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Abstract Background Numerous studies have demonstrated shared risk factors and pathophysiologic mechanisms between osteoporosis and cardiovascular disease. High-density lipoprotein cholesterol (HDL-C) and platelets have long been recognized as crucial factors for cardiovascular health. The platelet to HDL-C ratio (PHR) combines platelet count and high-density lipoprotein cholesterol (HDL-C) level, It is a novel biomarker for metabolic syndrome and cardiovascular disease. The platelet to HDL-C ratio (PHR) possibly reflects the balance between proinflammatory and anti-inflammatory states in the body. Therefore, we hypothesized that changes in PHR ratios may predict a predisposition to pro-inflammatory and increased bone resorption. However, the relationship between the platelet to HDL-C ratio (PHR) and bone mineral density (BMD) remains insufficiently understood. This study aimed to elucidate the relationship between the platelet to HDL-C ratio (PHR) index and bone mineral density (BMD). Methods Data from the NHANES 2005–2018 were analyzed, excluding adults with missing key variables and specific conditions. Nonlinear relationships were explored by fitting smoothed curves and generalized additive models, with threshold effects employed to calculate inflection points. Additionally, subgroup analyses and interaction tests were conducted. Results The study included 13,936 individuals with a mean age of 51.19 ± 16.65 years. Fitted smoothed curves and generalized additive models revealed a nonlinear, inverted U-shaped relationship between the two variables. Threshold effect analysis showed a significant negative association between PHR and total femur bone mineral density (BMD) beyond the inflection point of platelet to HDL-C ratio (PHR) 33.301. Subgroup analyses showed that a significant interaction between these two variables was observed only in the age and sex subgroups (P-interaction

Abstract Background & objective Osteoporosis is a growing public health concern, particularly among the aging population. This study aimed to evaluate the association between osteoporosis and quality of life (QoL) in a sample of older adults. Methods This cross-sectional study utilized data from all the participants of Bushehr Elderly Health program (BEHP), phase 2. QoL was assessed using the 12-Item Short Form Survey (SF-12 Questionnaire), and participants were classified as having osteoporosis or not based on the WHO diagnostic criteria. The physical (PCS) and mental (MCS) component summaries of QoL were estimated. The association between osteoporosis and QoL was evaluated separately for men and women, considering various health and lifestyle factors using linear regression analysis. Results The study included 2,399 participants (average age 71.27 ± 7.36 years). 1,246 were women and 1,153 were men. Osteoporosis was present in 59% of women and 23% of men. Participants with osteoporosis had significantly lower PCS scores compared to those without osteoporosis (women: 38.1 vs. 40.2, p

Objective To analyze the characteristics and influencing factors of young people with bone mass abnormality in Beijing who underwent health examination, providing a basis and reference for the prevention and treatment of osteopenia and osteoporosis. Methods Data were collected from 973 individuals aged≤40 years who underwent health examination, including bone mineral density (BMD) testing, at Beijing Friendship Hospital,Capital Medical University, from January to July 2023. Among them, 348 young people had bone mass abnormality,while 625 had normal bone mass.Potential related indicators were selected to analyze the occurrence and potential influencing factors of bone mass abnormality among young health examination population. Results The incidence of bone mass abnormality in young health examination population was 35.77%, with 91.67% of cases involving osteopenia and 8.33% involving osteoporosis. Males accounted for 57.47% and females for 42.53%. Univariate analysis showed that the occurrence of bone mass abnormality was correlated with multiple factors, including gender, age, weight, Body Mass Index (BMI), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), uric acid (UA), smoking, and alcohol consumption (P

Objective To investigate the impact of total parathyroidectomy with autotransplantation (tPTx+AT) on bone mineral density and serum soluble Klotho (sKlotho) level in patients with secondary hyperparathyroidism (SHPT). Methods A total of 86 patients undergoing tPTx+AT in the Second Affiliated Hospital of Anhui Medical University from June 2019 to May 2022 were recruited in this study. Their demographic characteristics were collected before surgery, along with serum levels of corrected calcium, phosphorus, intact parathyroid hormone (iPTH), alkaline phosphatase (ALP), fibroblast growth factor 23 (FGF23), and sKlotho before and at 5 d, and 1, 3, 6, 12 and 24 months after surgery. Dual energy X-ray absorptiometry was used to determine the BMD values of the lumbar spine L1-L4 before surgery and at 3, 6, 12 and 24 months after surgery. The changes in BMD and serum FGF23 and sKlotho levels before and after tPTx+AT were observed. Results Surgical treatment was successfully completed in all 86 patients, with their clinical symptoms such as bone pain and skin itching significantly improved postoperatively, and markedly decreased serum calcium, phosphorus, iPTH, ALP and FGF23 levels. The sKlotho level was significantly lower at 5 d postoperatively than that preoperatively, with that at 1 month after surgery increased by approximately 24.5% than the preoperative level, and then the level was in a stable trend. The BMD values at the lumbar spine L1-L4 were increased postoperatively, and reached the highest levels at 12 months postoperatively. Further analyses showed that dialysis vintage, duration of SHPT, and ALP, iPTH and FGF23 levels were negatively correlated with the Z-scores of the lumbar spine L1-L4, while sKlotho level was positively correlated with the Z-scores. Conclusion tPTx+AT can significantly improve the clinical symptoms of SHPT patients, regulate the balance of calcium and phosphorus metabolism, increase sKlotho level and reduce FGF23 level. It is an effective method to improve BMD.

Abstract Background: Both lipid metabolism and obesity are crucial factors in osteoporosis, influencing the relevance of the cardiometabolic index (CMI), a new body fat index incorporating obesity and lipid metrics. Our study aims to explore the relationship between CMI and lumbar spine bone mineral density (BMD) and the mediating role of body fat percentage. Methods: Utilizing the National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2018, we conducted a cross-sectional analysis. We employed multiple linear regression models, subgroup analyses, generalized additive models (GAM), smooth curve fitting, and mediation analysis to evaluate the linear and nonlinear relationships between CMI and lumbar spine BMD. Results: The study involved 5,124 participants with an average lumbar spine BMD of 1.03 ± 0.15 g/cm2. We identified a negative correlation between CMI and lumbar spine BMD (β = -0.015; 95% CI: -0.023, -0.008). Nonlinear associations were evident, with inflection points at CMI values of 1.12 and 2.86. Subgroup analyses showed consistent negative correlations across all categories without significant differences (p for interaction > 0.05). Moreover, body fat percentage negatively correlated with BMD (β = -0.005; 95% CI: -0.006, -0.004) and mediated 9.41% of the relationship between CMI and BMD. Conclusion: Increased CMI levels are associated with lower lumbar spine BMD, with body fat percentage significantly mediating this relationship. This underscores the importance of managing body composition in the context of bone health, highlighting CMI’s potential utility in osteoporosis risk assessment.

Abstract Primary Hyperparathyroidism (PHPT) is characterized by excessive parathormone (PTH) secretion and disrupted calcium homeostasis. Untargeted metabolomics offers a valuable approach to understanding the complex metabolic alterations associated with different diseases, including PHPT. Plasma untargeted metabolomics was applied to investigate the metabolic profiles of PHPT patients compared to a control group. Two complementary liquid-phase separation techniques were employed to comprehensively explore the metabolic landscape in this retrospective, single-center study. The study comprised 28 female patients diagnosed following the current guidelines of PHPT diagnosis and a group of 30 healthy females as a control group. To evaluate their association with PHPT, we identified changes in plasma metabolic profiles in patients with PHPT compared to the control group. The primary outcome measure included detecting plasma metabolites and discriminating PHPT patients from controls. The study unveiled specific metabolic imbalances that may link l-amino acids with peptic ulcer disease, gamma-glutamyls with oxidative stress, and asymmetric dimethylarginine (ADMA) with cardiovascular complications. Several metabolites, such as gamma-glutamyls, caffeine, sex hormones, carnitine, sphingosine-1-phosphate (S-1-P), and steroids, were connected with reduced bone mineral density (BMD). Metabolic profiling identified distinct metabolic patterns between patients with PHPT and healthy controls. These findings provided valuable insights into the pathophysiology of PHPT.

Abstract Background Breast cancer (BC) poses significant burdens on women globally. While past research suggests a potential link between bone mineral density (BMD) and BC risk, findings remain inconsistent. Our study aims to elucidate the causal relationship between BMD and BC in East Asians using bidirectional Mendelian randomization (MR). Methods Genetic association data for bone mineral density T-scores (BMD-T) and Z-scores (BMD-Z) (Sample size = 92,615) and BC from two different sources (Sample size1 = 98,283; Sample size2 = 79,550) were collected from publicly available genome-wide association studies (GWAS). Single-nucleotide polymorphisms (SNPs) associated with BMD-T and BMD-Z as phenotype-related instrumental variables (IVs) were used, with BC as the outcome. As the primary means of causal inference, the inverse variance weighted (IVW) approach was employed. Heterogeneity analysis was conducted using Cochran’s Q test, while MR-Egger regression analysis was implemented to assess the pleiotropic effects of the IVs. Sensitivity analyses were performed using methods such as MR-Egger, weighted median, and weighted mode to analyze the robustness and reliability of the results. The MR-PRESSO method and the RadialMR were used to detect and remove outliers. The PhenoScanner V2 website was utilized to exclude confounding factors shared between BMD and BC. Besides, the Bonferroni correction was also used to adjust the significance threshold. Then, the meta-analysis method was applied to combine the MR analysis results from the two BC sources. Finally, a reverse MR analysis was conducted. Results The results of the IVW method were consolidated through meta-analysis, revealing a positive correlation between genetically predicted BMD-T ( $$\:OR\:=\:1.22$$ , $$\:95\%\:CI:\:1.13-1.33$$ , $$\:P

Abstract Background Lifelong management of phenylketonuria (PKU) centers on medical nutrition therapy, including dietary phenylalanine (Phe) restriction in addition to Phe-free or low-Phe medical foods/protein substitutes. Studies have reported low bone mineral density (BMD) in mixed-age PKU populations, possibly related to long-term Phe restriction. Therefore, a meta-analysis investigating BMD specifically in adults with PKU was conducted. Methods Studies reporting BMD-related outcomes were identified from a systematic literature review evaluating somatic comorbidities experienced by adults with PKU on a Phe-restricted diet (searched February 1, 2022, updated November 1, 2023). Risk of study bias was assessed (Scottish Intercollegiate Guidelines Network checklists). The primary outcome of the meta-analysis was pooled mean BMD Z-scores of different bones. Secondary outcomes were the prevalence of low BMD Z-scores at pre-specified thresholds. Subgroup analyses of mean BMD Z-scores (decade of study publication, controlled versus uncontrolled blood Phe levels, gender) were conducted. Results BMD-related data from 4097 individuals across 10 studies rated as at least acceptable quality were included. Mean BMD Z-scores were statistically significantly lower compared with an age-matched control or reference (non-PKU) population, across bones, but still within the expected range for age (> -2.0): lumbar spine (seven studies, n = 304), -0.63 (95% confidence interval (CI): -0.74, -0.52); femoral neck (four studies, n = 170), -0.74 (95% CI: -1.25, -0.22); radius (three studies, n = 114), -0.77 (95% CI: -1.21, -0.32); total body (four studies, n = 157), -0.61 (95% CI: -0.77, -0.45). The small number of observations in the subgroup analyses resulted in a high degree of uncertainty, limiting interpretation. Estimated prevalence of BMD Z-scores ≤ -2.0 was 8% (95% CI: 5%, 13%; four studies, n = 221) and

Abstract Currently, the relationship between axial rotation of the vertebrae and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) remains controversial. The aim of this study is to quantitatively assess the effect of vertebral rotation on volumetric bone mineral density (v-BMD) and areal bone mineral density (a-BMD), further to propose the corrected strategies. To achieve this, a phantom, which was rotated from 0° to 25° in 5° increments, was utilized. Bone mineral content (BMC), a-BMD, v-BMD, and projected area (p-AREA) were measured. The Kruskal–Wallis non-parametric test or one-way ANOVA was used to examine the differences in variables between the different groups. The Pearson and Spearman correlation was used to test the relationships between quantitative parameters and rotated angles. Linear regression analysis was used to evaluate the relationship between angles and quantitative parameters. The findings indicate that, as the angle increased, a-BMD and v-BMD decreased (P

Objective: To determine the relationship between cartilage injury, bone marrow edema, and total bone mineral density in patients with knee osteoarthritis (KOA). Methods: Ninety patients with KOA admitted to the Sichuan Province Orthopedic Hospital between March 2023 and October 2023 were selected, all of whom underwent knee joint MRI and chest QCT examinations. The patients were divided into three groups according to the QTC results: normal bone density, reduced bone mass, and osteoporosis. Patient information, such as sex, age, body mass index (BMI), and course of illness, was also obtained. MRIs of the knee joints were scored separately according to the Recht grading and Whole-organ Magnetic Resonance Imaging Score (WORMS). The bone mineral density (BMD) of the patients was calculated and the BMD values were statistically analyzed using the MR score. Results: No statistically significant differences were observed in sex, BMI, or disease duration among the three groups; however, a statistically significant difference was observed in age. The Recht and WORMS scores among the three groups showed statistical significance between the normal bone density group and the reduced bone mass and osteoporosis groups; however, no statistical significance was observed between the reduced bone mass and osteoporosis groups. KOA cartilage injury was negatively correlated with bone density with a correlation coefficient of r=−0.412, while KOA bone marrow edema was negatively correlated with bone density with a correlation coefficient of r=−0.254. Conclusion: The total bone density in patients with KOA is related to knee joint cartilage injury and bone marrow edema. A decrease in total bone density may indicate the severity of knee cartilage injury or bone marrow edema.

Background: Poor bone and joint health, as evidenced by a reduction in bone mineral content and density (BMC, BMD) and progressive joint destruction, has been reported in hemophiliacs. Material and methods: Thirty children (4–17 y) with severe hemophilia A and 30 age and sex-matched healthy controls were included. Children with symptomatic hypocalcemia, rickets, recipients of drugs affecting BMD, and congenital skeletal malformation were excluded. Physical activity scoring (PAS), annualized bleeding rate (ABR), and annualized joint bleeding rate (AJBR) were determined in hemophiliacs. Joints were assessed by using Pettersson and Hemophilia Joint Health Score (HJHS) 2.1. BMC and BMD were estimated using a dual-energy X-ray absorptiometry (DEXA) scan. Serum vitamin D, calcium, phosphate, and alkaline phosphatase levels were estimated. Results: BMD, serum vitamin D, and calcium were lower in hemophiliacs than in controls (p

Context Achyranthes bidentata Blume (ABB), a plant of Amaranthaceae family, has been one of the more commonly used phytomedicine remedies for thousands of years, and recent studies have highlighted the efficacy of its extracts in the treatment of osteoporosis. Nonetheless, a thorough analysis of its benefits is currently absent.Objective This meta-analysis assessed the effects of ABB root extract (ABBRE) on osteoporotic rats and provides a rationale for future clinical studies.Methods Searches were conducted in seven different Chinese and English databases, and the search period was from their establishment to January 2024. This study was registered in PROSPERO (CRD42023418917). Selected research regarding the ABBRE treatment of osteoporotic rats, and the corresponding research has distinctly reported outcomes, and the data on the bone mineral density (BMD), bone histomorphometrics, biomechanical parameters, and bone biochemical markers of osteoporotic rats can be extracted.Results Through screening, 11 studies met the eligibility requirements for inclusion, in which 222 animals were studied. The treatment group with ABBRE exhibited increased bone mineral density (standardized mean difference [SMD] = 1.64, 95% CI = 0.52 to 2.77). Based on subgroup analysis, the greatest increase in bone mineral density was observed when the dose of ABBRE was ≤ 400 mg/kg/day and the duration of treatment was ≤ 12 weeks.Conclusions ABBRE is a phytomedicine that can effectively promote the enhancement of bone mineral density and ease osteoporosis. It can be developed into a new alternative therapy by conducting experiments and clinical studies on larger samples.

Background: Diet is an essential modifiable determinant of bone health, yet the associations between dietary patterns (DPs) and bone mineral density (BMD) in Chinese children remain limited. Objective: This study aimed to investigate the relationship between overall diet and low BMD risk among school-aged children in China. Methods: A total of 1,099 children aged 9–12 in China were recruited for this cross-sectional study. A semi-quantified food frequency questionnaire (FFQ) was used to assess dietary intake. A priori numerical index, the Chinese Dietary Guidelines Index for Children and Adolescents [CDGI (2021)-C] was utilized to assess dietary quality. Specific DPs were identified by using principal components analysis (PCA). The BMD of the left forearm was assessed using dual-energy X-ray absorptiometry (DXA). Spearman correlation test was conducted to investigate the associations between DPs. Multivariate logistic regression analysis and restricted cubic spline models (RCS) were applied to explore the associations between DPs and BMD. Results: Three distinct DPs were identified: the plant-animal balanced pattern, the grain-tuber-meat pattern, and the bean-dairy pattern. We found a weak but significant positive correlation of the CDGI (2021)-C with the plant-animal balanced pattern (R = 0.318, P < 0.001), and with the bean-dairy pattern (R = 0.266, P < 0.001), respectively. After adjusting for covariates, adherence to the CDGI (2021)-C (Q4 vs. Q1, OR = 0.45, 95% CI: 0.27–0.75), the plant-animal balanced pattern (Q4 vs. Q1, OR = 0.50, 95% CI: 0.31–0.81), and the bean-dairy pattern (Q3 vs. Q1, OR = 0.57, 95% CI: 0.33–0.96) were associated with a lower risk of low BMD. No significant association was observed between the grain-tuber-meat pattern and low BMD (Q4 vs. Q1, OR = 1.09; 95% CI: 0.90–1.31). Conclusion: Adherence to the CDGI (2021)-C and the plant-animal balanced pattern is advantageous for bone health and inversely correlated with the risk of low BMD among school-aged children in China. Additionally, moderate adherence to the bean-dairy pattern may also confer benefits to bone health. A balanced and overall healthy diet should be recommended in our daily life. [ABSTRACT FROM AUTHOR]

BACKGROUND: Percutaneous vertebroplasty is the most widely used method for the treatment of osteoporotic vertebral compression fractures, and most studies have concluded that percutaneous vertebroplasty increases the probability of adjacent vertebral secondary compression fractures in patients with osteoporotic vertebral compression fractures. However, controversy remains regarding the risk factors associated with adjacent vertebral re-fracture caused after percutaneous vertebroplasty. OBJECTIVE: To summarize the influencing factors of adjacent vertebral compression fractures after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures, in order to provide a certain reference for reducing the risk of its occurrence as well as formulating the corresponding treatment plan. METHODS: Using “osteoporosis, fracture, percutaneous vertebroplasty, adjacent vertebral compression fractures, risk factors” as the Chinese search terms, “osteoporosis, osteoporotic vertebral compression fractures, percutaneous vertebroplasty, adjacent vertebral compression fractures, risk factors” as English search terms, computerized searches were conducted on CNKI, Wanfang Medical Network, VIP, PubMed, Springer, ScienceDirect, and Elsevier databases. The search timeframe focuses on January 2018 through September 2023, with the inclusion of a few classic forward literature. The literature was screened by reading the titles and abstracts, and 83 papers were finally included in the review. RESULTS AND CONCLUSION: (1) Osteoporotic vertebral compression fractures are one of the most common complications of osteoporosis, placing elderly patients at a significant risk of disability and death. Percutaneous vertebroplasty is a practical and effective treatment for osteoporotic vertebral compression fractures. (2) With the popularity of percutaneous vertebroplasty, its secondary vertebral compression fractures have gradually increased, with adjacent vertebral compression fractures being the most common. (3) Previous studies have only discussed the effects of factors such as bone mineral density, multiple vertebral fractures, body mass index, age, sex, amount of bone cement, cement leakage, and anti-osteoporosis treatment on secondary compression fractures of adjacent vertebrae after percutaneous vertebroplasty, and summarized the number of vertebral fractures, timing of the operation, surgical approach, cement material, diffuse distribution of bone cement, recovery height of the injured vertebrae, and wearing of a support after surgery, which is not yet comprehensive. The analysis of the specific mechanisms of risk factor-induced adjacent vertebral fractures is relatively rare. (4) The results of the article showed that low bone mineral density, advanced age, perimenopausal women, multiple vertebral fractures, excessive recovery of the height of the injured vertebrae, cement leakage, comorbid underlying diseases, and poor lifestyle habits were the risk factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty, and that maintaining a normal body mass index, early surgery, bilateral percutaneous vertebroplasty, use of a new type of cement material, an appropriate volume of bone cement injection and uniform cement dispersion, regular anti-osteoporosis treatment, and postoperative brace wearing are protective factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty. [ABSTRACT FROM AUTHOR]

BACKGROUND: Epidemiologic studies have shown a correlation between type 2 diabetes mellitus and bone mineral density, but the causal association between the two and whether it is age-related remains unknown OBJECTIVE: To study the correlation between type 2 diabetes mellitus and whole body bone mineral density at unspecified age and at all ages based on the Mendelian randomization technique. METHODS: The genome-wide association study (GWAS) data of type 2 diabetes mellitus and bone mineral density at all ages were selected from the IEU GWAS database of the University of Bristol. The exposure data were single nucleotide polymorphisms with significant correlation with type 2 diabetes mellitus as instrumental variables, and bone mineral density at all ages was selected as the outcome variable. Two-sample Mendelian randomization analysis of type 2 diabetes mellitus and bone mineral density was performed using inverse variance weighted method, weighted median estimator, and MR-Egger regression. The βvalue was used to evaluate the causal relationship between type 2 diabetes mellitus and bone mineral density at all ages. RESULTS AND CONCLUSION: A total of 118 single nucleotide polymorphisms were extracted from the GWAS summary data as instrumental variables. The MREgger regression results showed that there was no horizontal pleiotropy, but there was heterogeneity. Therefore, this study was based on the inverse variance weighted results. Inverse variance weighted results showed that type 2 diabetes mellitus may be a potential protective factor for bone mineral density and is associated with age: age-unspecified bone mineral density [β=0.038, 95% confidence interval (CI): 1.01-1.07, P=0.002], bone mineral density over 60 years old (β=0.052, 95% CI: 1.01-1.09, P=0.027), bone mineral density between 45-60 years old (β=0.049, 95% CI: 1.01-1.09, P=0.009 ), bone mineral density between 30-45 years old (β=0.033, 95% CI: 0.99-1.07, P=0.127). bone mineral density of 15-30 years old (β=0.025, 95% CI: 0.95-1.10, P=0.506), bone mineral density of 0-15 years old (β=0.006, 95% CI: 0.96-1.04, P=0.716 ). Similar results were obtained from the MR-Egger regression and weighted median estimator analyses. These findings indicate that type 2 diabetes mellitus may be one of the protective factors of bone mineral density, and there is a correlation with age. [ABSTRACT FROM AUTHOR]

Summary: This study, using Mendelian randomization, reveals a causal link between nitrogen oxides and PM2.5 exposure and reduced total-body bone mineral density, highlighting a potential risk factor for osteoporosis. The findings emphasize the importance of targeted interventions in populations exposed to higher air pollution. Introduction: With the aging of the population, the prevalence of osteoporosis is escalating. Observational studies suggest that air pollution might diminish bone mineral density (BMD), contributing to elevating the likelihood of developing osteoporosis. Methods: Employing a two-sample Mendelian randomization (MR) analysis, our study aimed to explore the potential causal effect of air pollution on total-body BMD. We utilized extensive publicly available data from genome-wide association studies (GWAS) in this research. Inverse variance weighting was selected for the primary effect estimation, complemented by additional approaches such as the weighted median, MR-Egger, simple mode, and weighted mode. Sensitivity analyses were then conducted to evaluate heterogeneity, pleiotropy, and the presence of outliers. Results: In the MR analysis, our findings revealed causal associations between nitrogen oxides (β = − 0.55, 95% CI − 0.90 to − 0.21, P = 0.002) and particulate matter (PM) 2.5 (β = − 0.33, 95% CI − 0.59 to − 0.08, P = 0.010) and a reduction in total-body BMD. No significant associations were detected between PM2.5–10, PM10, nitrogen dioxide, and total-body BMD (P > 0.05). Rigorous sensitivity analyses verified the stability of these significant results. Conclusions: Our study illustrates that exposure to nitrogen oxides and PM2.5 may lead to a decrease in total-body BMD, increasing the risk of osteoporosis. This evidence holds crucial implications for policymakers and healthcare providers, as it can provide targeted interventions for the prevention of osteoporosis. [ABSTRACT FROM AUTHOR]

Perfluoroalkyl substances (PFAS) as a large group of synthetic compounds widely contaminated the environment and lead to health problems. However, the correlation between PFAS exposure, bone health parameters and osteoporosis remains controversial. Therefore, we conducted a systematic review and meta-analysis of published literature to evaluate the effects of PFAS on human bone health. All observational studies were collected up to 2 December 2023. A total of 2096 articles were retrieved. Of these, 21 articles investigated the association between PFAS exposure and human bone health. However, only 10 studies were included in the final meta-analysis. Doubling of serum perfluorooctanoic acid (PFOA) (β = -0.11, 95% confidence interval (CI): −0.18, −0.05) and perfluorooctane sulfonic acid (PFOS) (β = -0.06, 95% CI: −0.11, −0.01) levels showed significant negative correlations with total body less head bone mineral density (TBLH-BMD). Subgrouping showed that only perfluorohexane sulfonate (PFHxS) (odds ratio [OR] = 1.37, 95% CI: 1.12, 1.68) was correlated with osteoporosis. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate whether artistic gymnastics (AG) recreational practice has beneficial effects on bone mineral density (BMD) and bone mineral content (BMC) of young gymnasts. All girls involved in AG training from the city of Pelotas, aged 6 to 12 years were recruited. Participants on control group could not be involved in any extracurricular sports activity. Predictive equations based on anthropometric and physical tests were used to assess BMD and BMC. When compared to the control group, AG showed higher femoral neck (0.672 ± 0.147 vs. 0.561 ± 0.172) and upper limbs (1482 ± 0.159 vs. 1289 ± 0.178) BMD. In addition, lumbar spine BMD was higher in AG regardless of the predictive equation used. AG practice increased BMD on upper limbs, femoral neck and lumbar spine. However, caution is required when using predictive equations to assess BMD and BMC. [ABSTRACT FROM AUTHOR]

Preterm small for gestational age (SGA) children are at increased risk for low bone mineral content later in life; however, data on SGA children born at term are scarce. We included 44 SGA and 57 adequate for gestational age (AGA) children aged 6 to 11 years to compare bone mineral density (BMD) and bone mineral content (BMC) and to identify which anthropometric and biochemical values influence bone mineralization in these children. Fat mass, appendicular skeletal muscle mass index (ASMMI), BMC, and BMD were significantly lower in SGA children than in AGA (P ≤.005). Appendicular muscle mass index correlated with BMC(TBLH,FN,L1-L4) and BMD(TBLH,FN,L1-L4) in both groups (r2 = 0.7, P <.05). In multivariate analysis, ASMMI was strongly associated with BMC and BMD in both groups. There were no differences in clinical biomarkers, calcium intake, and physical activity between the groups. Achieving adequate muscle mass contributes to adequate bone mineralization and a lower risk for low BMC and BMD in SGA children. [ABSTRACT FROM AUTHOR]

Background: Ballet, epitomized by iconic seasonal performances such as "The Nutcracker," combines artistic expression with considerable physical demands. This study investigated the physiological and psychological responses of ballet dancers to the demands of intensive training and performance, with a specific focus on "The Nutcracker." Methods: Thirty- eight dancers volunteered for the study, including 6 youths (10.5 + 1.8 years, n = 6 female), 7 adolescents (15.4 + 1.1 years, n = 5 female), and 25 adults (21.1 + 2.1 years, n = 20 female). Employing an uncontrolled observational design, this pilot study tracked key biomarkers such as CK-MM for muscle damage and B-ALP for bone health, alongside psychological measures via PANAS-C/PANAS and DASS-21. Results: Significant findings included a post-performance reduction in cortisol and depression levels. Conclusion: These insights advocate for tailored strategies that address the multifaceted needs of dancers, acknowledging the intricate balance required to maintain peak performance and overall health within the demanding realm of professional ballet. [ABSTRACT FROM AUTHOR]

Background: Lower extremity bone stress injuries (BSI) are common injuries among athletes and military members. Typical management involves a period of restricted weightbearing which can have rapid detrimental effects upon both muscle and bone physiology. Few studies have investigated the effect of blood flow restriction (BFR) training on bone in the rehabilitative setting. Purpose: The purpose of this study was to investigate the effects of lower extremity exercise with the addition of BFR upon bone mineral density, bone mineral content, and lean body mass in military members with tibial BSIs. Study Design: Case series Methods: Twenty military members with MRI-confirmed tibial BSI were recruited to complete lower extremity exercise with the addition of BFR twice per week for four weeks. The BFR cuff was applied proximally to the participant's involved limb while they performed gluteal, thigh, and leg resistance exercises. Outcomes were assessed at baseline and four weeks. The primary outcomes were whole leg bone mineral density (BMD), bone mineral content (BMC), and lean body mass (LM) as measured by dual-energy x-ray absorptiometry. Secondary outcomes included thigh and leg circumference measures and patient-reported outcomes, including the Lower Extremity Functional Scale (LEFS), Patient-Reported Outcomes Measurement Information System 57 (PROMIS-57), and Global Rating of Change (GROC). Results: No significant differences were found in BMD (p=0.720) or BMC (p=0.749) between limbs or within limbs over time. LM was generally less in the involved limb (p=0.019), however there were no significant differences between or within limbs over time (p=0.404). For thigh circumference, significant main effects were found for time (p=0.012) and limb (p=0.015), however there was no significant interaction effect (p=0.510). No significant differences were found for leg circumference (p=0.738). Participants showed significant mean changes in LEFS (15.15 points), PROMIS physical function (8.98 points), PROMIS social participation (7.60 points), PROMIS anxiety (3.26 points), and PROMIS pain interference (8.39 points) at four weeks. Conclusion: The utilization of BFR in the early rehabilitative management of tibial BSI may help mitigate decrements in both bone and muscle tissue during periods of decreased physical loading. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

Background: Osteoporosis (OP) and osteomalacia (OM) are metabolic bone diseases characterized by mineral and matrix density changes. Quantitative bone matrix density differentiates OM from OP. MRI is a noninvasive and nonionizing imaging technique that can measure bone matrix density quantitatively in ex vivo and in vivo. Purpose: To demonstrate water + fat suppressed 1H MRI to compute bone matrix density in ex vivo rat femurs in the preclinical model. Study Type: Prospective. Animal Model: Fifteen skeletally mature female Sprague–Dawley rats, five per group (normal, ovariectomized (OVX), partially nephrectomized/vitamin D (Vit‐D) deficient), 250–275 g, ∼15 weeks old. Field Strength/Sequence: 7T, zero echo time sequence with water + fat (VAPOR) suppression capability, μCT imaging, and gravimetric measurements. Assessment: Cortical and trabecular bone segments from normal and disease models were scanned in the same coil along with a dual calibration phantom for quantitative assessment of bone matrix density. Statistical Tests: ANOVA and linear regression were used for data analysis, with P‐values <0.05 statistically significant. Results: The MRI‐derived three‐density PEG pellet densities have a strong linear relationship with physical density measures (r2 = 0.99). The Vit‐D group had the lowest bone matrix density for cortical bone (0.47 ± 0.16 g cm−3), whereas the OVX had the lowest bone matrix density for trabecular bone (0.26 ± 0.04 g cm−3). Gravimetry results confirmed these MRI‐based observations for Vit‐D cortical (0.51 ± 0.07 g cm−3) and OVX trabecular (0.26 ± 0.03 g cm−3) bone groups. Data Conclusion: Rat femur images were obtained using a modified pulse sequence and a custom‐designed double‐tuned (1H/31P) transmit‐receive solenoid‐coil on a 7T preclinical MRI scanner. Phantom experiments confirmed a strong linear relation between MRI‐derived and physical density measures and quantitative bone matrix densities in rat femurs from normal, OVX, and Vit‐D deficient/partially nephrectomized animals were computed. Level of Evidence: 2 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Purpose of Review: The purpose of this review is to provide a background of osteoporosis and air pollution, discussing increasing incidence of the disease with exposure to pollutants and the role that inflammation may play in this process. Recent Findings: Osteoporosis-related fractures are one of the most pressing challenges for the ageing global population, with significant increases in mortality known to occur after major osteoporotic fractures in the elderly population. Recent studies have established a firm correlative link between areas of high air pollution and increased risk of osteoporosis, particularly alarming given the increasingly urban global population. While the culprit pollutants and molecular mechanisms underlying this phenomenon have not yet been elucidated, initial studies suggest a role for inflammatory cascades in this phenomenon. Summary: While much more research is required to identify the most damaging air pollutants and to delineate the specific inflammatory molecular mechanisms, it is clear from the literature that shedding light on these pathways would unveil potential therapeutic targets to treat bone diseases, including osteoporosis. Major deficiencies of current animal models highlight the need for complex human invitro models such as organ-on-a-chip technology to better understand the impact of air pollution. [ABSTRACT FROM AUTHOR]

Purpose of Review: The impact of nephrolithiasis on skeletal growth and bone health across the life span of kidney stone formers is reviewed. Main Findings: Bone disease is an early event among kidney stone formers (SF), with distinct phenotypes according to each age, sex, menopausal status, dietary, hormonal and genetic factors. Nephrolithiasis-associated bone disorder is characterized by reduced bone mineral density (BMD) and histologically discloses low bone formation, high bone resorption and abnormal mineralization. Although hypercalciuria has been presumed to be pathogenic for bone loss in SF, the association of BMD with urinary calcium is not uniform in all studies. Hypocitraturia, metabolic disturbances, cytokines and receptors, growth factors and acid–base status may all influence skeletal outcomes. The potential link of bone disease with vascular calcification and cardiovascular disease among SF is discussed. Summary: The unique vulnerability of the younger skeleton to the effects of nephrolithiasis on attainment of peak bone mass and strength is highlighted and the association of bone loss with kidney stone formation early in life indicate the opportunity for intervention to reduce the risk of future bone fractures. [ABSTRACT FROM AUTHOR]

PURPOSE This study aimed to analyze the moderating effect of the walk ratio (WR), a quantitative indicator of gait pattern, on the relationship between bone mineral density (BMD), fall efficacy scale (FES) score, and activity-specific balance confidence (ABC) in the elderly. METHODS A total of 275 participants were categorized based on BMD into normal, osteopenia, and osteoporosis groups, and based on WR levels into high 25%, middle 50%, and low 25% groups. Logistic regression analysis was performed to determine the odds ratios (OR) for decreased FES and ABC exposure based on BMD and WR levels. To examine the moderating effect of WR on the relationship among BMD, FES, and ABC, a moderation analysis using Process Macro Model 1 was performed. RESULTS After adjusting for age and sex, individuals with osteopenia (FES, OR=2.738, p=.013; ABC, OR=4.020, p=.002) and osteoporosis (FES, OR=4.550, p=.001; ABC, OR=5.015, p=.001) showed significantly higher ORs for decreased FES and ABC compared to those in the normal group, while individuals in the high WR group (FES, OR=0.389, p=.015; ABC, OR=0.235, p

Introduction The association of air pollution with bone mineral density (BMD) has attracted increasing attention. However, establishing a causal relationship remains uncertain. Methods We conducted a Mendelian randomization (MR) study employing PM 2.5 , PM 2.5-10 , PM 10 , nitrogen dioxide, and nitrogen oxides as exposures and BMD as the outcome to explore the causality between air pollution and the occurrence of decreased BMD. Results By employing the IVW method, we identified a negative causality between air pollution (PM 2.5 , PM 10 , and nitrogen oxides) and BMD. Conclusions Our findings demonstrate that PM 2.5 , PM 10 and nitrogen oxides exposure may contribute to decreased BMD.

Purpose: The aim of this study was to investigate whether there is a difference in hand bone mineral density (BMD) between patients with traumatic hand injuries and healthy volunteers during the immobilization process, as well as to examine the change in BMD during follow-up and the effect of denervation on BMD. In addition, we aimed to compare the BMD in the dominant and nondominant hands. Methods: The study involved patients aged 18–55 years who had undergone surgery for hand tendon injuries (TIs), with or without accompanying nerve injury, and subsequently sought rehabilitation at our outpatient clinic. The study groups were comprised patients with TI, those with tendon and nerve injury (TNI), and healthy volunteers. Results: The study examined 24 patients with TI, 23 with TNI, and 31 healthy volunteers. In the healthy control group, the BMD of the dominant hand was significantly higher than that of the nondominant hand (P < 0.001). At 4 weeks, there was no significant decrease in BMD observed in the TI and TNI groups compared to controls (P > 0.05). However, at the 4th month, both groups showed a significant decrease in BMD, with the TNI group exhibiting higher changes (P < 0.05). Injuries to the dominant hand did not result in significant changes in BMD at 4 weeks and 4 months (P > 0.05). However, a significant decrease in BMD was observed in injuries to the nondominant hand compared to controls at 4 months (P < 0.05). Notably, nondominant hand TNI patients experienced a significant reduction in BMD during the 4th month compared to the 4th week (P < 0.05). In addition, a significant correlation (r = 0.567) was found between grip strength and BMD value in the 4th month of patients with hand injuries. Conclusion: In patients with traumatic hand injuries, nondominant hand injury and/or nerve injury may lead to a decrease in BMD in addition to immobilization.

Abstract The objectives of this study were to investigate the composition of gut microbiota and its relationship with bone loss in the Uyghur osteopenia population, identify potential disease-related taxa and collect information for the prevention and treatment of osteopenia in different people by regulating gut microbiota. We selected Uyghur residents, measured their heel BMD, collected faeces and general information, grouped them by BMD level, obtained faecal 16S rRNA sequences, and compared and analysed the differences between the groups. This study showed that the numbers of OTUs and species in the gut microbiota in the osteopenia group were higher than those in the control. At the phylum level, Erysipelotrichia was more abundant in the osteopenia group. At the genus level, Phascolarctobacterium was less abundant, and Ruminiclostridium_5 was more abundant in the osteopenia group compared to the control. Phascolarctobacterium and Z-score were positively correlated, and Ruminiclostridium_5 was negatively correlated with T and Z score. The different composition of the gut microbiota in Uyghur osteopenia patients and controls found in this study fills a knowledge gap in this ethnic group. The relationship between Uyghur osteopenia and BMD-associated bacterial genera deserves further exploration.

Study Design Prospective cohort study. Purpose This study aimed to identify the optimal preoperative bone health assessment for adult spinal deformity (ASD) surgery through correlation analysis between intraoperative pedicle screw (PS) insertion torque and various bone quality measures, including bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DEXA), Hounsfield unit (HU) by computed tomography (CT), and vertebral bone quality (VBQ) score by magnetic resonance imaging. Overview of Literature Existing data on optimal assessment tools for ASD surgery are limited. Methods The study included patients with ASD aged >60 years who underwent spinal corrective fusion surgery from the lower thoracic spine to the pelvis. The intraoperative PS insertion torque was measured using a torque meter. Pearson correlation coefficients were calculated between the PS insertion torque and the BMD, HU, and VBQ score. Preoperative bone quality was compared between the proximal junctional failure (PJF) and non-PJF groups. Results Thirty-one patients with 177 PS at T10, T11, and T12 were analyzed. The PS insertion torque showed a moderate positive correlation with lumbar spine BMD (r=0.59–0.69, p0.05). Notably, a strong correlation was found between the PS insertion torque and the HU value for screws of the same size (r=0.71 and 0.74, p

Abstract Background Older subjects have a higher risk for vertebral compression fracture. Maintaining a higher bone mineral density (BMD) at this age can protect individuals from osteoporosis-related events. Body mass index (BMI) has been found to have a robust association with BMD. However, excessive BMI is detrimental to bone health and may cause systemic disorders. Therefore, the present study aimed to determine the association between BMI and BMD, and identify a reasonable BMI range. Methods A total of 961 participants were recruited from community-dwelling residents between August 2021 and May 2022. A weighted multivariate linear regression model was applied to identify the relationship between BMI and BMD. Meanwhile, subgroup stratified analysis by BMI quartile and gender was also performed. A non-linear relationship and threshold value were determined based on the smooth curve fittings and threshold effects analysis model. Results A robust relationship was found between BMI and BMD, which remained significant in subgroups stratified by gender and BMI quartile. The BMI inflection point values in lumbar BMD and femoral neck BMD were 25.2 kg/m2 and 27.3 kg/m2, respectively. For individuals with BMI 25.2 kg/m2, an increase in BMI was associated with a decrease in lumbar BMD. For subjects with BMI

Abstract Machine learning (ML) models have been increasingly employed to predict osteoporosis. However, the incorporation of hair minerals into ML models remains unexplored. This study aimed to develop ML models for predicting low bone mass (LBM) using health checkup data and hair mineral analysis. A total of 1206 postmenopausal women and 820 men aged 50 years or older at a health promotion center were included in this study. LBM was defined as a T-score below − 1 at the lumbar, femur neck, or total hip area. The proportion of individuals with LBM was 59.4% (n = 1205). The features used in the models comprised 50 health checkup items and 22 hair minerals. The ML algorithms employed were Extreme Gradient Boosting (XGB), Random Forest (RF), Gradient Boosting (GB), and Adaptive Boosting (AdaBoost). The subjects were divided into training and test datasets with an 80:20 ratio. The area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and an F1 score were evaluated to measure the performances of the models. Through 50 repetitions, the mean (standard deviation) AUROC for LBM was 0.744 (± 0.021) for XGB, the highest among the models, followed by 0.737 (± 0.023) for AdaBoost, and 0.733 (± 0.023) for GB, and 0.732 (± 0.021) for RF. The XGB model had an accuracy of 68.7%, sensitivity of 80.7%, specificity of 51.1%, PPV of 70.9%, NPV of 64.3%, and an F1 score of 0.754. However, these performance metrics did not demonstrate notable differences among the models. The XGB model identified sulfur, sodium, mercury, copper, magnesium, arsenic, and phosphate as crucial hair mineral features. The study findings emphasize the significance of employing ML algorithms for predicting LBM. Integrating health checkup data and hair mineral analysis into these models may provide valuable insights into identifying individuals at risk of LBM.

Abstract Purpose This study aims to investigate the association of serum TSH with BMD in Chinese adults with normal thyroid function. Methods These participants were divided into tertiles based on serum TSH levels. Linear regression model and multinomial logistic regression models were used to analyze the associations of continuous BMD and categorical BMD with serum TSH, respectively. Results In women younger than 60 years, BMD decreased with the increase of TSH at normal level, while in women older than 60 years, BMD increased with the increase of TSH at normal level; besides, the BMD of women younger than 60 years old was significantly higher than that of women over 60 years old (156.05 ± 39.34 mg/cm3 vs. 86.95 ± 29.51 mg/cm3, P

Abstract This study aimed to explore the association between bone mineral density and physical frailty including nutrition, muscle mass, and oral function. We included participants aged 35–80 years and examined their bone mineral density, serum albumin level, body composition, and variance of hue (VOH) of two-colored gum. We also used the geriatric oral health assessment index (GOHAI). These data were used to calculate the geriatric nutritional risk index (GNRI) and skeletal muscle index (SMI). Multinomial logistic regression was performed to assess the relationship between GNRI, SMI, VOH, GOHAI, and bone mineral density after adjusting for comorbidities, including hypertension, diabetes mellitus, and previous bone fracture. We included 228 participants and classified their bone mineral density as normal, osteopenic, or osteoporotic. Older age (odds ratio (OR) 1.15, 95% confidence interval (CI) [1.08, 1.23]), low GNRI (OR 0.90, 95% CI [0.83, 0.98]), low SMI (OR 0.43, 95% CI [0.27, 0.68]), and high VOH (OR 1.08, 95% CI [1.01, 1.17]) were significantly associated with osteoporosis. Older age (OR 1.08, 95% CI [1.04, 1.11]) and low GNRI (OR 0.93, 95% CI [0.87, 0.99]) were significantly associated with osteopenia. GNRI, SMI, and VOH were significantly associated with osteoporosis among male participants. Although the multinomial logistic regression analysis indicated that GNRI, SMI, VOH, and GOHAI were not significantly associated with osteoporosis or osteopenia among female participants, the demographic distribution showed that older age, low GNRI, and low SMI were significantly associated with bone mineral density decline. Physical frailty, including nutritional decline, muscle mass loss, and poor oral status, is associated with low bone density. This easy-to-use tool can be used to detect osteoporosis early and to prevent osteoporosis and osteoporosis-related fractures.

Objective: This study aimed to assess the association between women’s platelet indices and bone mineral density to evaluate osteoporosis, which has a significant impact on quality of life throughout the postmenopausal age. Materials and Methods: The study was retrospectively designed, and data from 316 postmenopausal patients who applied to the obstetrics and gynecology outpatient clinic between January 2021 and January 2023, underwent bone mineral density measurements during follow-up, and met the inclusion and exclusion criteria were obtained. The data were evaluated in 3 groups as normal, osteopenia, and osteoporosis according to bone mineral density. Platelet indices, age, body mass index (BMI), and bone mineral density were compared with platelet indices in the hemogram results of the patients on the same day. Results: The mean ages of the osteoporosis, osteopenia, and normal groups were 61.4, 58.4, and 56.2 years, respectively. The mean weight was 72.9 kg in the osteoporosis group, 74.09 kg in the osteopenia group, and 79.4 kg in the normal group. When the groups were compared, no significant difference was observed between age, platelet count, platelet distribution width, mean platelet volume (MPV), platelet-large cell ratio, and thrombocytocrit but a significant difference was found between the osteoporosis and normal groups in terms of BMI (p=0.027). Conclusion: Although numerous studies in the literature have demonstrated a connection between osteoporosis and MPV and platelet count, our investigation revealed no such association and showed that the risk of osteoporosis decreased as BMI increased.

Shangjian Li, Xiumei Luo, Zhiqiang Lu, Ning Chen Department of Endocrinology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fudan University, Xiamen, People’s Republic of ChinaCorrespondence: Ning Chen, Department of Endocrinology, Zhongshan Hospital (Xiamen), Fudan University, No. 668 Jinhu Road, Xiamen, 361000, People’s Republic of China, Tel/Fax +86-0592-3569583, Email chen.ning@zsxmhospital.comObjective: To investigate the association of the midnight cortisol level with bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM).Methods: This study included 249 T2DM patients (148 males with an average age of 53.8 years and 101 postmenopausal females with an average age of 63.6 years) admitted to Xiamen Hospital of Zhongshan Hospital Affiliated to Fudan University from January 2018 to April 2020. Baseline data were compared between patients with normal BMD and those with osteoporosis/osteopenia. The patients also were divided into groups according to the tertiles of midnight cortisol levels.Results: Among all T2DM, 178 had osteoporosis/osteopenia, including 98 men and 80 women. The baseline data analysis showed that patients with osteoporosis/osteopenia were more likely to be older, female, and thin, and to have high cortisol. Additionally, elevated estradiol levels had a protective effect on bone; once osteoporosis/osteopenia occurred, the probability of severe osteoporotic fracture was significantly increased. The BMD of the femoral neck, hip joint and lumbar spine decreased with increasing midnight cortisol level in men, postmenopausal women, and all T2DM patients (P< 0.05). Multivariate logistic regression analysis identified body mass index, estradiol level, and midnight cortisol level as independent risk factors for osteoporosis/osteopenia in T2DM patients.Conclusion: Higher midnight cortisol levels are significantly associated with increased risk of osteoporosis/osteopenia in T2DM patients. Thus, the midnight cortisol level represents a valuable marker for assessing osteoporosis/osteopenia risk in these patients.Keywords: type 2 diabetes mellitus, midnight cortisol, bone mineral density, osteoporosis

Abstract Purpose Both vitamin C and D deficiencies are extremely common in clinical practice, especially in elderly population. Unfortunately, the role of vitamin C deficiency in osteoporosis related consequences is often neglected. The aim of the present study is to analyse if combined vitamin C and D deficiency would have an association with bone mineral density (BMD) and osteoporotic vertebral fracture (OVF). Methods Ninety-nine post-menopausal female patients admitted in the department of spine surgery of third affiliated hospital of Sun Yat-sen University were enrolled in the study. The participants were divided into four groups; vitamin D deficiency alone (comparator group), vitamin C deficiency alone and combined vitamin C and D deficiency as experimental group. The levels of vitamin C, vitamin D, calcium, phosphorous, BMD and condition of OVF were analysed. Results There were statistically significant differences between the groups in terms of vitamin C and D levels. In terms of lumbar BMD, significant differences were observed between vitamin D deficiency alone and combined vitamin C and D deficiency. Only the combined vitamin C and D deficiency had a significant negative association with lumbar BMD and T-score. Similarly, combined vitamin C and D deficiency had a significant positive association with lumbar osteoporosis. None of the groups had any significant association with OVF. Combined vitamin C and D deficiency was found to be significantly associated with lower lumbar BMD and osteoporosis. Conclusion Combined vitamin C and D deficiency results in lower bone mineral density and higher risk of osteoporosis. We believe that existence of deficiencies of both vitamins could have a synergistic effect. Therefore, we recommend that vitamin C and D should be routinely measured in clinical practice.

Abstract Background Physical function is an important risk factor for fracture. Previous studies found that different physical tests (e.g., one‐leg standing [OLS] and timed up and go [TUG]) predict fracture risk. This study aimed to determine which physical function test is the most optimal independent predictor of fracture risk, together with clinical risk factors (CRFs) used in fracture risk assessment (FRAX) and bone mineral density (BMD). Methods In total, 2321 women out of the included 3028 older women, aged 77.7 ± 1.6 (mean ± SD), in the Sahlgrenska University Hospital Prospective Evaluation of Risk of Bone Fractures study had complete data on all physical function tests and were included in the analysis. At baseline, hand grip strength, OLS, TUG, walking speed and chair stand tests were performed. All incident fractures were confirmed by X‐ray or review of medical records and subsequently categorized as major osteoporotic fractures (MOFs), hip fractures and any fracture. Multivariate Cox regression (hazard ratios [HRs] and 95% confidence intervals [CIs]) analyses were performed with adjustments for age, body mass index (BMI), FRAX CRFs, femoral neck BMD and all physical function tests as predictors both individually and simultaneously. Receiver operating characteristic (ROC) analyses and Fine and Gray analyses were also performed to investigate associations between physical function and incident fractures. Results OLS was the only physical function test to be significantly and independently associated with increased risk of any fracture (HR 1.13 [1.04–1.23]), MOF (HR 1.15 [1.04–1.26]) and hip fracture (HR 1.34 [1.11–1.62]). Adjusting for age, BMI, CRFs and femoral neck BMD did not materially alter these associations. ROC analysis for OLS, together with age, BMI, femoral neck BMD and CRFs, yielded area under the curve values of 0.642, 0.647 and 0.732 for any fracture, MOF and hip fracture, respectively. In analyses considering the competing risk of death, OLS was the only physical function test consistently associated with fracture outcomes (subhazard ratio [SHR] 1.10 [1.01–1.19] for any fracture, SHR 1.11 [1.00–1.22] for MOF and SHR 1.25 [1.03–1.50] for hip fracture). Walking speed was only independently associated with the risk of hip fracture in all Cox regression models and in the Fine and Gray analyses. Conclusions Among the five physical function tests, OLS was independently associated with all fracture outcomes, even after considering the competing risk of death, indicating that OLS is the most reliable physical function test for predicting fracture risk in older women.

Hong Xu,1 Zuoli Sun,1 Gang Wang,1,2 Rena Li1 1Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Gang Wang; Rena Li, Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People’s Republic of China, Email gangwangdoc@ccmu.edu.cn; renali@ccmu.edu.cnBackground: Several clinical studies have examined the connection between depression and bone loss, but the cause-and-effect relationship between the two conditions, especially in animal models, is not well-studied.Methods: A total of 32 female mice were, randomly divided into control group (CON, n=19) and depression group (DEP, n=13). The mice in the DEP group were subjected to 21 consecutive days of restraint stress, following depressive-like behaviors were assessment. The femurs were collected using Micro-Computed Tomography (μCT) and histochemical staining. In parallel, levels of serotonin-related proteins in the brain were measured using Western blot analysis, and sex hormone profiles were determined through liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS).Results: The mice in the DEP group exhibited clear signs of depressive-like behaviors and an increase in serotonin transporter levels (t=-2.435, P< 0.05). In comparison to the CON mice, the DEP mice showed a decrease in bone mineral density (t =3.741, P< 0.05), bone surface area density (t =8.009, P< 0.01), percent bone volume (t =4.293, P< 0.05), trabecular number (t =5.844, P< 0.01), and connected density (t =11.000, P< 0.05). Additionally, there was an increase in trabecular separation (t =-7.436, P< 0.01) in DEP mice. Furthermore, the DEP mice displayed a significant reduction in serum estrogen levels (t =4.340, P< 0.05) and changes in its metabolite (t =-3.325, P< 0.05), while the levels of androgens remained unchanged.Conclusion: The restraint stress not only led to the development of depressive-like behaviors but also disrupted the estrogen metabolism pathway, resulting in damage to bone mass and microstructure in female mice. These findings suggest that stress-induced depression may pose a risk for bone loss in female mice by altering estrogen metabolism pathways.Keywords: depression, bone mineral density, bone structure, estrogen, female

This review is based on the literature published between 2000 and 2023 and presents an up-to-date evidence-based discussion of anatomical considerations relevant to the management of pelvic trauma. In addition, it discusses the significance of the pelvic ligaments in stabilizing the pelvic ring and of bone mineral density (BMD) in fragility fracture of the pelvis (FFP), which is becoming increasingly common in today’s aging societies. Following an overview of the anatomy and function of the sacroiliac joint (SIJ), the pubic symphysis, and the surrounding ligaments, the suitability of the widely-used Young-Burgess classification (YB) of high-energy impact pelvic ring fractures, which emphasizes the role of the ligaments in pelvic ring injuries, is discussed. Based on the current body of knowledge, using 2.5 cm of pubic symphysis diastasis as the determinant for surgical intervention in anterior-posterior compression fracture is questioned, and evaluation under anesthesia and lateral stress radiography for accurate diagnosis and treatment planning is proposed instead. The review underscores the need for further research on how the pelvic ligaments can provide optimal stability in the treatment of various types of pelvic fracture. On the other hand, for fragility fracture of pelvis (FFP) in older adults caused by low-energy trauma, the emphasis is on the fragility of the bones. To better manage FFP, the importance of understanding the distribution of BMD in the pelvis is highlighted. Dual-energy X-ray absorptiometry is a common method for measuring BMD, but it has drawbacks. The advantages of measuring BMD using Hounsfield units on computed tomography scans as an alternative method are discussed. An understanding of these issues may lead to better management of the increasing number of FFP cases in older people with reduced BMD.

Abstract Background Some studies have suggested that uric acid has antioxidant properties that can prevent bone loss, but the relationship between uric acid and bone mineral density is controversial. The aim of this study was to investigate the relationship between UA and BMD in patients with CKD stage 1–3. Methods We extracted 13,047 participants from the NHANES database, including 7342 male subjects and 5705 female subjects. Weighted multiple linear regression analysis was used to investigate the correlation between UA and BMD in patients with CKD stages 1–3. Results In patients with CKD stage 1–3, UA was significantly correlated with BMD. In the male group, UA was positively associated with BMD (β, 7.94 [95%CI, 4.95, 10.94]). In the female group, there was a negative relationship between them (β, -5.33 [95%CI, -8.77, -1.89]). The relationship between UA and BMD in male group showed an inverted U-shaped curve, and UA was positively correlated before 6.1 mg/dl and negatively correlated after 6.1 mg/dl. The relationship was basically negative in the female group. Conclusions For the patients with CKD stage 1–3, the relationship between UA and BMD showed an inverted U-shaped curve in the males, while the relationship was largely negative in the females.

Abstract Dietary antioxidants may have beneficial effects on bone health, but it remains uncertain in children and adolescents. This study investigates the association of composite dietary antioxidant index (CDAI) with bone mineral density (BMD) in children and adolescents aged 8–19 years from the National Health and Nutrition Examination Survey (NHANES) 2007–2010. The study assessed the relationship between CDAI and BMD in 2994 individuals aged 8–19 years (average age 13.48 ± 3.32 years) from the NHANES 2007–2010. Multivariate linear regression analyses were utilized to detect the association between CDAI and total spine, femur neck, and total femur BMD, adjusting for confounders including age, race/ethnicity, sex, poverty income ratio (PIR), body mass index (BMI), serum phosphorus and calcium. Stratified analyses and interaction tests were performed to examine the stability of the results. The weighted characteristics showed that subjects in the fourth CDAI quartile were more likely to be older, men, and Non-Hispanic White. They have higher values of serum total calcium and phosphorus. After adjusting all confounders, CDAI was positively associated with the total spine (β = 0.0031 95% CI 0.0021–0.0040), total femur (β = 0.0039 95% CI 0.0028–0.0049), and femur neck BMD (β = 0.0031 95% CI 0.0021–0.0040) in children and adolescents. Furthermore, we found no interaction effects between different race/ethnicity, age, and sex groups. Our findings suggest that dietary intake of multiple antioxidants was positively associated with BMD in children and adolescents. These findings provide valuable evidence for improving bone health in the early stages of life. However, more prospective studies are required to validate our findings and their causal relationship.

Abstract Background Patients with Type 2 diabetes mellitus (T2DM) have decreased bone health. We aimed to investigate serum levels of bone turnover markers (BTMs) (markers of bone formation and bone resorption) and bone mineral density (BMD) at three sites (lumber, neck femur, and total femur) in middle-aged men with type 2 diabetes and to analyze the relationship between them. Also to evaluate serum osteoglycin as a novel marker and its relation to BTMs, BMD, and diabetic status. Methods We recruited seventy-eight patients with T2DM and thirteen non-diabetic, male volunteers as a control group. BMD was measured using a DEXA scan. BTMs (carboxy-terminal crosslinking telopeptide of type 1 collagen [CTX] and procollagen type 1 N propeptide [P1NP]), osteoglycin, PTH, and vitamin D were estimated. Data was compared among subjects and statistical analysis was performed. Results Most of the patients were having normal BMD with no significant difference between patients and the controls. BTMs and osteoglycin were significantly higher and vitamin D was significantly lower in the diabetic patients. Serum osteoglycin was positively correlated with DEXA Neck Femur (r = 0.233; p-value

Tinghua Hu,1,&ast; Shanshan Dai,2,&ast; Lan Yang,1 Bo Zhu1 1Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710000, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Xi’an No. 9 Hospital, Xi’an, Shaanxi, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bo Zhu, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, Shaanxi, 710061, People’s Republic of China, Email zhubo685689@163.comBackground: COPD, combined with Osteoporosis, has a high incidence and potential for great harm. Choosing an optimal diagnostic method to achieve bone mineral density (BMD) screening is crucial for COPD patients. Studies on COPD patients with BMD reduction are lacking.Purpose: To identify the risk factors of BMD reduction and osteoporosis in COPD patients.Patients and Methods: We included a total of 81 patients with AECOPD, who were admitted to the hospital from July 1, 2019, to January 31, 2020. Patients were grouped into BMD normal group, BMD reduced group and OP group. The areas under ROC curve were used to explore the value of CT values in the diagnosis of bone abnormality, and clinical indicators were collected.Results: The CT value of the vertebral cancellous bone is highly correlated with the T value of BMD (R > 5.5, P < 0.0001). Using multivariate Logistic regression analysis, we showed that COPD duration, BMI, 25-hydroxyvitamin D3, and long-term inhaled glucocorticoid were independent factors affecting different BMD levels in COPD patients. No significant difference in bone formation indexes between groups. β-crossL was negatively correlated with serum IL-6 (r=− 0.254, P=0.022), and ALP was positively correlated with serum TNF-α (r=0.284, P=0.023).Conclusion: Thoracolumbar vertebral cancellous bone CT has potential value in the diagnosis of bone abnormality. COPD duration, BMI, 25-hydroxyvitamin D3, and long-term inhaled glucocorticoid may contribute to the BMD reduction in COPD patients, and serum IL-6 and TNF-α regulate bone metabolism in COPD patients.Keywords: chronic obstructive pulmonary disease, osteoporosis, bone mineral density, chest CT

Objective: Previous studies have suggested that body mass index (BMI) should be considered when assessing the relationship between fatty liver (FL) and osteoporosis. The aim of this study was to investigate future fracture events in people with FL, focusing on the effect of BMI in both sexes. Methods: This retrospective cohort study, spanning from 2011 to 2019, enrolled 941 people, including 441 women and 500 men, aged 50 years or older who underwent liver imaging (ultrasound, computed tomography, or magnetic resonance image) and dual-energy X-ray absorptiometry (for bone mineral density measurements). The study examined predictors of osteoporosis in both sexes and the effect of different ranges of BMI (18.5–24, 24–27, and ≥27 kg/m2) on the risk of future fracture events in FL patients. Results: The average follow-up period was 5.3 years for women and 4.2 years for men. Multivariate analysis identified age and BMI as independent risk factors of osteoporosis in both sexes. Each unit increase in BMI decreased the risk of osteoporosis by ≥10%. In both women and men with FL, a BMI of 24–27 kg/m2 offered protection against future fractures, compared to those without FL and with a BMI of 18.5–24 kg/m2. Conclusion: The protective effect of a higher BMI against future fractures in middle-aged and elderly female and male patients with FL is not uniform and diminishes beyond certain BMI ranges.

Abstract Background Previous studies have implicated rheumatoid arthritis as an independent risk factor for bone density loss. However, whether there is a causal relationship between rheumatic diseases and bone mineral density (BMD) and fractures is still controversial. We employed a bidirectional Mendelian analysis to explore the causal relationship between rheumatic diseases and BMD or fractures. Methods The rheumatic diseases instrumental variables (IVs) were obtained from a large Genome-wide association study (GWAS) meta-analysis dataset of European descent. Analyses were performed for the three rheumatic diseases: ankylosing spondylitis (AS) (n = 22,647 cases, 99,962 single nucleotide polymorphisms [SNPs]), rheumatoid arthritis (RA) (n = 58,284 cases, 13,108,512 SNPs), and systemic lupus erythematosus (SLE) (n = 14,267 cases, 7,071,163 SNPs). Two-sample Mendelian randomization (MR) analyses were carried out by using R language TwoSampleMR version 0.5.7. The inverse-variance weighted (IVW), MR-Egger, and weighted median methods were used to analyze the causal relationship between rheumatic diseases and BMD or fracture. Results The MR results revealed that there was absence of evidence for causal effect of AS on BMD or fracture. However, there is a positive causal relationship of RA with fracture of femur (95% CI = 1.0001 to 1.077, p = 0.046), and RA and fracture of forearm (95% CI = 1.015 to 1.064, p = 0.001). SLE had positive causal links for fracture of forearm (95% CI = 1.004 to 1.051, p = 0.020). Additionally, increasing in heel bone mineral density (Heel-BMD) and total bone mineral density (Total-BMD) can lead to a reduced risk of AS without heterogeneity or pleiotropic effects. The results were stable and reliable. There was absence of evidence for causal effect of fracture on RA (95% CI = 0.929 to 1.106, p = 0.759), and fracture on SLE (95% CI = 0.793 to 1.589, p = 0.516). Conclusions RA and SLE are risk factors for fractures. On the other hand, BMD increasing can reduce risk of AS. Our results indicate that rheumatic diseases may lead to an increased risk of fractures, while increased BMD may lead to a reduced risk of rheumatic diseases. These findings provide insight into the risk of BMD and AS, identifying a potential predictor of AS risk as a reduction in BMD.

Abstract Background Although previous studies have suggested a possible association between bone mineral density (BMD) and intervertebral disc degeneration (IDD), the causal relationship between them remains unclear. Evidence from accumulating studies indicates that they might mutually influence one another. However, observational studies may be affected by potential confounders. Meanwhile, Mendelian randomization (MR) study can overcome these confounders to assess causality. Objectives This Mendelian randomization (MR) study aimed to explore the causal effect of bone mineral density (BMD) on intervertebral disc degeneration (IDD). Methods Summary data from genome-wide association studies of bone mineral density (BMD) and IDD (the FinnGen biobank) have been acquired. The inverse variance weighted (IVW) method was utilized as the primary MR analysis approach. Weighted median, MR-Egger regression, weighted mode, and simple mode were used as supplements. The Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) and MR-Egger regression were performed to assess horizontal pleiotropy. Cochran’s Q test evaluated heterogeneity. Leave-one-out sensitivity analysis was further conducted to determine the reliability of the causal relationship. Multivariate MR (MVMR) analyses used multivariable inverse variance-weighted methods to individually and jointly adjust for four potential confounders, body mass index (BMI), Type2 diabetes, hyperthyroidism and smoking. A reverse MR analysis was conducted to assess potential reverse causation. Results In the univariate MR analysis, femoral neck bone mineral density (FNBMD), heel bone mineral density (eBMD), lumbar spine bone mineral density (LSBMD), and total body bone mineral density (TB BMD) had a direct causal effect on intervertebral disc degeneration (IDD) [FNBMD-related analysis: OR(95%CI) = 1.17 (1.04 to 1.31), p = 0.008, eBMD-related analysis: OR(95%CI) = 1.06 (1.01 to 1.12), p = 0.028, LSBMD-related analysis: OR(95%CI) = 1.20 (1.10 to 1.31), p = 3.38E-7,TB BMD-related analysis: OR(95%CI) = 1.20 (1.12 to 1.29), p = 1.0E-8]. In the MVMR analysis, it was revealed that, even after controlling for confounding factors, heel bone mineral density (eBMD), lumbar spine bone mineral density (LSBMD), and total body bone mineral density (TB BMD) still maintained an independent and significant causal association with IDD(Adjusting for heel bone mineral density: beta = 0.073, OR95% CI = 1.08(1.02 to 1.14), P = 0.013; Adjusting for lumbar spine bone mineral density: beta = 0.11, OR(95%CI) = 1.12(1.02 to 1.23), P = 0.03; Adjusting for total body bone mineral density: beta = 0.139, OR95% CI = 1.15(1.06 to 1.24), P = 5.53E − 5). In the reverse analysis, no evidence was found to suggest that IDD has an impact on BMD. Conclusions The findings from our univariate and multivariable Mendelian randomization analysis establish a substantial positive causal association between BMD and IDD, indicating that higher bone mineral density may be a significant risk factor for intervertebral disc degeneration. Notably, no causal effect of IDD on these four measures of bone mineral density was observed. Further research is required to elucidate the underlying mechanisms governing this causal relationship.

Abstract The relationship between bone mineral density and type 2 diabetes is still controversial. The aim of this study is to investigate the relationship between type 2 diabetes mellitus (T2DM) and bone mineral density (BMD) in elderly men and postmenopausal women. The participants in this study included 692 postmenopausal women and older men aged ≥ 50 years, who were divided into the T2DM group and non-T2DM control group according to whether or not they had T2DM. The data of participants in the two groups were collected from the inpatient medical record system and physical examination center systems, respectively, of the Tertiary Class A Hospital. All data analysis is performed in SPSS Software. Compared with all T2DM group, the BMD and T scores of lumbar spines 1–4 (L1–L4), left femoral neck (LFN) and all left hip joints (LHJ) in the non-T2DM group were significantly lower than those in the T2DM group (P

Abstract Background The number of football teams in senior categories has increased. As outdoor sports entail players being exposed to sunlight, playing football may contribute to maintaining vitamin D stores and body mineral density while preventing osteoporosis. This study aimed to determine the bone mineral density and vitamin D levels in middle-aged premenopausal female football players. Methods Participants were premenopausal females in their 40s. We evaluated bone mineral density of the second to the fourth lumbar vertebrae and femoral neck, serum 25-hydroxy vitamin D (25-OHD) levels, which is an indicator of vitamin D stores, and body composition. In addition, we administered a questionnaire survey on exercise habits and lifestyle. Ninety-two participants were categorised into three groups: the football group (n = 27), volleyball group (n = 40), and non-exercise group (n = 25). Results Bone mineral density was higher in the football and volleyball groups than in the non-exercise group (P

Background/purpose: The impact of temporomandibular joint (TMJ) osseous destruction on bone mineral density (BMD) remains unclear due to controversial findings. Besides, no previous study has explored the relationship between idiopathic condylar resorption (ICR) and body composition. This study aimed to investigate the relationship between ICR and BMD or body composition. Materials and methods: Between July 2018 and August 2022, patients evaluated by an experienced dentist and diagnosed with temporomandibular disorders (TMDs) were referred to our center. They were recruited while they received the magnetic resonance image (MRI) examination, BMD and body composition completely. Patients were further categorized into TMDs with or without ICR groups according to MRI findings. One-way analysis of variance was used to compare the variables of BMD and body composition in the two groups. Results: In total, 67 patients were included in the analysis, with 42 categorized as TMDs with ICR and 25 as TMDs without ICR. Patients with ICR had a significantly higher lean mass percentage and lower fat mass percentage; lower android/gynoid fat ratio, and visceral adipose tissue area than those without ICR (P

Background. According to the GOLD guidelines, glucocorticoids (GCs) are recommended for exacerbations of chronic obstructive pulmonary disease (COPD). Bone mineral density (BMD) can be reduced in case of the use of therapeutic doses of GCs. The aim of the study was to determine the influence of GCs on BMD and the frequency of osteoporosis in patients with COPD depending on the prescribed therapy. Materials and methods. We examined 202 patients with COPD (group E) in the acute phase. Group I consisted of 129 patients taking basic dual treatment, group II — 73 patients taking triple therapy with inhaled GCs. During exacerbations, systemic GCs were prescribed at the cumulative dose of 352.94 ± 30.51 mg/year. The bone state was examined using an ultrasound densitometer SONOST-2000. A Speed of Sound (SOS), Broadband Ultrasound Attenuation (BUA), Stiffness index (SI), and T- and Z-scores were determined. Results. Decreases in SI, BUA, T- and Z- scores were established in 43.51 % of the patients from the I group and 83.56 % from the II group (p < 0.05). In the II group, SI was lower by 9.54 %, BUA — by 14.35 %, SOS — by 14.57 %, T- score — by 6.9 %, Z- score — by 25.86 %; in subjects with GOLD 3: BUA — by 40.27 %, SI — by 3.25 %, T- score — by 17.9 %; in patients with GOLD 4: SI — by 19.9 %, BUA — by 77.8 %, T- score — by 5.6 % compared to the I group. Conclusions. Glucocorticoid-induced osteoporosis was diagnosed in 10.71 % of patients from the I group and 20.55 % of the II group. Its frequency depended on the stage of COPD: GOLD 3 — in 22.22 % of patients, GOLD 4 — in 50.0 % of the subjects.