Disease Action Group.","authors":"Corinna Grasemann, Joline Wernsmann, Natasha M Appelman-Dijkstra, Chloe Morgan, Tenna Toft Sylvest, Adalbert Raimann, Heide Siggelkow, Willem F Lems, Serap Turan, M Carola Zillikens, Lena Lande Wekre, Inês Alves, M Cohen Solal, Maria P Yavropoulou, Gavin Clunie","doi":"10.1007/s00223-025-01382-w","DOIUrl":"https://doi.org/10.1007/s00223-025-01382-w","url":null,"abstract":"<p><p>Transition care (TC) is crucial for young persons with rare bone and mineral conditions (RBMCs) as they move from pediatric to adult healthcare. Effective TC prevents care disruptions and supports medical and psychosocial needs. However, gaps in communication, a shortage of adult RBMC specialists, and challenges in navigating adult healthcare necessitate standardized care. This study aimed to develop consensus-based recommendations for TC in RBMCs, focusing on best practices for seamless transition and patient empowerment. A two-round Delphi survey (September 2023-April 2024) was conducted among European RBMC experts, including 3 pediatric and 8 adult clinicians and 3 patient representatives from the European Calcified Tissue Society (ECTS). The panel formulated and refined statements through literature review and iterative scoring. Statements reaching ≥ 70% consensus were retained. A total of 81 statements were finalized across seven domains: initiation and planning, TC requirements, patient empowerment, organization and communication, service infrastructure and funding, and clinical care. Consensus was achieved on 64 out of 81 statements, with strong agreement on general and RBMC-specific recommendations. Key priorities included structured coordination among healthcare providers and a patient-centered approach that fosters self-advocacy and self-management. This Delphi consensus provides a structured framework for TC in young persons with RBMCs, emphasizing multidisciplinary care and patient empowerment. Future studies should assess the feasibility and impact of these guidelines across diverse healthcare systems.</p>","PeriodicalId":9601,"journal":{"name":"Calcified Tissue International","volume":"116 1","pages":"73"},"PeriodicalIF":3.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977699","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}