Journal of Bone Metabolism

"Bone density"

Original Articles

Cross-Calibration of Bone Mineral Density and Body Composition between GE Lunar Prodigy and Hologic Horizon W Dual Energy X-Ray Absorptiometry Systems: Sujin Kim, Guen Young Lee, Jun-Il Yoo, Sang-Wook Lee, Yong-Chan Ha; J Bone Metab 2026;33(1):84-93.
Published online February 28, 2026; DOI: https://doi.org/10.11005/jbm.26.1014

Background
Dual energy X-ray absorptiometry (DXA) measurements vary among instruments from different manufacturers. This study aimed to assess the correlation between bone mineral density (BMD) and body composition measured by the GE Lunar Prodigy and Hologic Horizon W DXA systems and to develop conversion equations.
Methods
A total of 120 healthy volunteers (59 males, 61 females) aged 20 to 70 years were scanned on both DXA systems on the same day. BMD was measured at the lumbar spine (L1-L4) and bilateral femurs. Body composition parameters were measured for the whole body and regional sites. Bland-Altman analysis, Pearson correlation, and concordance correlation coefficient (CCC) were used to assess agreement. Linear regression was performed to derive conversion equations.
Results
The Hologic system measured BMD values 14% to 20% lower at the lumbar spine and 8% to 17% lower at femoral sites compared to the GE Lunar system (all P<0.0001). Lean mass values were 4% to 10% lower on the Hologic system. Very strong correlations were observed for both BMD (r=0.944-0.980) and lean mass (r=0.963-0.984). Cross-calibration equations were developed for all measurement sites.
Conclusions
Despite significant systematic differences, there was very high correlation between the two DXA systems. The conversion equations can facilitate comparison of measurements between these systems in clinical practice and research.

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Distribution and Characteristics of Fall Risk Index-21 Scores in Patients with Fall-Related Hip Fractures: Norifumi Fujii, Manabu Tsukamoto, Ryoichi Nakamura, Sachio Himei, Daisuke Nakagawa, Yoshiaki Ikejiri, Toru Yoshioka, Takayuki Nabeshima, Nobukazu Okimoto; J Bone Metab 2026;33(1):73-83.
Published online February 28, 2026; DOI: https://doi.org/10.11005/jbm.25.931

Background
Fall risk assessment and preventive interventions are important for preventing secondary fractures after hip fracture. The aim of this study was to investigate the distribution and characteristics of Fall Risk Index-21 (FRI-21) scores based on prefracture living conditions in patients with fall-related unilateral hip fracture.
Methods
This study included 95 people who had suffered a hip fracture after a fall and had undergone surgery. FRI-21, dual energy X-ray absorptiometry (DXA), and hip structure analysis/trabecular bone score based on DXA were performed within 1 week after surgery. We compared bone parameters between the two groups, which were divided according to the cutoff value of the FRI-21. We also performed cluster analysis on the components of the FRI-21 and compared the characteristics of the subgroups via analysis of variance and multiple comparison tests.
Results
All participants had experienced a fall-related fracture, but 47 (49.5%) of the patients were judged to have low scores (<10) on the FRI-21. Moreover, cluster analysis revealed that the subjects were classified into three subgroups, and the characteristics of the items that constitute fall risk, namely, physical function, disease or geriatric syndrome, and environmental factors, were diverse.
Conclusions
These results suggest that caution is needed when interpreting the FRI-21 total score based on preoperative living conditions in post-fracture patients, as it may not adequately reflect fall risk. Considering the characteristics of the FRI-21 score in patients with hip fractures, identifying appropriate fall prevention strategies and healthcare professionals involved may be important for preventing future re-fractures.

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Trabecular Bone Score and Mortality Risk in a Population-Based Cohort of Older Adults: Carlos H. Orces; J Bone Metab 2026;33(1):40-49.
Published online February 28, 2026; DOI: https://doi.org/10.11005/jbm.25.917

Background
Osteoporosis is consistently reported to increase mortality risk in older adults. Whether trabecular bone score (TBS), an indirect index of trabecular microarchitecture, increases mortality risk has not been widely studied.
Methods
Participants aged 60 years and older in the National Health and Nutritional Examination Survey 2005 to 2008 with complete data on TBS lumbar vertebrae were linked to the public-use mortality files through December 31st, 2019. The X-tile software (version 3.6.1; Yale University) was used to obtain the overall and sex-specific optimal TBS cut-off values associated with all-cause mortality (log-rank test P<0.0001). Then, TBS was grouped into low (≤1.24), medium (1.25-1.39), and high (≥1.40) categories.
Results
A total of 2,641 participants with a mean age of 69.8 (standard error 0.2) years comprised the study sample. Of those, 1,109 older adults died after a median follow-up of 140 months. Overall, survival probability progressively decreased across TBS categories, which was accentuated in subjects with low TBS. Cox regression analysis demonstrated that participants with low TBS had 47% (hazard ratio [HR], 1.47; 95% confidence interval [CI], 1.10-1.96) greater all-cause mortality risk than their counterparts with high TBS, even after accounting for potential confounders including bone mineral density. Notably, older adults with low TBS had 2-fold higher risk of cancer-related mortality than those with high TBS (HR, 2.07; 95% CI, 1.17-3.67).
Conclusions
Low TBS was significantly associated with greater all-cause and cancer-related mortality in older adults.

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Evaluation of Trabecular Bone Score and Bone Mineral Density in Patients with Primary Hyperparathyroidism under 50 Years Old: Yunkyung Jeon, Myungsoo Im, Doohwa Kim, Jihyun Kim, Kyoungjune Pak, Seong-Jang Kim, Keunyoung Kim; J Bone Metab 2026;33(1):63-72.
Published online February 28, 2026; DOI: https://doi.org/10.11005/jbm.25.885

Background
This study aimed to investigate the densitometric characteristics and qualitative bone status in patients with normocalcemic primary hyperparathyroidism (PHPT) compared with those in controls who were younger adults under 50 years.
Methods
This retrospective study included 60 controls and 31 patients with PHPT who underwent dual energy X-ray absorptiometry (DXA) of the lumbar spine (LS), femoral neck (FN), and total hip (TH). Trabecular bone score (TBS) was derived from LS DXA images. Bone mineral density (BMD) values were assessed using Z-scores, and correlations between TBS, BMD, and laboratory parameters were examined.
Results
The median ages of the control and PHPT groups were 41 and 42 years, respectively. The proportion of individuals classified as “below the expected range for age” based on Z-scores differed significantly between groups only when considering any site collectively. Median TBS was significantly lower in PHPT patients than in controls, even when BMD values at LS, FN, and TH fell within similar diagnostic categories. In controls, TBS and BMD demonstrated very low correlation coefficients. In contrast, PHPT patients showed a stronger correlation between TBS and femoral BMD, whereas the association between TBS and LS BMD was largely absent. Among laboratory markers, only serum intact parathyroid hormone was significantly negatively correlated with TBS.
Conclusions
Young adults with PHPT exhibit impaired bone quality despite relatively preserved BMD, suggesting early microarchitectural deterioration. These findings support the combined use of LS and femoral BMD with TBS for more accurate assessment of skeletal health in PHPT.

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Determinants of Bone Mineral Density in Postmenopausal Women: The Role of Lean and Fat Mass by Dual Energy X-Ray Absorptiometry Assessment: Luis A. Ramírez Stieben, Lucas R. Brun, Silvana Di Gregorio, Luis Miguel Del Río Barquero, María Lorena Brance; J Bone Metab 2025;32(4):306-314.
Published online November 30, 2025; DOI: https://doi.org/10.11005/jbm.25.881

Background
Bone mineral density (BMD) is a key predictor of fracture risk in postmenopausal women. Evidence on the influence of fat and lean mass (LM) on BMD remains contradictory. This study aimed to assess the associations between BMD at different sites (whole-body, upper, and lower limbs) and anthropometric and body composition variables measured by dual energy X-ray absorptiometry (DXA) in postmenopausal women.
Methods
A cross-sectional study was conducted on 308 healthy postmenopausal women. Anthropometric data and whole-body DXA scans were used to measure BMD, total fat mass (FM), LM, appendicular LM index (ALMI), and abdominal fat. Pearson or Spearman correlation analyses were used according to variable distribution, and a correlation matrix along with variance inflation factor analyses was used to reduce 18 variables to a final set of 5. Multiple linear regression models were built for BMD at each site.
Results
Age was negatively correlated with BMD at all sites. Total LM and ALMI demonstrated positive correlations with BMD, whereas body mass index (BMI) and abdominal fat exhibited weaker positive associations. In multivariable analyses, age was negatively associated with whole-body BMD, while total LM was positively associated. For lower-limb BMD, age and total LM were significant predictors, with BMI showing a positive but weaker association. For upper-limb BMD, total LM, and ALMI were all positively associated. The models demonstrated satisfactory fit (adjusted R², 0.341-0.438; global P<0.0001).
Conclusions
Age and total LM were independently and consistently associated with BMD in postmenopausal women, whereas FM and BMI had a limited impact.

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Nano Calcium from Marine Fish Bones via High-Energy Ball Milling: A Potential Natural Supplement for Bone Health: Devy N. A. Hasanuddin, Safira Prisya Dewi, Sri Fatmawati, Annis Catur Adi, Heni Rachmawati; J Bone Metab 2025;32(4):285-296.
Published online November 30, 2025; DOI: https://doi.org/10.11005/jbm.25.875

Background
Calcium is essential for bone health, but its intake remains inadequate in populations with limited dairy consumption. Fish bones, abundant in calcium and phosphorus, represent a largely untapped natural resource for dietary calcium supplementation. The application of high-energy ball milling (HEM) presents a promising strategy to enhance calcium bioavailability by producing particles at the nanoscale.
Methods
This study used HEM to convert fish bones from Euthynnus affinis (tuna) and Lutjanus sp. (snapper) into nanoparticles. The resulting powder was analyzed for particle size, morphology, crystallinity, thermal, flowability, hygroscopicity, mineral composition, and proximate constituents.
Results
The HEM process successfully reduced the particle size of snapper and tuna bone powder to 729.83 and 847.93 nm, respectively, without altering their crystallinity. Morphological analysis revealed irregularly shaped particles, while thermal analysis indicated an exothermic decomposition pattern. No hygroscopic properties were observed in any of the samples. The nanonization process preserved the intrinsic mineral composition of the fish bones. Calcium/Phosphorus ratios remained >1.8. Elemental analysis confirmed high levels of calcium, phosphorus, and essential minerals such as potassium, magnesium, and sodium, while the protein and ash contents met nutritional standards.
Conclusions
Fish bone-derived nanoparticles produced via HEM exhibit advantageous physicochemical characteristics for nutraceutical applications and represent a promising source of bioavailable calcium to support bone health.

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Effect of Thyroid-Stimulating Hormone Suppression on Bone Mineral Density in Patients with Differentiated Thyroid Carcinoma: A Single Center Retrospective Study: Meihua Jin, Won Sang Yoo; J Bone Metab 2025;32(3):221-231.
Published online August 31, 2025; DOI: https://doi.org/10.11005/jbm.25.869

Background
This study evaluated the correlation between the degree and duration of thyroid-stimulating hormone (TSH) suppression and changes in bone mineral density (BMD) in patients who underwent surgery for differentiated thyroid carcinoma (DTC).
Methods
We included 65 women who underwent surgery for DTC and had at least two BMD measurements. Changes in BMD were statistically analyzed with a focus on postmenopausal women.
Results
The mean patient age was 52.2 years. During the follow-up period, 10 patients (15.4%) received osteoporosis treatment, and six (9.2%) experienced fractures. Analysis of 50 postmenopausal women revealed significant decreases in lumbar spine BMD (P=0.007), femoral neck BMD (P=0.008), and total hip BMD (P=0.010). Patients with TSH suppression <0.5 mU/L exhibited a 1.24%/y decrease in lumbar spine BMD, showing a marked reduction compared to a 0.33%/y decrease in BMD in the group with TSH ≥0.5 mU/L (P=0.025). Linear regression analysis comparing the duration of TSH suppression revealed a significant correlation with lumbar spine BMD (P<0.001). However, no correlation was observed between TSH suppression and decreased femoral neck BMD. Although not significant, the reduction in BMD in the lumbar spine was greater in the calcium and vitamin D non-supplementation group than in the supplementation group (1.31%/y vs. 0.71%/y; P=0.349).
Conclusions
Prolonged aggressive TSH suppression significantly affects lumbar spine BMD in patients with DTC. These findings highlight the need to balance TSH suppression with the risk of bone health deterioration, particularly in postmenopausal women.

Citations

Citations to this article as recorded by

1. TSH suppression attenuates the early efficacy of zoledronic acid in osteoporosis
Yujuan Liu, Yilei Zhang, Meiye Li, Ying Qian, Zongjing Zhang, Zhaoshun Jiang, Wei Qu
Archives of Osteoporosis.2026;[Epub] CrossRef

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Side-to-Side Differences in Bone Mineral Density, Bone Mineral Content, and Lean Mass in Healthy Subjects: María Lorena Brance, Silvana Di Gregorio, Luis A. Ramírez Stieben, Luis Miguel Del Río Barquero, Lucas R. Brun; J Bone Metab 2025;32(3):212-220.
Published online August 31, 2025; DOI: https://doi.org/10.11005/jbm.25.865

Background
Limb dominance is influenced by daily activity and muscle strength. Previous studies have demonstrated lateral differences in bone mineral density (BMD), bone mineral content (BMC), and lean mass as a result of asymmetric mechanical loading. Understanding these variations is crucial, especially in conditions with regional bone demineralization, where the contralateral limb can serve as a reference. We aimed to analyze side-to-side differences in BMD, BMC, and lean mass, as measured by dual energy X-ray absorptiometry (DXA), in healthy subjects.
Methods
A cross-sectional study included 802 whole-body composition assessments in Spanish adults (20-80 years). Athletes and individuals with bone metabolism disorders were excluded. Hand and foot dominance were self-reported. BMD, BMC, and lean mass were measured using a DXA scanner (Lunar Prodigy).
Results
The sample (57.1% women, 42.9% men; mean age, 53.0±16.7 years) showed strong correlations between dominant and non-dominant limbs (r>0.90). The dominant upper limb had significantly higher BMD (~4%), BMC (~5-6%), and lean mass (~3-4%) in both sexes. In women, the dominant lower limb showed slight differences (~1%), while in men, only lean mass was significantly higher. Aging led to BMD and BMC reductions after a peak in the fourth decade in women and the third in men. Lean mass showed a higher decline in men in both upper and lower limbs.
Conclusions
Limb dominance affects body composition differently between sexes, primarily in the upper limb, potentially due to differences in physical activity or mechanical loading. This study provides insight into how laterality and aging influence body composition in healthy individuals.

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Positive Effect of Yerba Mate (Ilex paraguariensis) Consumption on Bone Mineral Density in Postmenopausal Women Assessed by Dual Energy X-Ray Absorptiometry-Based 3-Dimensional Modeling: Lucas R. Brun, Muriel M. Henríquez, Luis A. Ramírez Stieben, Mariana Cusumano, Jorge Homero Wilches-Visbal, Fernando Daniel Saraví, María Lorena Brance; J Bone Metab 2025;32(2):123-132.
Published online May 31, 2025; DOI: https://doi.org/10.11005/jbm.24.827

Background
Yerba mate (YM) drinking is associated with higher lumbar spine and femoral neck bone mineral density (BMD) in postmenopausal women. We analyzed its effect on total hip BMD and reported the contribution of the trabecular and cortical components to this effect.
Methods
A control group of 147 non-drinkers was compared to 153 YM drinkers. Left hip BMD was measured using dual energy X-ray absorptiometry (DXA), and three-dimensional (3D)-Shaper software was used to estimate integral volumetric BMD (vBMD), cortical surface BMD (sBMD), and trabecular vBMD through 3D modeling.
Results
No significant difference was found between groups in either age (p=0.746) or body mass index (BMI; p=0.329). The YM group had significantly higher total hip BMD, integral vBMD, cortical sBMD, and trabecular BMD (all p<0.0001). The frequency of DXA-based osteoporosis diagnosis was lower in YM drinkers (3.3% vs. 10.9%; odds ratio [OR], 0.276). The rate of low-impact fractures was significantly reduced in YM drinkers (5.9% vs. 12.9%; OR, 2.197). Linear regression analyses revealed that cortical and trabecular parameters correlated positively with BMI and negatively with age in both groups. The slope of the lines did not differ between groups, but the elevation was uniformly higher in the YM group (p=0.0004 to p<0.0001).
Conclusions
Our study provides novel insights into YM consumption and bone health in postmenopausal women. We confirm its positive association with BMD and demonstrate, for the first time, that both cortical and trabecular compartments contribute to this effect. Our findings also suggest a potential protective role of YM against osteoporosis and fragility fractures.

Citations

Citations to this article as recorded by

1. Yerba Mate (Ilex paraguariensis) and Rheumatoid Arthritis: A Systematic Review of Mechanistic and Clinical Evidence
Manuela Cassotta, Qingwei Cao, Haixia Hu, Carlos Rabeiro Martinez, Luis Alonso Dzul Lopez, Santos Gracia Villar, Maurizio Battino, Francesca Giampieri
Nutrients.2025; 17(24): 3853. CrossRef

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The Influence of Fish Bone Powders on the Bone Density in Corticosteroid-Induced Osteoporosis Rats: Annis Catur Adi, Wizara Salisa, Sri Fatmawati, Emyr Reisha Isaura, Heni Rachmawati; J Bone Metab 2025;32(2):103-113.
Published online April 18, 2025; DOI: https://doi.org/10.11005/jbm.24.819

Background
The adequacy of calcium from food consumption is difficult to meet because of its low absorption rate, causing an increased risk of osteoporosis. One of the ways to increase calcium absorption is to increase its solubility by decreasing its particle size. This study aimed to observe the influence of particle size and mineral composition of various fish bone powders on bone density enhancement after oral administration to corticosteroid-induced osteoporosis rats.
Methods
The test stages carried out include manufacturing fish bone flour and nanonization, characterization (particle size and nutritional content), conducting experimental tests on rats using blood serum samples, and observing bone growth and density. The types of fish studied were catfish, snakehead fish, mackerel, and snapper.
Results
Nanonization processing has been proven to reduce the size of flour particles, increase its nutritional and mineral content, and maximize the calcium absorption rate in rats. The results of the test on experimental animals induced osteoporosis showed that rats given the intervention of milling snapper fish bone meal produced the best outcomes in body length, body mass index, calcium, magnesium, and serum phosphorus (P<0.05). While in bone parameters, catfish bone meal was the most optimal in encouraging bone density percentage.
Conclusions
In conclusion, to increase serum minerals and bone density optimally, in addition to reducing particle size, the ratio of mineral content also needs to be considered.

Citations

Citations to this article as recorded by

1. Integration of fishbone deep processing technology with animal experiments on inventive calcium supplements for aquatic circular economy
Erh Ruei Wang, Chih Hsiung Huang, Kuang Ting Huang, Wen Ling Shih, Tsung Ming Yeh
Applied Food Research.2025; 5(2): 101334. CrossRef

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Review Article

Efficacy of Bisphosphonate in Patients with Neurofibromatosis Type 1: Arzu Jalilova, Alessandra Cocca; J Bone Metab 2025;32(1):1-10.
Published online February 28, 2025; DOI: https://doi.org/10.11005/jbm.24.809

This review aims to synthesize current knowledge regarding the use of bisphosphonates (BPs) in the treatment of bone complications in patients with neurofibromatosis type 1 (NF1). NF1 is a genetic disorder marked by multiple benign tumors of the nervous system and various skeletal abnormalities, such as osteoporosis and an increased risk of fractures. BPs are drugs that inhibit bone resorption, commonly used to treat osteoporosis and other bone diseases. The review identified multiple studies examining the effects of BP therapy in NF1 patients. Most studies reported improvements in bone mineral density and reduced fracture occurrence. The most commonly reported side effects were mild gastrointestinal symptoms and transient musculoskeletal pain. However, the evidence is limited by the small number of studies and the heterogeneity of patient populations and treatment protocols. In conclusion, BPs show improvements in managing NF1 complications such as osteoporosis and a reduction of fracture risk in NF1 patients. While the existing studies suggest positive outcomes, there is a need for more rigorous, large-scale studies to establish standardized treatment protocols and long-term safety profiles. Healthcare providers should consider BP therapy as a potential option for NF1 patients with significant bone complications, while also monitoring for possible adverse effects.

Citations

Citations to this article as recorded by

1. Molecular role of developmentally regulated GTP-binding protein 1 in coordinating osteoclast and osteoblast differentiation during bone remodeling
Jung Ha Kim, Semun Seong, Kabsun Kim, Inyoung Kim, Jeong-Tae Koh, Nacksung Kim
Molecules and Cells.2026; 49(5): 100342. CrossRef

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Original Articles

Generate Quantitative Computed Tomography-Equivalent Computed Tomography Image Interpretation Reports in Patients with Spinal Deformities: Hyunbin Kim, Hyeon Su Kim, Shinjune Kim, Jun-Il Yoo; J Bone Metab 2025;32(1):31-37.
Published online February 28, 2025; DOI: https://doi.org/10.11005/jbm.24.801

Background
Quantitative computed tomography (QCT) is essential for assessing osteoporosis and monitoring spinal deformities. “Clari-QCT,” a software that uses artificial intelligence to analyze conventional computed tomography (CT) scans and produce QCTequivalent reports. This study aims to evaluate the effectiveness of Clari-QCT by comparing its results with traditional QCT, with the goal of validating new diagnostic tools for spinal deformities.
Methods
The study analyzed dual energy X-ray absorptiometry, CT, and QCT data from 18 patients at Inha University Hospital. Clari-QCT software was evaluated for its ability to generate QCT-equivalent reports from CT images. The software processes abdomen CT images, calculates bone density in designated slices, and provides bone mineral density (BMD), T-score, and Z-score values. Patients were classified into normal, mild, and severe spinal deformity groups. Intraclass correlation coefficient (ICC) analysis was used to measure the agreement between actual and predicted BMD values.
Results
The study included participants with an average age of 64 and a mean body mass index of 24.88. The average BMD was 94.7 g/cm³ by QCT and 122.5 g/cm³ by Clari- QCT, with individual differences ranging from 4.9 to 61.8. T-score discrepancies ranged from 0.16 to 6.86. ICC analysis showed moderate to high agreement between methods, with ICC1 values of 0.597, ICC2 of 0.64, ICC3 of 0.81, and ICC1k, ICC2k, ICC3k values ranging from 0.748 to 0.895.
Conclusions
Clari-QCT demonstrates good agreement with actual QCT measurements in normal and severe spinal deformity groups but shows reduced accuracy in patients with mild deformities. If the limitations are addressed, it could become a useful tool for monitoring bone health in patients with spinal deformities.

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Relationships among Physical Activity Bone Mineral Density and Body Composition in Obese and Athletes: Dutsadee Suttho, Sudarat Apibantaweesakul, Jatesupa Soponputthaporn, Salintip Hemapaibun, Maitee Santipongphibool, Chatchaya Tengcharoenkul; J Bone Metab 2024;31(4):326-334.
Published online November 30, 2024; DOI: https://doi.org/10.11005/jbm.24.791

Background
Osteoporosis is a significant global public health issue, increasingly affecting younger individuals and placing substantial economic burdens on society. Risk factors vary, with non-modifiable ones like age and ethnicity, as well as modifiable factors including corticosteroid use, caffeine intake, and reduced exercise. This study examines the relationship between bone density, body components, and physical activity (PA) in enhancing bone health, particularly in obese athletes.
Methods
The 66 participants aged 18 to 30 were classified into two groups: 34 obese and 32 athletes. Measured parameters included body composition through bioelectrical impedance analysis, and bone mineral density (BMD) via quantitative ultrasound, while PA was assessed using the International PA Questionnaire.
Results
Our findings revealed a significant positive correlation between BMD and PA (r=0.284, P=0.023). Additionally, PA demonstrated strong negative correlations with body mass index (BMI), fat mass, and visceral fat (r=-0.738, r=-0.733, and r=-0.704 respectively, all P<0.001). In contrast, no significant correlation was observed between PA and lean mass (r=0.065, P=0.609). BMD was negatively associated with BMI and visceral fat, while a robust correlation between basal metabolic rate and lean mass was evident.
Conclusions
A study comparing athletes involved in high-impact sports indicated that these athletes maintained adequate BMD for their chronological age (Z-score≥-2.0). Moreover, a significant difference in BMD was observed when comparing the athletes to the obese group(P=0.018).

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Age- and Sex-Related Volumetric Density Differences in Trabecular and Cortical Bone of the Proximal Femur in Healthy Population: María Lorena Brance, Fernando Daniel Saraví, Muriel M. Henríquez, María Silvia Larroudé, Jorge E. Jacobo, Sebastian Abalo Araujo, Vanesa Longobardi, María Bélen Zanchetta, María Rosa Ulla, Florencia Martos, Helena Salerni, Beatriz Oliveri, Marina Soledad Bonanno, Naraline Luna Meneses, Pilar Diaz Baclini, Luis A. Ramírez Stieben, Silvana Di Gregorio, Lucas R. Brun; J Bone Metab 2024;31(4):279-289.
Published online November 30, 2024; DOI: https://doi.org/10.11005/jbm.24.765

Background
There are age- and sex-related increases in the prevalence of osteoporosis. Bone densitometry based on dual energy X-ray absorptiometry (DXA) is the gold standard for the assessment of bone mineral density (BMD). Three-dimensional (3D) analysis of the proximal femur (3D-DXA) allows discrimination between cortical and trabecular compartments, and it has shown a good correlation with computed tomography. We aimed to assess age- and sex-related volumetric density differences in trabecular and cortical bone using 3D-DXA and determine the reference intervals for integral volumetric (v)BMD within the Argentine population.
Methods
Healthy female and male adult subjects (N=1,354) from Argentina were included. Hip BMD was measured using DXA, and 3D analysis was performed using 3D-Shaper software. The integral vBMD, cortical surface BMD, and trabecular vBMD (trab vBMD) were measured.
Results
The study population included 73.9% women (N=1,001) and 26.13% men (N=353). We found a significant decrease in integral vBMD between 20 and 90 years in both sexes (women, -23.1%; men, -16.6%). Bone loss indicated in the integral vBMD results was mainly due to a decrease in trabecular bone in both sexes (women, -33.4%; men, -27.7%). The age-related loss of cortical bone density was less and was limited to the female population, without no age-related differences in men. Moreover, 3D-DXA allowed us to propose reference intervals for integral vBMD.
Conclusions
We found age- and sex-related bone loss between 20 and 90 years in an Argentine cohort via integral vBMD measurements using 3D-DXA, mainly due to decreases in trabecular bone in both sexes. The age-related loss of cortical bone density was less and was limited to the female population.

Citations

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1. Comparative Analysis of Cortical and Trabecular Bone Structure Between Patients with Type 2 Diabetes and Healthy Controls
Griselda-Adriana Cruz-Priego, Miguel Ángel Guagnelli, Sergio Ortiz Santiago, Karina Geraldine González Castelan, Rita A. Gomez-Diaz, Ludovic Humbert, Patricia Clark
Archives of Medical Research.2026; 57(1): 103269. CrossRef
2. Effects of low-level lead exposure on hematological parameters and the possible underlying mechanisms
Xiaojing Liao, Tao Lin, Zhaorui Zhang, Peng He, Haimei Wu, Xinyi Ouyang, Qianxi Li, Zihan Yu, Ziyan Zhang, Jiahui Wu, Yingxin Guo, Shanshan Wang, Tianpeng Wang, Lixuan Chen, Weiqi Zhang, Kang Liu, Yu Yuan, Wending Li, Yongmei Xiao, Tangchun Wu, Degang Wu,
Environmental Pollution.2026; 396: 127884. CrossRef
3. Multifaceted Preprocessing Optimization for Post-Mortem Radiomics Analysis: A Pilot Study on Forensic Age Estimation Using Proximal Femur Radiomics
Despoina E. Flouri, Matthaios Triantafyllou, Kostas Marias, Apostolos H. Karantanas, Elena F. Kranioti, Michail E. Klontzas
Journal of Imaging Informatics in Medicine.2025;[Epub] CrossRef
4. Positive Effect of Yerba Mate (Ilex paraguariensis) Consumption on Bone Mineral Density in Postmenopausal Women Assessed by Dual Energy X-Ray Absorptiometry-Based 3-Dimensional Modeling
Lucas R. Brun, Muriel M. Henríquez, Luis A. Ramírez Stieben, Mariana Cusumano, Jorge Homero Wilches-Visbal, Fernando Daniel Saraví, María Lorena Brance
Journal of Bone Metabolism.2025; 32(2): 123. CrossRef
5. Side-to-Side Differences in Bone Mineral Density, Bone Mineral Content, and Lean Mass in Healthy Subjects
María Lorena Brance, Silvana Di Gregorio, Luis A. Ramírez Stieben, Luis Miguel Del Río Barquero, Lucas R. Brun
Journal of Bone Metabolism.2025; 32(3): 212. CrossRef
6. Research hotspots and trends of pediatric bone age: A bibliometric and visualization analysis
Huaping Tang, Zenan Ma, Lanping Gao
Lasers in Medical Science.2025;[Epub] CrossRef
7. The contribution of trabeculae and the failure initiation in the proximal femur: a finite element analysis
Peng Jia, Yi Yang, Zheng Fang, Xin Tang
Journal of Orthopaedic Surgery and Research.2025;[Epub] CrossRef
8. Investigating the association between creatinine-adjusted urinary catecholamines and site-specific bone mineral density in older adults
Laith Ashour, Shahed Hammad, Randa Shahwan, Rashed Musamih, Omer Aziziye, Mohammad Zaita, Qusai Aref Fraihat, Ali Schumannalkhtib, Mohammad Al Khreisha, Hani Barakat, Mohammad Sawalmeh
Hormone Molecular Biology and Clinical Investigation.2025;[Epub] CrossRef
9. Determinants of Bone Mineral Density in Postmenopausal Women: The Role of Lean and Fat Mass by Dual Energy X-Ray Absorptiometry Assessment
Luis A. Ramírez Stieben, Lucas R. Brun, Silvana Di Gregorio, Luis Miguel Del Río Barquero, María Lorena Brance
Journal of Bone Metabolism.2025; 32(4): 306. CrossRef

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Zoledronate Therapy in Osteogenesis Imperfecta: Perspectives in Indonesia Tertiary Hospital: Tri Wahyu Martanto, Aliefio Japamadisaw, Dian Nurhayati, Rob G. H. H. Nelissen; J Bone Metab 2024;31(4):290-295.
Published online November 4, 2024; DOI: https://doi.org/10.11005/jbm.24.767

Background
Osteogenesis imperfecta (OI) is a rare disease with an estimated incidence of between 1/25,000 and 1/10,000 globally. The main treatment for OI is the administration of bisphosphonate drugs. Research on clinical, radiographic, and biochemical markers to monitor patients with OI treated with zoledronate can be challenging in countries in which patients have limited national health insurance. We aimed to examine patients with OI treated in Indonesia with a minimum follow-up period of 2 years.
Methods
An observational study was conducted of all patients with OI treated with zoledronate between 2021 and 2023 at a tertiary hospital in Indonesia. We evaluated the paediatric quality of life (PedsQL), bone mineral density (BMD), and alkaline phosphatase (ALP) level before and after zoledronate treatment. To monitor safety, serum creatinine and calcium levels were also measured.
Results
Eleven boys (55%) and nine girls (45%), with an average age of 6.9 years (range, 4–17 years), were included. After 2 years of zoledronate treatment, the total PedsQL score increased from 66.7 to 76.9 (P=0.0001) and the mean lumbar and total body BMD increased from 0.467 and 0.501 to 0.599 g/cm², and 0.626 g/cm² (P=0.001), respectively. The ALP level decreased from 310.6 to 186.4 mg/mL (P=0.0001). Neither serum creatinine (P=0.586) nor calcium (P=0.53) levels changed from the pre-treatment to 2 years post-treatment time points.
Conclusions
Zoledronate was safe and effective for the treatment of OI. There were significant improvements in the quality of life and BMD in patients with OI. The ALP level decreased, but serum creatinine and calcium levels were not affected by zoledronate.

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Bone Mineral Density and Clinical Outcome after Ankle Fracture: Hyunseong Kang, Ho-Hyup Kim, Chaemoon Lim; J Bone Metab 2024;31(3):228-235.
Published online August 31, 2024; DOI: https://doi.org/10.11005/jbm.2024.31.3.228

Background
No gold standard exists for bone mineral density (BMD) measurement of the ankle. This study aimed to determine the correlation between bone density using Hounsfield units (HU) based on computed tomography (CT) and BMD using dual energy X-ray absorptiometry (DXA) as well as to evaluate the correlation between HU and clinical outcome of ankle fracture.
Methods
Fifty-one patients aged ≥65 years who underwent surgical treatment for trimalleolus or bimalleolus ankle fractures were included. The HU were measured at the distal tibia metaphyseal region approximately 1 cm proximal to the plafond on the axial images of preoperative CT. BMD was measured using DXA within one year before the injury. The clinical outcome was evaluated according to the Foot and Ankle Outcome Score (FAOS).
Results
Although the HU of an osteoporosis group was lower than that of a non-osteoporosis group, we observed no significant difference between the two groups. The mean HU significantly correlated with the lumbar and total lumbar spine BMD using DXA. Increased HU significantly correlated with improved clinical outcomes in three of five FAOS subscales: symptoms, pain, activity of daily living (ADL), and quality of life (QOL). In a linear regression analysis adjusted for age and body mass index, increased HU significantly correlated with improved clinical outcomes in three of five FAOS subscales: symptoms, pain, ADL, and QOL.
Conclusions
The correlations between bone density using HU and BMD and those between HU and the clinical outcome were confirmed in ankle fractures. The HU of preoperative CT might provide valuable information for predicting postoperative clinical outcomes.

Citations

Citations to this article as recorded by

1. Influencing factors of fracture in elderly ankle fracture patients in the emergency department and the construction of nomogram prediction model
Yu-Lei Mao, Yong-Kang Wei
Medicine.2026; 105(7): e45997. CrossRef

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Comparison of Clinical and Radiological Outcomes after Vertebroplasty and Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures: Sung-Hyun Yoon, Hee-Gon Park, Dae-Hee Lee, Dong-Uk Lee; J Bone Metab 2024;31(1):56-62.
Published online February 29, 2024; DOI: https://doi.org/10.11005/jbm.2024.31.1.56

Background
Vertebroplasty (VP) and balloon kyphoplasty (KP) are effective means with which to improve pain and function in osteoporotic vertebral compression fractures. However, the risk of complications after these procedures is poorly understood, with concerns regarding adjacent vertebral fractures. This study retrospectively investigated the clinical and radiological outcomes of these procedures.
Methods
A total of 115 patients who experienced their first vertebral fracture were treated with VP (N=63) or KP (N=52) at the Dankook University Hospital between January 2013 and December 2022. The clinical outcomes were evaluated using the visual analog scale (VAS) preoperative and at 1-year follow-up. Radiological comparisons were performed for kyphosis correction, vertebral height restoration, and postoperative cement leakage.
Results
KP was more effective than VP, especially for vertebral body height restoration and kyphotic angle reduction (P<0.05). However, the incidence of cement leakage, new adjacent vertebral fractures, and improvement in pain assessed by VAS did not differ statistically between the 2 groups (P>0.05).
Conclusions
Considering that KP was performed on fractures with severe deformity, no differences were observed in the clinical outcomes and incidence of adjacent vertebral fractures compared Considering that KP was performed for fractures with severe deformity, there was no difference in clinical outcomes and incidence of adjacent vertebral fractures compared to VP. Improvements in radiological measurements were demonstrated. Therefore, KP may be a good treatment option for pain relief and long-term prognosis in patients with high-compressive-rate vertebral fractures.

Citations

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1. Incidence of New Fractures in Patients Treated with Kyphoplasty/Vertebroplasty or Conservative Methods
Alper Tabanli, Hakan Yilmaz, Hüseyin Berk Benek, Mehmet Akif Ercan, Gulsen Ozgenc, Cafer Ak, Onur Bologur, Emrah Akcay, Alaettin Yurt
Medicina.2025; 61(11): 2012. CrossRef

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Cross-Sectional and Longitudinal Associations between Forearm Bone Mineral Density and Anthropometry in Adult Japanese Men and Women: Masahiro Ishizawa, Kazuya Fujihara, Junko Yachida, Izumi Ikeda, Takaaki Sato, Takaho Yamada, Ayako Kobayashi, Shiro Tanaka, Yoshimi Nakagawa, Takashi Matsuzaka, Hitoshi Shimano, Minoru Tashiro, Satoru Kodama, Kiminori Kato, Hirohito Sone; J Bone Metab 2024;31(1):21-30.
Published online February 29, 2024; DOI: https://doi.org/10.11005/jbm.2024.31.1.21

Background
No consensus exists regarding which anthropometric measurements are related to bone mineral density (BMD), and this relationship may vary according to sex and age. A large Japanese cohort was analyzed to provide an understanding of the relationship between BMD and anthropometry while adjusting for known confounding factors.
Methods
Our cohort included 10,827 participants who underwent multiple medical checkups including distal forearm BMD scans. Participants were stratified into four groups according to age (≥50 years or <50 years) and sex. The BMD values were adjusted for confounding factors, after which single and partial correlation analyses were performed. The prevalence of osteopenia was plotted for each weight index (weight or body mass index [BMI]) class.
Results
Cross-sectional studies revealed that weight was more favorably correlated than BMI in the older group (R=0.278 and 0.212 in men and R=0.304 and 0.220 in women, respectively), whereas weight and BMI were weakly correlated in the younger age groups. The prevalence of osteopenia exhibited a negative linear relationship with weight among older women ≥50 years of age, and an accelerated increase was observed with decreasing weight in older men weighing <50 kg and younger women weighing <60 kg. When weight was replaced with BMI, the prevalence was low in most subgroups classified by weight.
Conclusions
Weight, rather than BMI, was the most important indicator of osteopenia but it might not be predictive of future bone loss.

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Bone Health Status of Children with Spinal Muscular Atrophy: Joanna Yuet-Ling Tung, Tsz-Kit Chow, Monique Wai, Jasmine Lo, Sophelia Hoi Shan Chan; J Bone Metab 2023;30(4):319-327.
Published online November 30, 2023; DOI: https://doi.org/10.11005/jbm.2023.30.4.319

Background
Spinal muscular atrophy (SMA) is a group of rare, inherited neuromuscular disorders. Bone health is often a neglected issue in children with SMA. This study aimed to evaluate the bone health status of children with SMA in Hong Kong.
Methods
This retrospective study included children with SMA who were managed in the Neuromuscular Disorder Clinics of 2 quaternary centers in Hong Kong. Bone health status was assessed by fracture history, bone mineral density (BMD) measured by dual energy X-ray absorptiometry, and serum 25-hydroxy-vitamin D (25[OH]D) level.
Results
Thirty-two children were included (males, 12). The median age was 10.8 years. BMD assessments were performed in 17 patients (SMA type 1=2, type 2=8, type 3=7). Low BMD was observed in 16 out of 17 patients. Four had a history of long bone fractures and were started on bisphosphonates. SMA types, age at last visit, sex, ambulation, and 25(OH)D level were not associated with fracture history or BMD Z-scores. Only one fulfilled the 2019 International Society for Clinical Densitometry (ISCD) pediatric definition of osteoporosis, with both low BMD and a history of clinically significant fracture.
Conclusions
Children with SMA on disease-modifying treatments commonly had Low BMD and a history of fractures, but osteoporosis was uncommon according to the 2019 ISCD pediatric definition. A special definition of osteoporosis may be needed for this high-risk group.

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1. Italian survey on evolving SMA care with disease-modifying therapies: a consensus workshop on nutrition, swallowing, respiratory and rehabilitation care
Stefania Corti, Valeria Sansone, Ilaria Bitetti, Noemi Brolatti, Giulio Gadaleta, Agata Katia Patanella, Giorgia Coratti, Eugenio Mercuri
Neuromuscular Disorders.2025; 48: 105278. CrossRef
2. Awareness of bone strength in patients with neuromuscular disorders: ERN EURO-NMD clinician survey and European patient survey
M.T.A. Kruse, B.A.S. Olde Dubbelink, M. Kroneman, I. de Groot, S. Schlüter, M. de Visser, T. Evangelista, A. Moretti, D. Weber, L.M. Ward, N.C. Voermans, A. D'Amico, J. Baets, M. Baumann, N. van der Beek, J. De Bleecker, A. Bruijnes, K. Claeys, C. Bruno,
Journal of the Neurological Sciences.2025; 472: 123420. CrossRef
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Haikuan Yu, Taojin Feng, Chengcheng Zhang, Zhouguang Jiao, Wenkai Fan, Rongxian Jiang, Dewen Kong, Fubing Li
Frontiers in Pharmacology.2025;[Epub] CrossRef
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Elizabeth A. Lechtholz-Zey, Mina Ayad, Brandon S. Gettleman, Emily S. Mills, Hannah Shelby, Andy T. Ton, Ishan Shah, Jeffrey C. Wang, Raymond J. Hah, Ram K. Alluri
Journal of Bone Metabolism.2024; 31(2): 114. CrossRef
5. 274th ENMC international workshop: recommendations for optimizing bone strength in neuromuscular disorders. Hoofddorp, The Netherlands, 19–21 January 2024
Nicol C. Voermans, Anne T.M. Dittrich, Sara Liguori, Chiara Panicucci, Antimo Moretti, David R. Weber, Leanne M. Ward, Ingrid de Groot, Michela Guglieri, Claire Wood, Sara Liguori, Giovanni Iolascon, Anna Kostera-Pruszczyk, Corrie E. Erasmus, Marianne de
Neuromuscular Disorders.2024; 43: 1. CrossRef
6. Low bone mineral density and its influencing factors in spinal muscular atrophy without disease-modifying treatment: a single-centre cross-sectional study
Chuan Liu, Dandan Yang, Lekai Luo, Xinmao Ma, Xijian Chen, Yi Liao, Gang Ning, Haibo Qu
BMC Pediatrics.2024;[Epub] CrossRef
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Specialty Journal of Pharmacognosy, Phytochemistry, and Biotechnology.2021; 1(1): 138. CrossRef

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Development and Validation of a New Clinical Diagnostic Screening Model for Osteoporosis in Postmenopausal Women: Jirapong Leeyaphan, Karn Rojjananukulpong, Piyapong Intarasompun, Yuthasak Peerakul; J Bone Metab 2023;30(2):179-188.
Published online May 31, 2023; DOI: https://doi.org/10.11005/jbm.2023.30.2.179

Background
Age and weight are not only strong predictive parameters for osteoporosis diagnosis but can also be easily acquired from patients. This study aimed to develop and validate a new diagnostic screening model for postmenopausal osteoporosis that uses only 2 parameters, viz., age and weight. The discriminative ability of the model was analyzed and compared with that of the osteoporosis self-assessment tool for Asians (OSTA) index.
Methods
The age–weight diagnostic screening model was developed using a retrospective chart review of postmenopausal women aged ≥50 years who underwent dual energy X-ray absorptiometry at a tertiary hospital from November 2017 to April 2022. Logistic regression analysis was used to derive a diagnostic screening model for osteoporosis.
Results
A total of 533 postmenopausal women were included in the study. According to the highest Youden index value, a probability cut-off value of 0.298 was used in the diagnosis screening model at any site, which yielded a sensitivity of 84.3% and a specificity of 53.8%. For increased sensitivity as a screening tool, a cut-off value of 0.254 was proposed to obtain a sensitivity of 90.2% and a specificity of 42.2%. The area under receiver operating characteristic curves from all screening models were significantly higher than those from the OSTA index model (p<0.05).
Conclusions
This study showed the feasibility of a postmenopausal osteoporosis diagnostic screening model that uses 2 strong predictors for osteoporosis diagnosis: age and weight. This age–weight diagnostic model is a simple, effective option in postmenopausal osteoporosis screening.

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1. Performance of clinical prediction models for identifying postmenopausal osteoporosis: a systematic review and meta-analysis
Xinyi Huang, Yiwen Gan, Xiangyun Guo, Yunning Li, Liang Wang, Jinran Qin, Chuanrui Sun, Yuhui Yin, Ming Chen, Yanming Xie, Yang Guo, Xu Wei, Yili Zhang
BMC Musculoskeletal Disorders.2026;[Epub] CrossRef
2. Simple clinical predictors for making directive decisions in osteoporosis screening for women: a cross-sectional study
Jirapong Leeyaphan, Karn Rojjananukulpong, Piyapong Intarasompun, Yuthasak Peerakul
Journal of Orthopaedic Surgery and Research.2024;[Epub] CrossRef

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Position Statement: Exercise Guidelines for Osteoporosis Management and Fall Prevention in Osteoporosis Patients: Seongryu Bae, Seungyong Lee, Hyuntae Park, Yongin Ju, Seok-Ki Min, Jinkyung Cho, Hyojin Kim, Yong-Chan Ha, Yumie Rhee, Young-Pyo Kim, Changsun Kim; J Bone Metab 2023;30(2):149-165.
Published online May 31, 2023; DOI: https://doi.org/10.11005/jbm.2023.30.2.149

Background
The effectiveness of exercise for improving osteoporosis and fall prevention in patients diagnosed with osteoporosis or osteopenia has not been fully summarized. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology has developed exercise guidelines for patients with osteoporosis or osteopenia and provide evidence-based recommendations.
Methods
A systematic review identified randomized controlled trials (RCT) assessing the effect of resistance, impact, balance, aerobic training, and physical activity in osteoporosis and osteopenia on bone quality, physical performance, quality of life, and fall prevention. PubMed, Embase, KoreaMed, and RISS were searched from January 2000 to August 2022. Ten key questions were established to review the evidence and formulate recommendations.
Results
The 50 RCTs reported that even with osteoporosis and osteopenia, resistance and impact training consistently maximized bone strength, improved body strength and balance, and eventually reduced fall incidences. Resistance exercise combining 3 to 10 types of free weight and mechanical exercise of major muscle groups performed with an intensity of 50% to 85% 1-repetition maximum, 5 to 12 repetitions/set, 2 to 3 days/week, for 3 to 12 months is recommended. Impact exercises such as jumping chin-ups with drop landings and jump rope performed 50 jumps/session for at least 6 months with 3 or more days/week are recommended.
Conclusions
A multi-component exercise mainly comprised of resistance and impact exercise seems to be an effective strategy to attenuate the risk factors of osteoporosis and osteopenia. The integration of exercise guidelines and individualized exercise plans has significant potential to reduce the morbidity and mortality of osteoporosis.

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5. Current Perspectives on Exercise for Osteoporosis Prevention in Korean Older Adults: A Scoping Review regarding Mechanisms, Interventions, and Clinical Implications
Ji-Sik An, Wi-Young So
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Different Pattern of T-Score Discordance between Patients with Atypical Femoral Fracture and Femur Neck Fracture: Byung-Ho Yoon, Jang-Won Park, Chan Woo Lee, Young Do Koh; J Bone Metab 2023;30(1):87-92.
Published online February 28, 2023; DOI: https://doi.org/10.11005/jbm.2023.30.1.87

Background
Our study evaluated the prevalence and pattern of T-score discordance between the spine and hip in Korean patients with atypical femoral fracture (AFF) and femur neck fracture (FNF).
Methods
A total of 49 patients (all women) who were treated for AFF and 1:3 matched 147 female patients with FNF were included from January 2012 to August 2022. A discordance of more than 1.5 between lumbar spine and femur neck bone mineral density (BMD) was defined as a difference and divided into 3 groups: lumbar low (LL; lumbar BMD is less than femur neck BMD), no discordance (ND), and femur neck low (FL; femur neck BMD is less than lumbar BMD). We compared the prevalence and pattern of discordance between 2 groups, and the associated risk factors of T-score discordance among the subjects were evaluated using regression analysis.
Results
The prevalence of discordance was significantly higher in patients with AFF (51%) than in those with FNF (25.2%; p<0.001). LL discordance was found in 46.9% of the patients with AFF but only 4.8% in those with FNF. Conversely, FL discordance was found in 4.1% of the patients with AFF and 20.4% in those with FNF, respectively. No specific risk factor was found as T-score discordance in the 2 groups.
Conclusions
Clinicians should be aware that the pattern of T-score discordance can vary depending on the location of osteoporotic fractures. In addition, a longitudinal study would be necessary to verify the pattern of T-score discordance related to the osteoporotic fracture location.

Citations

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1. Association between decreased bone mineral density and Pauwels angle in femoral neck fractures: a cross-sectional study
Soo-Hwan Jung, Yong-Uk Kwon, Ji-Hun Park
Journal of Musculoskeletal Trauma.2026; 39(1): 20. CrossRef
2. Development of AI model for dual detection of low bone mineral density in the femoral neck and lumbar vertebrae using chest radiographs
Yukino Ohta, Kouichi Yamamoto, Yutaka Katayama, Takahiro Ideta, Hiroaki Matsuzawa, Takao Ichida, Akane Utsunomiya, Takayuki Ishida
Journal of Clinical Densitometry.2025; 28(4): 101604. CrossRef
3. Factors Associated with Discordance between Hip and Spine Bone Mineral Density
Weon Kim, Min Kyu Choi
Korean Journal of Family Practice.2025; 15(3): 167. CrossRef

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Trabecular Bone Score and Central Quantitative Computed Tomography for the Prediction of Vertebral Fragility Fractures in Postmenopausal Women: Soree Ryang, Yun Kyung Jeon, Tae Sik Goh, In-Joo Kim, Keunyoung Kim; J Bone Metab 2023;30(1):77-86.
Published online February 28, 2023; DOI: https://doi.org/10.11005/jbm.2023.30.1.77

Background
We aimed to investigate whether densitometry results and volumetric bone mineral density (vBMD) can predict vertebral fragility fractures (VFF) in postmenopausal women.
Methods
We enrolled 271 postmenopausal women aged >45 years who visited our hospital for health check-ups between September 2016 and September 2017. The lumbar spine (LS) and femoral neck (FN) densitometry results and trabecular bone score (TBS) were calculated using dual energy X-ray absorptiometry. vBMD was assessed using central quantitative computed tomography (cQCT). Baseline and follow-up X-ray images were reviewed to evaluate thoracolumbar vertebral compression fractures (CFs), according to the Genant criteria.
Results
At baseline, 76 patients (28.0%) had CF. Additional or progressive fractures were noted in 26 participants (9.6%) with a median follow-up of 19.5 months. The median TBS and cQCT were significantly higher in participants without baseline CF than those with baseline CF (p<0.001). During the follow-up, Kaplan–Meier analysis showed that T-scores of the LS and FN <-2.5, degraded microarchitecture based on the TBS (≤1.200), and vBMD <80 mg/cm3 was significantly associated with future osteoporotic CF. The final multivariate Cox regression analysis showed that baseline CF and low TBS and vBMD were significant risk factors for future VFF.
Conclusions
Participants with baseline CF and degraded microarchitecture had higher CF predisposition. Moreover, cQCT can predict future vertebral fractures.

Citations

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1. Assessment of trabecular bone score (TBS) in the prediction of vertebral fracture in postmenopausal osteoporosis
Federica Biamonte, Jessica Pepe, Luciano Colangelo, Giovambattista Desideri, Evaristo Ettorre, Luciano Nieddu, Davide Diacinti, Daniele Diacinti, Salvatore Minisola, Cristiana Cipriani
Bone.2025; 190: 117307. CrossRef
2. Functional outcomes following hip fracture with concurrent vertebral fracture within a fracture liaison service
Ong-art Phruetthiphat, Wasin Kanokwongnuwat, Yodhathai Satravaha, Panukorn Pinijprapa, Chaisiri Chaichankul, Pawin Gajaseni
Scientific Reports.2025;[Epub] CrossRef
3. TBS correlates with bone density and microstructure at trabecular and cortical bone evaluated by HR-pQCT
E. M. F. Gama, L. M. C. Mendonça, F. P. Paranhos-Neto, L. Vieira Neto, M. Madeira, M. L. F. Farias
Journal of Bone and Mineral Metabolism.2024; 42(3): 352. CrossRef
4. Unraveling the relationship between serum parathyroid hormone levels and trabecular bone score: a cross-sectional study
Tingxiao Zhao, Yanlei Li, Jinlong Tian, Yao Kang, Jiongnan Xu, Haiyu Shao, Jinlei Zhou, Chen Xia, Yongguang Wang, Jun Zhang
Scientific Reports.2024;[Epub] CrossRef
5. Development and validation of a predictive model for vertebral fracture risk in osteoporosis patients
Jun Zhang, Liang Xia, Xueli Zhang, Jiayi Liu, Jun Tang, Jianguo Xia, Yongkang Liu, Weixiao Zhang, Zhipeng Liang, Guangyu Tang, Lin Zhang
European Spine Journal.2024; 33(8): 3242. CrossRef
6. Comparative effectiveness of four techniques for identifying vertebral fragility fractures among elderly patients
Hui-Ya Ma, Ren-Jie Zhang, Lu-Ping Zhou, Yan-Xin Wang, Jia-Qi Wang, Cai-Liang Shen, Xiu-Jun Zhang
European Radiology.2024; 35(6): 3673. CrossRef

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Bone Mineral Density in Patients with Pediatric Inflammatory Bowel Disease Using Dual Energy X-Ray Absorptiometry: Hasan M. Isa, Amira A. Ezzaldin, Mohamed M. Alabbasi, Noora H. ALaazmi, Abdulrahman S. Masood, Hissa M. Alabbasi; J Bone Metab 2023;30(1):59-68.
Published online February 28, 2023; DOI: https://doi.org/10.11005/jbm.2023.30.1.59

Background
Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated condition that affects the gastrointestinal system and alters bone growth and bone mineral density (BMD). Here we aimed to study the prevalence and predictors of a low BMD in pediatric patients with IBD.
Methods
This retrospective cross-sectional analytical study included pediatric patients with IBD in whom BMD was evaluated using dual energy X-ray absorptiometry of the total body and lumbar spine. Osteoporosis was defined as a BMD Z-score ≤-2, osteopenia as -2 to -1, and normal as >-1. Clinical and laboratory findings were compared between patients with and without osteoporosis.
Results
Of the 48 patients, 30 (62.5%) were males, 35 (72.9%) had Crohn’s disease, and 13 (27.1%) had ulcerative colitis. The mean age at diagnosis was 9.9±2.8 years. The median age at the time of the BMD scans was 11.9 (interquartile range, 9.9–14.3) years. Total body BMD scans identified 13 (27.1%) and 16 (33.3%) patients with osteoporosis and osteopenia, respectively. Spinal BMD scans revealed that 17 (39.5%) and 14 (32.6%) patients had osteoporosis and osteopenia, respectively. A low body mass index (BMI) Z-score (p=0.038), ileocolonic disease location (p=0.008), and a low calcium level (p=0.008) were significant predictors of osteoporosis on the total body BMD scans. A low BMI Z-score (p=0.039), decreased hemoglobin level (p=0.018), low calcium level (p=0.033), and infliximab use (p=0.019) were significant predictors of osteoporosis on the spinal BMD scans.
Conclusions
This study showed a high prevalence of low BMD among pediatric patients with IBD. A low BMI, ileocolonic disease location, low hemoglobin and calcium levels, and infliximab use were significantly associated with osteoporosis.

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1. Decreased Bone Mineralization in Children with Inflammatory Bowel Diseases
M. I. Erokhina, N. D. Odinaeva, E. I. Kondratуeva, A. I. Khavkin, E. A. Yablokova, E. K. Zhekaite
Russian Journal of Gastroenterology, Hepatology, Coloproctology.2026; 35(6): 72. CrossRef
2. Factors associated with low bone mineral density at diagnosis in pediatric Crohn’s disease: a large retrospective cohort study
Hansol Kim, Yoon Zi Kim, Seon Young Kim, Yon Ho Choe, Mi Jin Kim
BMC Gastroenterology.2026;[Epub] CrossRef
3. Mendelian randomization analysis to identify potential drug targets for osteoarthritis
Chengyang Lu, Yanan Xu, Shuai Chen, Li Guo, Pengcui Li, Xiaochun Wei, Xueqin Rong, Stephan N. Witt
PLOS ONE.2025; 20(2): e0316824. CrossRef
4. Bone Health in Paediatric Inflammatory Bowel Disease
Proteek Sen, Suma Uday
Diagnostics.2025; 15(5): 580. CrossRef
5. Bone-Specific Alkaline Phosphatase as a Complementary Diagnostic Marker for the Assessment of Children and Adolescents with Secondary Osteoporosis
Eunha Bae, Soo Yeun Sim, Su Jin Park, Sung Eun Kim, Seulki Kim, Shin-Hee Kim, Won Kyoung Cho, Kyoung Soon Cho, Min Ho Jung, Byung-Kyu Suh, Moon Bae Ahn
Diagnostics.2025; 15(5): 630. CrossRef
6. Pediatric inflammatory bowel disease in patients of Middle Eastern descent seen at a large urban children's hospital
Renee Dass, Gillian Greenberg, Ronald Thomas, Kirsten Cares
Journal of Pediatric Gastroenterology and Nutrition.2025; 81(3): 583. CrossRef
7. Gut, bone, and muscle: the triad of osteosarcopenia in inflammatory bowel disease
Shilpa Sharma
Intestinal Research.2025; 23(3): 254. CrossRef
8. Genetic variants of MTHFR gene in relation to folic acid levels and bone mineral density in Polish patients with inflammatory bowel disease
Alicja E. Ratajczak-Pawłowska, Szymon Hryhorowicz, Aleksandra Szymczak-Tomczak, Ewa Wysocka, Michał Michalak, Marta Kaczmarek-Ryś, Emilia Lis-Tanaś, Lena Bielawska, Andrzej Pławski, Ryszard Słomski, Agnieszka Dobrowolska, Iwona Krela-Kaźmierczak
Journal of Applied Genetics.2024; 65(1): 73. CrossRef
9. Causality between Sex Hormones and Bone Mineral Density in Childhood: Age- and Tanner-Stage-Matched Sex Hormone Level May Be an Early Indicator of Pediatric Bone Fragility
Sung Eun Kim, Seulki Kim, Shin-Hee Kim, Won Kyoung Cho, Kyoung Soon Cho, Min Ho Jung, Moon Bae Ahn
Biomedicines.2024; 12(6): 1173. CrossRef
10. The Prevalence of Iron and Vitamin D Deficiencies in Pediatric Patients With Inflammatory Bowel Disease in Bahrain
Hasan M Isa, Fawzeya A Alahmed, Masooma Mohamed, Afaf Mohamed
Cureus.2023;[Epub] CrossRef

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Daily Walking Accompanied with Intermittent Resistance Exercise Prevents Osteosarcopenia: A Large Cohort Study: Sangyeob Lee, Ji-Seok Kim, Ki-Soo Park, Kyung-Wan Baek, Jun-Il Yoo; J Bone Metab 2022;29(4):255-263.
Published online November 30, 2022; DOI: https://doi.org/10.11005/jbm.2022.29.4.255

Background
This study aimed to analyze the effects of walking and resistance exercises on bone structure, bone mineral density (BMD), and skeletal muscle mass. We used data from the fourth Korean National Health and Nutrition Examination Survey (KNHANES).
Methods
A total of 3,477 participants aged ≥19 years underwent hip structural analysis (HSA), BMD, and skeletal muscle index (SMI). All radiologic evaluations were performed using dual energy X-ray absorptiometry (DXA). The Korean short version of the International Physical Activity Questionnaire was used to measure physical activity status. The physical activity recommendations of the American College of Rheumatology Work Group Panel were used to evaluate the extent of activity.
Results
The BMD and SMI in the group in which walking activity was performed 5 days or more per week for at least 30 min per day were significantly higher than those in the group in which walking activity was not performed. HSA and SMI in the group in which resistance exercise was performed 2 days or more per week for at least 30 min per day were found to be significantly higher than those in the group in which strengthening exercises were not performed.
Conclusions
If resistance exercise and walking are combined, bone loss and muscle loss are prevented maintaining cortical thickness in the elderly. Walking for more than 5 days a week and resistance exercise for more than 2 days a week will help to maintain the skeletal muscle as well as the cortex around the femur neck, thus helping to prevent fragility fractures in older individuals.

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Effect of Lactobacillus Fermentum as a Probiotic Agent on Bone Health in Postmenopausal Women: Hee Soo Han, Jung Geul Kim, Yoon Hyo Choi, Kyoung Min Lee, Tae Hun Kwon, Sae Hun Kim; J Bone Metab 2022;29(4):225-233.
Published online November 30, 2022; DOI: https://doi.org/10.11005/jbm.2022.29.4.225

Background
Probiotics are live microorganisms that confer health benefits on the host. Many animal studies have shown that among the probiotics, lactobacilli exert favorable effects on bone metabolism. Herein, we report the results of a randomized controlled trial performed to investigate the effect of Lactobacillus fermentum (L. fermentum) SRK414 on bone health in postmenopausal women.
Methods
The bone turnover markers (BTMs) and bone mineral density (BMD) in participants in the study group (N=27; mean age, 58.4±3.4 years) and control group (N=26; mean age, 59.5±3.4 years) were compared during a 6-month trial. BTMs were measured at pretrial, 3 months post-trial, and 6 months post-trial, while BMD was measured at pre-trial and 6 months post-trial. Changes in the gut microorganisms were also evaluated.
Results
Femur neck BMD showed a significant increase at 6 months post-trial in the study group (P=0.030) but not in the control group. The control group showed a decrease in osteocalcin (OC) levels (P=0.028), whereas the levels in the study group were maintained during the trial period. The change in L. fermentum concentration was significantly correlated with that in OC levels (r=0.386, P=0.047) in the study group at 3 months post-trial.
Conclusions
Probiotic (L. fermentum SRK414) supplementation was found to maintain OC levels and increase femur neck BMD during a 6-month trial in postmenopausal women. Further studies with a larger number of participants and a longer study period are required to increase the utility of probiotics as an alternative to osteoporosis medication.

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1. Probiotic Supplementation and Bone Health Parameters in Adults: A Systematic Review and Meta-Analysis
Khemayanto Hidayat, Yan Zhu, René Rizzoli, Hong Wei, Bi-Min Shi, Li-Qiang Qin
Osteoporosis International.2026; 37(1): 41. CrossRef
2. Complementary therapies for management of menopausal symptoms: a systematic review to inform the update of the International Menopause Society recommendations on women’s midlife health
Alison Maunder, Amelia K. Mardon, Vibhuti Rao, Sophia Torkel, Najwa-Joelle Metri, Jing Liu, Guoyan Yang, Nora Giese, Evangeline Mantzioris, Nur K. Abdul Jafar, Geovanna E. Rodrigues de Souza, Ieman Al-Kanini, Lorena Romero, Nick Panay, Hugo Pedder, Caroly
Climacteric.2026; 29(2): 165. CrossRef
3. Efficacy and safety of probiotic/synbiotic supplementation for osteoporosis: a meta-analysis of randomized controlled trials
Xinyu Wang, Lei Zhou, Xingming Yu, Qiang Hou, Chenglong Wang, Wei Cui, Yuheng Hu, Xiumei Wang, Zhuangchen Zhu
Frontiers in Medicine.2026;[Epub] CrossRef
4. Anti-osteoporosis properties and regulatory impact on gut microbiota of yak bone meal in ovariectomized osteoporotic mice
Haiyun Zhou, Jia Wei, Ziheng Wang, Lin Bai, Qianyu Wang, Yumei Wei, Xiaoxia Hu, Xiaojing Tian, Fumei Zhang
Food Bioscience.2025; 66: 106267. CrossRef
5. The Impact of Fermented Dairy Products and Probiotics on Bone Health Improvement
Hafiza Hira Bashir, Muhammad Adeel Hasnain, Aoun Abbas, Jae-Hyuk Lee, Gi-Seong Moon
Food Science of Animal Resources.2025; 45(2): 449. CrossRef
6. Potential of Kefir-Derived Peptides, Probiotics, and Exopolysaccharides for Osteoporosis Management
Jen-Chieh Lai, Gary Ro-Lin Chang, Min-Yu Tu, Abdulkadir Cidem, I-Chien Chen, Chuan-Mu Chen
Current Osteoporosis Reports.2025;[Epub] CrossRef
7. Next-generation probiotics and engineered BEVs for precision therapeutics in osteoporosis
Jiecheng Wei, Wenshuo Ding, Kaiyi Song, Yongkang Zhang, Qi Luo, Chan Qi
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8. Investigating the effects of probiotics during the menopause transition: A systematic review & meta-analysis
Robin A.F. Andrews, Arron Lacey, Helen Roach, Rebeccah Tomlinson, Emma J. Kidd, Kate Bache
Clinical Nutrition ESPEN.2025; 69: 241. CrossRef
9. Effects of probiotic supplements on bone mineral density and bone turnover markers in postmenopausal women: A systematic review
Harini J N, Gayathri G, Shriraam Mahadevan, Ilangovan R
Clinical Nutrition ESPEN.2025; 69: 503. CrossRef
10. Effects of dietary supplements on bone turnover markers in women after menopause: a network meta-analysis
Yan Wei, Congjie Lei, Yue Zhong, Hongchun Shen
PeerJ.2025; 13: e19882. CrossRef
11. Probiotic and synbiotic supplements for osteoporosis: a meta-analysis of randomized trials
Zhiyuan Gong, Qi Hu, Zahra Sabagh, Tianyu Liang, Cheng He
Journal of Health, Population and Nutrition.2025;[Epub] CrossRef
12. Exploring the gut microbiome: probiotics, prebiotics, synbiotics, and postbiotics as key players in human health and disease improvement
You-Tae Kim, David A. Mills
Food Science and Biotechnology.2024; 33(9): 2065. CrossRef
13. Effects of daily probiotic supplementation with Lactobacillus acidophilus on calcium status, bone metabolism biomarkers, and bone mineral density in postmenopausal women: a controlled and randomized clinical study
Iskandar Azmy Harahap, Małgorzata Moszak, Magdalena Czlapka-Matyasik, Katarzyna Skrypnik, Paweł Bogdański, Joanna Suliburska
Frontiers in Nutrition.2024;[Epub] CrossRef
14. Lactobacilli and Their Fermented Foods as a Promising Strategy for Enhancing Bone Mineral Density: A Review
Weiwei He, Hanne Christine Bertram, Jun-Yi Yin, Shao-Ping Nie
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Kunchen Teng, Xin Li, Ting Huang, Shuang Zhang, Qiuxi Zhang, Namuna Rousitemu, Ting Lan, Youfeng Wen
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Suk-Gyun Park, Jung-Woo Kim, Ju Han Song, Seung-Hee Kwon, Sin-Hye Oh, Xianyu Piao, Zhao Wang, Je-Hwang Ryu, Nacksung Kim, Ok-Su Kim, Jeong-Tae Koh
Communications Biology.2024;[Epub] CrossRef

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Roles of Follicle-Stimulating Hormone on Bone Metabolism in Late Postmenopausal Women: Chaiho Jeong, Jinyoung Kim, Yejee Lim, Jeonghoon Ha, Mee Kyoung Kim, Hyuk-Sang Kwon, Ki-Ho Song, Moo Il Kang, Ki-Hyun Baek; J Bone Metab 2022;29(3):175-183.
Published online August 31, 2022; DOI: https://doi.org/10.11005/jbm.2022.29.3.175

Background
The effects of elevated follicle-stimulating hormone (FSH) levels on physiological changes in the bone remain unclear. This study aimed to clarify the association between FSH concentrations and bone mineral density (BMD) and bone turnover markers (BTM) in late postmenopausal women.
Methods
A total of 169 Korean women were enrolled. The participants’ ages ranged from 60 to 84 years (mean age, 69.0±5.1) and reported a mean duration of 19.4±6.6 years since menopause (YSM). The participants showed an average body mass index (BMI) of 24.4±2.8 kg/m². Age, YSM, estradiol, testosterone, and BMI were confounders in the Pearson's partial correlation. A test for trends across the quartiles of FSH levels was performed for each variable.
Results
The mean FSH and estradiol concentrations were 61.5 IU/L and 2.9 pg/mL, respectively. Serum FSH concentration was not significantly associated with BMD (lumbar, r=0.09, P=0.30; total hip, r=0.00, P=0.96; and femoral neck, r=0.05, P=0.62). BTM across the FSH quartiles did not show any trend association (bone-specific alkaline phosphate, P=0.31; crosslinked C-terminal telopeptide of type I collagen, P=0.90). Instead, FSH levels were negatively correlated with BMI (r=-0.34, P=0.00). In the multivariate regression model adjusted for age, testosterone, and estradiol, only BMI showed a negative value across the FSH quartiles (β coefficient -0.11, P=0.00).
Conclusions
This study identified that high FSH concentrations were not associated with bone loss or high bone turnover in women in the late postmenopausal period.

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1. The link between osteoporosis and cardiovascular diseases: a review of shared mechanisms, risk factors, and therapeutic approaches
Mohammad Hasan Sharafi, Afshin Nazari, Mostafa Cheraghi, Faraz Souri, Morteza Bakhshesh
Osteoporosis International.2025; 36(7): 1129. CrossRef
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E. S. Krutikov, Z. S. Rumyantseva, N. S. Tribrat, E. Yu. Zyablitskaya, V. B. Demyanova, G. A. Puchkina, N. V. Efremova, A. A. Gorbunov
Сибирский научный медицинский журнал.2024; 44(1): 147. CrossRef

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Bone Marrow Adiposity, Bone Mineral Density and Wnt/β-catenin Pathway Inhibitors Levels in Hemodialysis Patients: Yue-Pei Wang, Nada Khelifi, Cyrille de Halleux, Roth-Visal Ung, France Samson, Claudia Gagnon, Fabrice Mac-Way; J Bone Metab 2022;29(2):113-122.
Published online May 31, 2022; DOI: https://doi.org/10.11005/jbm.2022.29.2.113

Background
Marrow adipose tissue (MAT) is known to accumulate in patients with chronic kidney disease. This pilot study aimed to evaluate bone mineral density (BMD), MAT, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) using computed tomography (CT) scans and to explore correlations between bone parameters, circulating Wnt/β-catenin pathway inhibitor levels, and adipose tissue parameters.
Methods
Single-center cross-sectional pilot study conducted in hemodialysis patients at the Centre Universitaire de Québec, Hôtel-Dieu de Québec hospital, Canada. CT-scan slices were acquired at the levels of the hip, L3 vertebra, and tibia. Volumetric and areal BMD, tibia cortical thickness, VAT and SAT area, and fat marrow index (FMI) were analyzed using the Mindways QCT Pro software. Blood levels of sclerostin, dickkopf-related protein 1 (DKK1), fibroblast growth factor 23, and α-Klotho were assessed. Spearman’s rho test was used to evaluate correlations.
Results
Fifteen hemodialysis patients (median age, 75 [66–82] years; 80% male; dialysis vintage, 39.3 [27.4–71.0] months) were included. While inverse correlations were obtained between L3 FMI and BMD, positive correlations were found between proximal tibial FMI and vertebral and tibial BMD, as well as with tibial (proximal and distal) cortical thickness. VAT had a positive correlation with α-Klotho levels, whereas L3 FMI had a negative correlation with DKK1 levels.
Conclusions
CT-scan allows simultaneous evaluation of bone and marrow adiposity in dialysis patients. Correlations between MAT and BMD vary depending on the bone site evaluated. DKK1 and α-Klotho levels correlate with adipose tissue accumulation in dialysis patients.

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1. Site-specific inverse associations between FGF23 levels and marrow adiposity content at the proximal femur in post-menopausal women
Julien Paccou, Sammy Badr, Nassima Ramdane, Laetitia Michou, Guillaume Courbon, Romuald Mentaverri
Bone.2026; 205: 117813. CrossRef
2. Comparison of Differences in Cell Migration during the Osteogenic and Adipogenic Differentiation of the Bone Marrow-Derived Stem Cells
Anirban Sardar, Shikha Verma, Anuj Raj, Bhaskar Maji, Ritu Trivedi
Journal of Bone Metabolism.2025; 32(2): 69. CrossRef
3. Association of serum sclerostin levels with marrow adiposity in postmenopausal women with glucocorticoid-induced osteoporosis
Wei Li, Wei Wang, Minlan Zhang, Qi Chen, Fengyi Li, Shaojun Li
BMC Endocrine Disorders.2024;[Epub] CrossRef
4. Relationships between Circulating Sclerostin, Bone Marrow Adiposity, Other Adipose Deposits and Lean Mass in Post-Menopausal Women
Marion Courtalin, Nicolas Bertheaume, Sammy Badr, Alexandrine During, Daniela Lombardo, Valérie Deken, Bernard Cortet, Aline Clabaut, Julien Paccou
International Journal of Molecular Sciences.2023; 24(6): 5922. CrossRef
5. Relationship between bone marrow adipose tissue and kidney function in postmenopausal women
Sammy Badr, Anne Cotten, Romuald Mentaverri, Daniela Lombardo, Julien Labreuche, Claire Martin, Lucie Hénaut, Bernard Cortet, Julien Paccou
Bone Reports.2023; 19: 101713. CrossRef

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Moderate-Intensity Exercise Preserves Bone Mineral Density and Improves Femoral Trabecular Bone Microarchitecture in Middle-Aged Mice: Seungyong Lee, Yun-A Shin, Jinkyung Cho, Dong-Ho Park, Changsun Kim; J Bone Metab 2022;29(2):103-111.
Published online May 31, 2022; DOI: https://doi.org/10.11005/jbm.2022.29.2.103

Background
Aging leads to significant bone loss and elevated osteoporosis risk. Exercise slows age-related bone loss; however, the effects of various moderate-intensity exercise training volumes on bone metabolism remain unclear. This study aimed to determine the degree to which different volumes of moderate-intensity aerobic exercise training influence bone mineral density (BMD), bone mineral content (BMC), femoral trabecular bone microarchitecture, and cortical bone in middle-aged mice.
Methods
Twenty middle-aged male C57BL/6 mice were randomly assigned 8 weeks of either (1) non-exercise (CON); (2) moderate-intensity with high-volume exercise (EX_MHV); or (3) moderate-intensity with low-volume exercise (EX_MLV) (N=6-7, respectively). Femoral BMD and BMC were evaluated using dual energy X-ray absorptiometry, and trabecular and cortical bone were measured using micro-computed tomography.
Results
Femoral BMD in EX_MHV but not EX_MLV was significantly higher (P<0.05) than in CON. The distal femoral fractional trabecular bone volume/tissue volume (BV/TV, %) was significantly higher (P<0.05) in both EX_MHV and EX_MLV than in CON mice. Increased BV/TV was induced by significantly increased trabecular thickness (mm) and tended to be higher (P<0.10) in BV (mm³) and lower in trabecular separation (mm) in EX_MHV and EX_MLV than in CON. The femoral mid-diaphysis cortical bone was stronger in EX_MLV than EX_MHV.
Conclusions
Long-term moderate-intensity aerobic exercise with low to high volumes can be thought to have a positive effect on hindlimb BMD and attenuate age-associated trabecular bone loss in the femur. Moderate-intensity aerobic exercise may be an effective and applicable exercise regimen to prevent age-related loss of BMD and BV.

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1. Diverse exercise modalities in alleviating osteoporosis: A narrative review
Wanlin Zou, Renhui Liu
Endocrine.2026;[Epub] CrossRef
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Junpei Hatakeyama, Shota Inoue, Changxin Li, Daisuke Takamura, Hanlin Jiang, Hiroshi Kuroki, Hideki Moriyama
Journal of Bone and Mineral Metabolism.2024; 42(2): 185. CrossRef
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Chengyu Zhu, Haili Ding, Liang Shi, Shihua Zhang, Xiaoyang Tong, Mei Huang, Lifei Liu, Xiaotian Guan, Jun Zou, Yu Yuan, Xi Chen
Frontiers in Endocrinology.2023;[Epub] CrossRef
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Frontiers in Endocrinology.2022;[Epub] CrossRef

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Prevalence and Risk Factors of T-Score Spine-Hip Discordance in Patients with Osteoporotic Vertebral Compression Fracture: Byung-Ho Yoon, Ho Won Kang, Su Min Kim, Young Do Koh; J Bone Metab 2022;29(1):43-49.
Published online February 28, 2022; DOI: https://doi.org/10.11005/jbm.2022.29.1.43

Background
T-score discordance between the spine and hip is commonly observed when dual energy X-ray absorptiometry (DXA) is used to diagnose osteoporosis. However, information is scarce regarding the prevalence and risk factors for this problem in Korea. This study evaluated the prevalence of major/minor discordance and associated risk factors in elderly Korean patients with osteoporotic vertebral compression fractures (OVCFs).
Methods
This study included 200 patients (37 men, 163 women) treated for thoracic or lumbar compression fractures between January 2015 and August 2021. DXA was performed to examine T‐scores and determine the prevalence of discordance, defined as a difference between the T-score categories of the femur and spine in the same individual. The t-tests, χ² tests, and regression analyses were used to assess the associated risk factors of T-score discordance among the subjects.
Results
T-score concordance, minor discordance, and major discordance were observed in 137 (68.5%), 59 (29.5%), and 4 (2%) patients with OVCFs, respectively. The spinal T-score was lower than the femoral T-score in all major discordance and 81.3% (48/59) of minor discordant cases. Overall, the only factor related to T-score discordance was the age at fracture (odds ratio, -0.01; P=0.014).
Conclusions
The results of this study showed that a significant number of subjects (31.5%) showed spine-hip discordance, even with a mean age in their 80s. More attention should be paid to the appropriate evaluation and management of elderly patients with OVCFs. Moreover, a longitudinal study is necessary to verify the clinical importance of T-score discordance in this population.

Citations

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1. Factors Associated with Discordance between Hip and Spine Bone Mineral Density
Weon Kim, Min Kyu Choi
Korean Journal of Family Practice.2025; 15(3): 167. CrossRef
2. From Detection to Decision: T-Score-Guided Use of STIR MRI After CT in Vertebral Fractures
Lior Yehuda Fitoussi, Árpád Viola, Siran Aslan, Réka Viola, Viktor Foglar, Mohammad Walid Al-Smadi
Diagnostics.2025; 15(18): 2370. CrossRef
3. Older Adults With Alzheimer's Disease Have Lower Bone Mineral Density Compared to Older Adults Without Dementia: A Systematic Review With Meta-analysis of Observational Studies
Natália Oiring de Castro Cezar, Stéfany Gomes da Silva, Jéssica Bianca Aily, Marcos Paulo Braz de Oliveira, Marcos Amaral de Noronha, Stela Márcia Mattiello
Journal of Geriatric Physical Therapy.2024; 47(3): 162. CrossRef
4. Medical optimization of osteoporosis for adult spinal deformity surgery: a state-of-the-art evidence-based review of current pharmacotherapy
Andrew S. Zhang, Surya Khatri, Mariah Balmaceno-Criss, Daniel Alsoof, Alan H. Daniels
Spine Deformity.2023; 11(3): 579. CrossRef
5. Different Pattern of T-Score Discordance between Patients with Atypical Femoral Fracture and Femur Neck Fracture
Byung-Ho Yoon, Jang-Won Park, Chan Woo Lee, Young Do Koh
Journal of Bone Metabolism.2023; 30(1): 87. CrossRef
6. The risk of osteoporotic fracture in gastric cancer survivors: total gastrectomy versus subtotal gastrectomy versus endoscopic treatment
HyunJin Oh, Byung-Ho Yoon, Jung-Wee Park, Ye Jhin Jeon, Bit-Na Yoo, Jean Kyung Bak, Yong-Chan Ha, Young-Kyun Lee
Gastric Cancer.2023; 26(5): 814. CrossRef
7. Fatty infiltration of the multifidus muscle independently increases osteoporotic vertebral compression fracture risk
Dong Gyu Lee, Jae Hwa Bae
BMC Musculoskeletal Disorders.2023;[Epub] CrossRef
8. T-score discordance between hip and lumbar spine: risk factors and clinical implications
Ming-Hsiu Chiang, Yeu-Chai Jang, Yu-Pin Chen, Wing P. Chan, Ying-Chin Lin, Shu-Wei Huang, Yi-Jie Kuo
Therapeutic Advances in Musculoskeletal Disease.2023;[Epub] CrossRef
9. Vertebra Segmentation Based Vertebral Compression Fracture Determination from Reconstructed Spine X-Ray Images
Srinivasa Rao Gadu, Chandra Sekhar Potala
International Journal of Electrical and Electronics Research.2023; 11(4): 1225. CrossRef

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Effect of Romosozumab on Trabecular Bone Score Compared to Anti-Resorptive Agents in Postmenopausal Women with Osteoporosis: Chaiho Jeong, Jinyoung Kim, Yejee Lim, Jeonghoon Ha, Moo Il Kang, Ki-Hyun Baek; J Bone Metab 2021;28(4):317-323.
Published online November 30, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.4.317

Background
Romosozumab has shown significant improvement in bone mineral density (BMD) in previously reported trials. However, BMD reflects only bone strength and does not offer insight into the bone microarchitecture. The trabecular bone score (TBS) is a non-invasive tool used to assess bone microarchitecture. Several previous studies have evaluated the efficacy of anti-osteoporotic agents using the TBS. However, data regarding the potency of romosozumab based on the TBS is lacking. This retrospective observational cohort study demonstrated the impact of romosozumab use on the TBS.
Methods
The primary outcome was the percentage change in the TBS from baseline to post-treatment. Postmenopausal osteoporosis patients were followed up for 6 and 12 months after romosozumab (210 mg monthly, N =10) and denosumab (60 mg every 6 months, N=21) or ibandronate (150 mg monthly, N=24) treatments, respectively. Patients who had previously used osteoporosis medications were included, if any the washout period was sufficient.
Results
The percentage change in TBS from baseline to post-treatment was 2.53±2.98% (6 months, N=10; P=0.04), 0.59%±3.26% (12 months, N=21; P=0.48), and -0.45±3.66% (12 months, N=24; P=0.51) in the romosozumab, denosumab, and ibandronate groups, respectively. Romosozumab demonstrated a noticeable increase in TBS, although it did not reach the least significant change (5.8%) in TBS.
Conclusions
Romosozumab improved the TBS in postmenopausal women with osteoporosis. TBS may be potentially useful for monitoring romosozumab treatment.

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1. Romosozumab improves microarchitecture as assessed by tissue thickness–adjusted trabecular bone score in postmenopausal women with osteoporosis
Michael R McClung, Donald Betah, Benjamin Z Leder, David L Kendler, Mary Oates, Jen Timoshanko, Zhenxun Wang
Journal of Bone and Mineral Research.2025; 40(2): 193. CrossRef
2. Effect of romosozumab on bone mineral density and trabecular bone score in premenopausal women with low bone mass
Seunghyun Lee, Namki Hong, Sung Joon Cho, Sungjae Shin, Yumie Rhee
Osteoporosis International.2025; 36(2): 323. CrossRef
3. Romosozumab Improves Tissue Thickness–Adjusted Trabecular Bone Score in Women With Osteoporosis and Diabetes
Serge Ferrari, Donald Betah, Robert G Feldman, Bente L Langdahl, Mary Oates, Jen Timoshanko, Zhenxun Wang, Ruban Dhaliwal
The Journal of Clinical Endocrinology & Metabolism.2025; 110(10): 2861. CrossRef
4. Trabecular Bone Score: From Over a Decade of Evidence to a Connected Bone Health Ecosystem
Karen Hind, Madeleine Davies, Elena Gonzalez-Rodriguez, Didier Hans
Osteologie.2025; 34(03): 213. CrossRef
5. Efficacy comparison of 6-month romosozumab plus denosumab versus 12-month romosozumab in Koreans
Seung-Eun Lee, Seong Hee Ahn, Beom-Jun Kim, Seung Hun Lee, Ha Young Kim, Seongbin Hong, Jung-Min Koh
European Journal of Endocrinology.2025; 193(5): 527. CrossRef
6. Prognostic value of trabecular bone score for major osteoporotic fractures in patients with radiographic axial spondyloarthritis: a 3-year prospective cohort study
Paweł Żuchowski, Marta Dura, Daniel Jeka, Katarzyna Gajewicz-Sawicka, Michał Kułakowski, Burkhard Muche
Rheumatology International.2025;[Epub] CrossRef
7. Clinical Use of Trabecular Bone Score: The 2023 ISCD Official Positions
Heenam Goel, Neil Binkley, Miranda Boggild, Wing P. Chan, William D. Leslie, Eugene McCloskey, Sarah L. Morgan, Barbara C. Silva, Angela M. Cheung
Journal of Clinical Densitometry.2024; 27(1): 101452. CrossRef
8. Update on the utility of trabecular bone score (TBS) in clinical practice for the management of osteoporosis: a systematic review by the Egyptian Academy of Bone and Muscle Health
Yasser El Miedany, Walaa Elwakil, Mohammed Hassan Abu-Zaid, Safaa Mahran
Egyptian Rheumatology and Rehabilitation.2024;[Epub] CrossRef
9. Romosozumab versus denosumab in long‐term users of glucocorticoids: A pilot randomized controlled trial
Chi Chiu Mok, Kar Li Chan, Sau Mei Tse, Sammy Pak Lam Chen, Kathryn Choon Beng Tan, Wai Han Ma
Journal of Internal Medicine.2024; 296(6): 481. CrossRef
10. Trabecular Bone Score to Enhance Fracture Risk Prediction and Treatment Strategies in Osteoporosis
Guillaume Gatineau, Didier Hans, Karen Hind
Seminars in Musculoskeletal Radiology.2024; 28(05): 539. CrossRef
11. Il ruolo del Trabecular Bone Score (TBS) nella gestione dell’osteoporosi primaria e secondaria
Fabio Bioletto, Massimo Procopio, Marco Barale
L'Endocrinologo.2024; 25(6): 634. CrossRef
12. Incident Vertebral Fractures During Romosozumab Treatment in a Patient With a Pathogenic LRP5 Variant
Evert F S van Velsen, Mark Wijnen, Galied S R Muradin, M Carola Zillikens
JCEM Case Reports.2024;[Epub] CrossRef
13. Long-term effect of denosumab on bone microarchitecture as assessed by tissue thickness–adjusted trabecular bone score in postmenopausal women with osteoporosis: results from FREEDOM and its open-label extension
Didier Hans, Michele McDermott, Shuang Huang, Min Kim, Enisa Shevroja, Michael McClung
Osteoporosis International.2023; 34(6): 1075. CrossRef
14. Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Disease
Enisa Shevroja, Jean-Yves Reginster, Olivier Lamy, Nasser Al-Daghri, Manju Chandran, Anne-Laurence Demoux-Baiada, Lynn Kohlmeier, Marie-Paule Lecart, Daniel Messina, Bruno Muzzi Camargos, Juraj Payer, Sansin Tuzun, Nicola Veronese, Cyrus Cooper, Eugene V.
Osteoporosis International.2023; 34(9): 1501. CrossRef
15. Meta-analysis of the effects of denosumab and romosozumab on bone mineral density and turnover markers in patients with osteoporosis
Mingwei Hu, Yifan Zhang, Jianjun Guo, Cuicui Guo, Xue Yang, Xue Ma, Hao Xu, Shuai Xiang
Frontiers in Endocrinology.2023;[Epub] CrossRef
16. Romosozumab is associated with greater trabecular bone score improvement compared to denosumab in postmenopausal osteoporosis
Namki Hong, Sungjae Shin, Seunghyun Lee, Yumie Rhee
Osteoporosis International.2023; 34(12): 2059. CrossRef
17. Clinical Studies On Romosozumab: An Alternative For Individuals With A High Risk Of Osteoporotic Fractures: A Current Concepts Review (Part II)
E. Carlos Rodriguez-Merchan, Alonso Moreno-Garcia, Hortensia De la Corte-Rodriguez
SurgiColl.2023;[Epub] CrossRef
18. The efficacy of denosumab in Korean male patients with osteoporosis
Chaiho Jeong, Jeonghoon Ha, Jinyoung Kim, Yejee Lim, Mee Kyoung Kim, Hyuk-Sang Kwon, Ki-Ho Song, Moo Il Kang, Ki-Hyun Baek
The Korean Journal of Internal Medicine.2022; 37(5): 1011. CrossRef
19. Update on trabecular bone score
Telma Palomo, Patricia Muszkat, Fernanda G. Weiler, Patricia Dreyer, Cynthia M. A. Brandão, Barbara C. Silva
Archives of Endocrinology and Metabolism.2022; 66(5): 694. CrossRef

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Effects of the Lysine Methyltransferase Inhibitor AZ505 on Bone Metabolism: Min-Kyoung Song, Suhan Jung, Seojin Hong, Jun-Oh Kwon, Min Kyung Kim, Hong-Hee Kim; J Bone Metab 2021;28(4):297-305.
Published online November 30, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.4.297

Background
Protein methylation has important role in regulating diverse cellular responses, including differentiation, by affecting protein activity, stability, and interactions. AZ505 is an inhibitor of the SET and MYND domain-containing protein 2 lysine methylase. In this study, we investigated the effect of AZ505 on osteoblast and osteoclast differentiation in vitro and evaluated the effect of AZ505 in vivo on the long bones in mice.
Methods
Osteoblast differentiation was assessed by alkaline phosphatase (ALP) and Alizarin red staining after culturing calvarial preosteoblasts in an osteogenic medium. Osteoclast differentiation was analyzed by tartrate-resistant acid phosphatase (TRAP) staining in bone marrow-derived macrophages cultured with macrophage-colony stimulating factor and receptor activator of nuclear factor-κB ligand (RANKL). For in vivo experiments, mice were intraperitoneally injected with AZ505 and femurs were examined by micro-computed tomography.
Results
AZ505 increased ALP and Alizarin red staining in cultured osteoblasts and the expression of osteoblast marker genes, including Runx2 and osteocalcin. AZ505 resulted in decreased TRAP-staining of osteoclasts and expression of c-Fos and nuclear factor of activated T cells transcription factors and osteoclast marker genes, including cathepsin K and dendritic cell-specific transmembrane protein. Unexpectedly, in vivo administration of AZ505 markedly decreased the trabecular bone mass of femurs. In support of this catabolic result, AZ505 strongly upregulated RANKL expression in osteoblasts.
Conclusions
The results indicate that AZ505 has a catabolic effect on bone metabolism in vivo despite its anabolic effect in bone cell cultures. The findings indicate that cell culture data should be extrapolated cautiously to in vivo outcomes for studying bone metabolism.

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1. Balanced spatiotemporal arrangements of histone H3 and H4 posttranslational modifications are necessary for meiotic prophase I chromosome organization
S. Lava Kumar, Aradhana Mohanty, Anjali Kumari, Ajith Kumar Etikuppam, Ranjith Kumar S., Mohd Athar, Kiran Kumar P., Rohit Beniwal, Moukthika M. Potula, Ravi Kumar Gandham, H. B. D. Prasada Rao
Journal of Cellular Physiology.2024;[Epub] CrossRef
2. Targeting Epigenetic Changes Mediated by Members of the SMYD Family of Lysine Methyltransferases
Alyssa Padilla, John F. Manganaro, Lydia Huesgen, Deborah A. Roess, Mark A. Brown, Debbie C. Crans
Molecules.2023; 28(4): 2000. CrossRef

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Review Article

Medication Related Osteonecrosis of the Jaw: 2021 Position Statement of the Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons: Jin-Woo Kim, Mi Kyung Kwak, Jeong Joon Han, Sung-Tak Lee, Ha Young Kim, Se Hwa Kim, Junho Jung, Jeong Keun Lee, Young-Kyun Lee, Yong-Dae Kwon, Deog-Yoon Kim; J Bone Metab 2021;28(4):279-296.
Published online November 30, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.4.279

Antiresorptives are the most widely prescribed drugs for the treatment of osteoporosis. They are also used in malignant bone metastases, multiple myeloma, and Paget's disease, and provide therapeutic efficacy on those diseases. However, it was reported that the occurrence of osteonecrosis of the jaw (ONJ) could be related to antiresorptive exposures, and there have been many cases regarding this issue. Therefore, a clearer definition and treatment guidelines were needed for this disease. The American Society for Bone and Mineral Research and the Amnerican Association of Oral and Maxillofacial Surgeons reported statements on bisphosphonate-related ONJ (BRONJ), and a revised version was recently presented. In the revised edition, the diagnosis BRONJ was changed to medication-related ONJ (MRONJ), which reflects consideration of the fact that ONJ also occurs for denosumab, a bone resorption inhibitor of the receptor activator of the nuclear factor-κB ligand antibody family, and bevacizumab, an anti-angiogenesis inhibitor. The Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons had collectively formed a task force for the preparation of an official statement on MRONJ based on a previous position paper in 2015. The task force reviewed current knowledge and coordinated dental and medical opinions to propose the guideline customized for the local Korean situation.

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Journal of Bone and Mineral Metabolism.2026;[Epub] CrossRef
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Osayd Alawawda, Gelengül Urvasızoğlu, Funda Bayındır
New Trends in Medicine Sciences.2025; 6(1): 26. CrossRef
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Ling-Ying Wei, Ching-Ming Chiu, Sang-Heng Kok, Hao-Hong Chang, Shih-Jung Cheng, Hung-Ying Lin, Wei-Yih Chiu, Jang-Jaer Lee
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10. Utility of quantitative standardized uptake value from pre-operative bone SPECT/CT for predicting post-surgical MRONJ healing response
Jung-Hyun Park, Da-Mi Yoon, Hai-Jeon Yoon, Jin-Woo Kim
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30. DEPENDENCE OF LEVELS OF BONE METABOLISM MARKERS ON THE STAGE OF MEDICATION-RELATED OSTEONECROSIS OF THE JAWS
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32. Non-Interventional Prospective Observational Study of Platelet Rich Fibrin as a Therapy Adjunctive in Patients with Medication-Related Osteonecrosis of the Jaw
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Sakiko Soutome, Mitsunobu Otsuru, Maho Murata, Kota Morishita, Keisuke Omori, Koki Suyama, Saki Hayashida, Masahiro Umeda, Toshiyuki Saito
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E. M. Spevak, D. Yu. Christophorando, V. A. Shutov, A. V. Ermakova
Creative surgery and oncology.2022; 12(2): 151. CrossRef
38. Ineffectiveness of Antiresorptive Agent Drug Holidays in Osteoporosis Patients for Treatment of Medication-Related Osteonecrosis of the Jaw: Consideration from Immunohistological Observation of Osteoclast Suppression and Treatment Outcomes
Keisuke Omori, Mitsunobu Otsuru, Kota Morishita, Saki Hayashida, Koki Suyama, Tomofumi Naruse, Sakiko Soutome, Masahiro Umeda
International Journal of Environmental Research and Public Health.2022; 19(17): 10898. CrossRef

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Original Articles

Trabecular Bone Score Could Not Predict the Bone Mineral Density of Proximal Humerus: Hyeon Jang Jeong, Joong Mo Ahn, Joo Han Oh; J Bone Metab 2021;28(3):239-247.
Published online August 31, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.3.239

Background
Osteoporosis is an important clinical factor for tendon healing after arthroscopic rotator cuff repair (ARCR). Conventional dual energy X-ray absorptiometry (DXA) of the hip and lumbar spine (LS) does not represent proximal humeral bone mineral density (BMD). Theoretically, direct measurement of the BMD of the proximal humerus is the best method; however, it is not popular and is non-standardized. Therefore, we evaluate whether the trabecular bone score (TBS) using LS DXA would represent proximal humeral BMD.
Methods
Conventional hip and LS DXA and proximal humeral BMD were measured in 212 consecutive ARCR patients, and TBS was calculated using LS DXA. Comparative analysis between the affected and contralateral asymptomatic shoulders was done; moreover, correlation analysis was conducted to evaluate the representativity of TBS for proximal humeral BMD. Regression analysis was performed to elucidate the risk factor of intraoperative suture anchor failure (ISAF).
Results
BMDs of the affected shoulder were significantly lower than those of the contralateral side (all P<0.05). TBS failed to present a strong correlation with proximal humeral BMD (correlation coefficients 0.155-0.506, all P<0.05), and the BMD of the greater tuberosity (GT) of the proximal humerus was revealed to be a sole risk factor for ISAF (odds ratio, 0.01, P=0.020).
Conclusions
TBS and conventional hip and LS DXA did not represent proximal humeral BMD. Furthermore, among the various radiological measurements, the BMD of the GT was a sole risk factor of ISAF. Therefore, further research for the direct measurement of proximal humeral BMD is mandatory to predict proximal humeral focal osteoporosis.

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1. Preliminary evaluation of the clinical efficacy of salmon calcitonin nasal spray in patients with rotator cuff tears after arthroscopic repair: a multi-center retrospective cohort study
Fei Lyu, Dai Shi, Kapil Sugand, Xingguang Tao, Jianhong Wu, Zheng Xu, Huixiang Wang
International Journal of Surgery.2026;[Epub] CrossRef
2. Deltoid tuberosity index for proximal humerus fracture: reliability and a predictor of systemic osteoporosis in an Asian population
Wei Xiang Ng, Sanchalika Acharyya, Shirong Huang, Ernest Beng Kee Kwek, Bryan Yijia Tan
Journal of Shoulder and Elbow Surgery.2025; 34(3): e133. CrossRef
3. Age- and sex-related changes in proximal humeral volumetric BMD assessed via chest CT with a deep learning–based segmentation model
Shihuai Li, Chong Tang, Hongda Zhang, Chi Ma, Yuanzhi Weng, Bo Chen, Shenghao Xu, Hao Xu, Fausto Giunchiglia, Weijia William Lu, Deming Guo, Yanguo Qin
Osteoporosis International.2025; 36(11): 2185. CrossRef
4. Management of Rotator Cuff Tears in Severely Osteoporotic Patients
Devin A. Maez, Bryan A. Marquez, Christopher L. Shultz, Sheila N. Acheson, Dustin L. Richter
JBJS Journal of Orthopaedics for Physician Assistants.2024; 12(4): e24.00022. CrossRef
5. Arthroscopic transosseous anchorless rotator cuff repair reduces bone defects related to peri-implant cyst formation: a comparison with conventional suture anchors using propensity score matching
Hyeon Jang Jeong, Ji Soo Lee, Young Kyu Kim, Sung-Min Rhee, Joo Han Oh
Clinics in Shoulder and Elbow.2023; 26(3): 276. CrossRef

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Association between Bone Mineral Density and Fracture Characteristics in the 5th Metatarsal Bone Base Fracture in Elderly for Prediction of Osteoporotic Fracture: Dong-Il Chun, Tae-Hong Min, Jae-Ho Cho, Sung-Hun Won, Jeong-In Shon, Young Yi; J Bone Metab 2021;28(3):231-237.
Published online August 31, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.3.231

Background
This study aimed to analyze the correlation between bone mineral density (BMD) and the type of 5th metatarsal fracture, as well as to demonstrate whether there is a difference in radiological findings (heel alignment angle [HAA], heel moment arm [HMA], and metatarsus angle) between fracture types.
Methods
A total of 87 patients were enrolled in the study and allocated into 3 groups: the Zone 1 group (N=36), the Zone 2 group (N=33), and the Zone 3 group (N=18). The participants’ demographic data, T-scores, existing fracture or osteoporosis medications, and radiologic parameters including HAA, HMA, and metatarsus adductus angle were analyzed and compared.
Results
There was a significant difference between the mean age of the participants, with the highest age in the Zone 1 group and the lowest in the Zone 3 group. Regarding the history of concurrent fracture or osteoporosis medications, there was no significant difference between the 3 groups. Similarly, no significant difference was observed between the 3 groups about the BMD values. In contrast, the HAA was statistically significant in all groups with a positive correlation of -8.9 in the Zone 1 group, a negative correlation of 3.55 in the Zone 2 group, and an inverse relationship of 6.1 in the Zone 3 group. The metatarsus adductus angle was significantly higher in the Zone 3 group than the Zone 1 and Zone 2 groups.
Conclusions
The location of a 5th metatarsal bone fracture is not significantly associated with BMD. However, mechanical influences, such as hindfoot varus or forefoot adductus, have a significant correlation with fracture types.

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Lara Krüger, Ali Hedar, Tanja Spethmann, Benjamin Ondruschka, Frank Timo Beil, Felix von Brackel, Alexander Simon, Tim Rolvien
Bone & Joint Research.2026; 15(1): 16. CrossRef
2. Risk factors for first metatarsal fracture in minimally invasive hallux valgus surgery
Gabriel Ferraz Ferreira, Daniel Sonnewend Proença, Guilherme Ferrari Araujo, Renato Savariego Porto, Davy Sevilla, Gustavo Araujo Nunes, Mauro Cesar Mattos e Dinato, Thomas Lorchan Lewis, Robbie Ray, Miguel Viana Pereira Filho
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Manasa L. Kadiyala, Matthew T. Kingery, Raymond Walls, Abhishek Ganta, Sanjit R. Konda, Kenneth A. Egol
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Cross-Calibration of Bone Mineral Densities and Body Composition between GE Lunar Prodigy and Osteosys Primus: Yong-Chan Ha, Jun-Il Yoo; J Bone Metab 2021;28(3):215-221.
Published online August 31, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.3.215

Background
The aim of this study was to investigate the correlation between bone mineral density (BMD) and body composition measured by the Osteosys Primus^® and the GE Lunar Prodigy^® and to calculate the conversion rate between the 2 devices.
Methods
The 40 subjects were men and women in aged 20 to 29 years old. All participants were scanned twice on both the Osteosys Primus (OsteoSys) and the GE Lunar Prodigy (GE Healthcare) DXA systems using the manufacturers’ standard scanning and positioning protocols.
Results
Compared to the GE Lunar device, the mean Osteosys fat mass was overestimated to be 12.1% (1,776.9 g) in the whole body, 5.1% (163.9 g) in gynoid, and 6.7% (87.2 g) in android. Compared with the GE Lunar device, the mean BMDs of the Osteosys Primus were underestimated to be 2.3% (0.023 g/cm²) in the whole body and 3.1% (0.035 g/cm²) in L1-4. Compared with the GE Lunar device, the mean lean mass derived by the Osteosys Primus were underestimated to 2.3% (1,045.3 g) in the total body, 3.8% (179.4 g) in arms, and 7.7% (1,104.8 g) in legs, respectively. There were a strong correlation of BMD and body composition between both groups.
Conclusions
Linear correction equations were developed to ensure comparability of BMD and muscle mass between the Osteosys Primus and the GE Lunar Prodigy. Importantly, use of equations from previous studies would have increased the discrepancy between the Osteosys Primus and the GE Lunar Prodigy.

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Sujin Kim, Guen Young Lee, Jun-Il Yoo, Sang-Wook Lee, Yong-Chan Ha
Journal of Bone Metabolism.2026; 33(1): 84. CrossRef
2. Inter‐scanner variability in bone mineral density and T‐score measurements: A comparison of Stratos, Lunar, and Osteosys DXA systems
Yakup Erden, Mustafa H. Temel, Fatih Bağcıer
Clinical Physiology and Functional Imaging.2026;[Epub] CrossRef
3. Cross-Calibration of Areal Bone Mineral Densities and Body Composition between DMS Stratos and Hologic Horizon A Dual-Energy X-ray Absorptiometers: The Effect of Body Mass Index
Laurent Maïmoun, Sandrine Alonso, Krishna Kunal Mahadea, Julien Dubois, Tom Paunet, Florentin Kucharczak, Lisa Maïmoun Nande, Vincent Boudousq, Thibault Mura, Denis Mariano-Goulart
Journal of Clinical Densitometry.2025; 28(1): 101553. CrossRef
4. Opportunistic screening of low bone mass using knowledge distillation-based deep learning in chest X-rays with external validations
Junhyeok Park, Nha-Young Kim, Hyun-Jin Bae, Jinhoon Jeong, Miso Jang, Sung Jin Bae, Jung-Min Koh, Seung Hun Lee, Joo Hee Yoon, Chang Hoon Lee, Namkug Kim
Archives of Osteoporosis.2025;[Epub] CrossRef
5. Comparison of muscle and fat parameters measured by ultrasonography and dual‐energy x‐ray absorptiometry between older palliative care patients with and without type 2 diabetes mellitus
Nezahat Muge Catikkas, Vildan Binay Safer, Suleyman Bas, Deniz Sevindik Gunay, Ayfer Durak, Irem Kirac Utku, Umut Safer
Journal of Clinical Ultrasound.2024; 52(5): 608. CrossRef
6. Standardization of body composition parameters between GE Lunar iDXA and Hologic Horizon A and their clinical impact
Colin Vendrami, Guillaume Gatineau, Elena Gonzalez Rodriguez, Olivier Lamy, Didier Hans, Enisa Shevroja
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Yong-Chan Ha, Shinjune Kim, Jun-Il Yoo
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Sung-Woo Kim, Hun-Young Park, Won-Sang Jung, Kiwon Lim
International Journal of Environmental Research and Public Health.2022; 19(21): 14554. CrossRef

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Specific Bioactive Collagen Peptides in Osteopenia and Osteoporosis: Long-Term Observation in Postmenopausal Women: Denise Zdzieblik, Steffen Oesser, Daniel König; J Bone Metab 2021;28(3):207-213.
Published online August 31, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.3.207

Background
The effects of specific collagen peptides on bone mineral density (BMD) in subjects with osteoporosis or osteopenia have already been investigated in 131 postmenopausal women in a randomized controlled trial. The purpose of this follow-up observation was to determine the longer-term effects of the same specific bioactive collagen peptides after a total intervention time of 4 years.
Methods
In this open-label follow-up observation, 31 postmenopausal women with reduced BMD (initial T-score lower than−1 of either the femoral neck or the lumbar spine) completed the follow-up. BMD was measured via dual energy X-ray absorptiometry. Absolute changes in BMD and T-scores in the spine and femoral neck were assessed. The number of fractures was also recorded. All participants received specific bioactive collagen peptides.
Results
Supplementation with bioactive collagen peptides during follow-up led to a clinically relevant increase in BMD in the spine. These findings were consistent with the results for the femoral neck.
Conclusions
Long-term supplementation with specific bioactive collagen peptides appears to be effective in counteracting losses in BMD. Moreover, significant increases in BMD could contribute to improved bone stability.

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2. Re-engineering bone: pathogenesis, diagnosis and emerging therapies for osteoporosis
Xinyi Dong, Hao Liu, Dian Yuan, Karan Gulati, Yan Liu
Journal of Materials Chemistry B.2025; 13(17): 4938. CrossRef
3. Efficacy of collagen peptide supplementation on bone and muscle health: a meta-analysis
Chongxiao Sun, Ao Yang, Fei Teng, Yayi Xia
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Yonghui Yu, Xinping Li, Mengjun Zheng, Linyue Zhou, Jingjie Zhang, Jing Wang, Baoguo Sun
Critical Reviews in Food Science and Nutrition.2024; 64(18): 6380. CrossRef
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Yaoyao Li, Xinhui Huang, Weihao Fu, Zonghao Zhang, Kuancheng Xiao, Hongbing Lv
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6. Anti-osteoporosis effects and underpinning mechanisms of food-derived bioactive peptides: A review
Yan Zhang, Zhaojun Zheng, Yuanfa Liu
Trends in Food Science & Technology.2024; 147: 104431. CrossRef
7. Decellularized human amniotic membrane scaffolds: influence on the biological behavior of dental pulp stem cells
Zonghao Zhang, Bingling Lu, Luning Zou, Xinhui Huang, Fan Yang, Hongbing Lv
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Mats I. Nilsson, Donald Xhuti, Nicoletta Maria de Maat, Bart P. Hettinga, Mark A. Tarnopolsky
Nutrients.2024; 16(24): 4407. CrossRef
9. A Comprehensive Review on the Role of Collagen in Health and Disease
Nipun Saravanan Pillai, Sara Anees Khan, Nupur Mehrotra, Kaustubh Jadhav
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10. The Role of Macronutrients, Micronutrients and Flavonoid Polyphenols in the Prevention and Treatment of Osteoporosis
Monika Martiniakova, Martina Babikova, Vladimira Mondockova, Jana Blahova, Veronika Kovacova, Radoslav Omelka
Nutrients.2022; 14(3): 523. CrossRef
11. A peptide from wheat germ abolishes the senile osteoporosis by regulating OPG/RANKL/RANK/TRAF6 signaling pathway
Fang Wang, Gaohong Yang, Yu Li, Zhijuan Tang, Jiayi Du, Haizhao Song, Ling Xiong, Luanfeng Wang, Zebin Weng, Xinchun Shen
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Bone Loss and Radiographic Damage Profile in Rheumatoid Arthritis Moroccan Patients: Hamida Azzouzi, Linda Ichchou; J Bone Metab 2021;28(2):151-159.
Published online May 31, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.2.151

Background
Rheumatoid arthritis (RA) is a known cause of joint destruction and systemic bone loss. In this study, we aimed to evaluate the bone damage and bone loss profiles of established RA patients.
Methods
We designed a cross-sectional study on a cohort of established RA patients. The bone evaluation was performed by obtaining standard X-ray images of hands and feet combined with bone mineral density (BMD) measurements. Radiographic joint damage was calculated by the modified total Sharp /van der Heijde score (mTSS). BMD was obtained by performing dual energy X-ray absorptiometry of the lumbar spine and femoral neck. Data on age, smoking, alcoholism, steroid prescription, body mass index (BMI), disease duration, disease activity, and functional disability were collected.
Results
A total of 93 RA patients were recruited. Their mean age was 51.59±12.38 years, with a mean disease duration of 12.07±9.19 years. A total of 36.6% of patients had osteoporosis, and the mean mTSS was 70.33±48.93. Both hip (P=0.0005) and lumbar BMD (P=0.0005) were correlated with mTSS. Backward regression analyses determined that bone damage was associated with high titers of rheumatoid factor, low lumbar BMD, and low BMI. General bone loss was associated with gender, steroid dose, steroid duration, menopause, and BMI.
Conclusions
Bone damage was associated with low BMI and axial bone loss in our RA population.

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1. Damage in rheumatic diseases: Contemporary international standpoint and scores emerging from clinical, radiological and machine learning
Samar Tharwat, Iman I. El-Gazzar, Rawhya El Shereef, Faten Ismail, Fatma Ali, Hanan Taha, Ahmed Elsaman, Amany El-Bahnasawy, Yousra Hisham, Marwa Amer, Amany El Najjar, Hanan M. Fathi, Nahla Eesa, Reem H. Mohammed, Noha M. Khalil, Nouran M. Shahaat, Nevin
The Egyptian Rheumatologist.2024; 46(1): 12. CrossRef

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Comparison of Bone Mineral Density and Markers of Bone Turnover in Osteoporotic Women after 6-Month Treatment with Alendronate or Bazedoxifene: A Randomized Controlled Trial: Hee Soo Han, Sung Hee Cho, Moon Seok Park, Ki Hyuk Sung, Kyoung Min Lee; J Bone Metab 2021;28(2):131-137.
Published online May 31, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.2.131

Background
In a randomized controlled trial, we compared the bone mineral densities (BMDs) and blood markers of bone turnover during short-term treatment of osteoporotic women with bisphosphonate alendronate or bazedoxifene, a selective estrogen receptor modulator.
Methods
Ten and eleven patients were randomized to the alendronate and bazedoxifene groups, respectively. BMDs were measured before and after 6 months of treatment. Blood tests were used to measure the levels of osteocalcin (OC), C-terminal telopeptide of type I collagen (CTX), vitamin D3, and parathyroid hormone pretreatment and after 3 and 6 months of treatment. The variables were compared statistically.
Results
The alendronate group showed decreases in blood levels of both OC and CTX during the study period (P<0.001 and P=0.002, respectively), while the bazedoxifene group had a decrease only in OC levels (P=0.012). After 6 months of treatment, BMDs significantly increased in the alendronate group at multiple bone sites, including the L1–4 lumbar vertebrae, femur trochanter, and total femur. However, there was no significant increase in BMD in the bazedoxifene group. BMDs were not significantly different between the 2 groups.
Conclusions
Patients treated with alendronate showed more rapid suppression of markers of bone turnover and higher BMD than those treated with bazedoxifene during a short-term regime. Considering the effects and complications of each medication, the relationship between bone turnover rate and bone quality will need to be investigated in future studies.

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Andrew Miller, Sujee Jeyapalina, Jayant P. Agarwal, James Peter Beck
Journal of Biomedical Materials Research Part B: Applied Biomaterials.2024;[Epub] CrossRef
2. Position Statement: Vitamin D Intake to Prevent Osteoporosis and Fracture in Adults
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The Characteristics of Women with Subsequent Distal Radius Fracture after Initial Distal Radius Fracture: Jongjin Lee, Jae Kwang Kim, Minyoung Oh, Young Ho Shin; J Bone Metab 2021;28(2):123-129.
Published online May 31, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.2.123

Background
The purpose of this study was to investigate the characteristics of women with subsequent distal radius fracture (DRF) and to compare bone fragility variables in women with initial and subsequent DRF.
Methods
We enrolled 227 women who experienced DRF (203 women with initial DRF and 24 women with subsequent DRF) between September 2016 and April 2019. We compared demographic characteristics and bone fragility variables, including bone mineral density, trabecular bone score, hip geometry, bicortical thickness of the distal radius, and fracture risk assessment tool (FRAX) scores between the 2 groups. To reduce bias, patients with subsequent DRF were propensity score-matched in a 1:2 manner with patients affected by initial DRF, and additional comparisons were performed.
Results
Patients in the subsequent DRF group were older than those in the initial DRF group, but this difference was not significant (P=0.091). The proportion of patients receiving treatment with osteoporosis medication was significantly higher in the subsequent DRF group (41.7% vs. 19.2%, P=0.011). Bone fragility variables did not differ significantly between the 2 groups. However, the ten-year probability of major osteoporotic fractures based on FRAX scores was significantly higher in patients with subsequent DRF (7.5% vs. 10.8%, P<0.001). Similar results were observed when comparing the propensity score-matched initial and subsequent DRF groups.
Conclusions
These findings suggest that the occurrence of subsequent DRF after initial DRF can be attributed to multiple factors rather than bone fragility alone. Systematic and multidisciplinary management would be helpful in preventing the occurrence of subsequent DRF after the initial DRF.

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Does Bone Mineral Density Differ between Fan-Beam and Pencil-Beam?: A Meta-Analysis and Systemic Review: Byung-Ho Yoon, Young Do Koh, Jun-Il Yoo, Sujin Kim, Guen Young Lee, Sung Bin Park, Yong-Chan Ha; J Bone Metab 2021;28(1):67-77.
Published online February 28, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.1.67

Background
Dual energy X-ray absorptiometry (DXA) has evolved from pencil-beam (PB) to narrow fan-beam (FB) densitometers. We performed a meta-analysis of the available observational studies to determine how different modes of DXA affect bone mineral density (BMD) measurements.
Methods
A total of 1,233 patients (808 women) from 14 cohort studies were included. We evaluated the differences in BMD according to the DXA mode: PB and FB. Additionally, we evaluated the differences in BMD between the 2 types of FB mode: FB (Prodigy) and the most recent FB (iDXA). Pairwise meta-analysis was performed, and weighted mean differences (WMD) were calculated for (total lumbar, total hip, and total body).
Results
No significant difference was observed in total lumbar (pooled WMD, -0.013; P=0.152) and total hip BMD (pooled WMD, -0.01; P=0.889), between PB and FB. However, total body BMD was significantly lower in the PB compared to the FB group (pooled WMD, -0.014; P=0.024). No significant difference was observed in lumbar BMD (pooled WMD, -0.006; P=0.567), total hip (pooled WMD, -0.002; P=0.821), and total body (pooled WMD, 0.015; P=0.109), between Prodigy and iDXA.
Conclusions
The results of this study warrant the recommendation that correction equations should not be used when comparing BMD from different modes. Further research is still needed to highlight the ways in which differences between DXA systems can be minimized.

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1. Cross-Calibration Study of The Stratos And Hologic QDR 4500A Dual-Energy X-Ray Absorptiometers to Assess Bone Mineral Density And Body Composition
Laurent Maïmoun, Sandrine Alonso, Krishna Kunal Mahadea, Vincent Boudousq, Thibault Mura, Denis Mariano-Goulart
Journal of Clinical Densitometry.2023; 26(4): 101434. CrossRef

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Effect of Cross-Sex Hormones on Body Composition, Bone Mineral Density, and Muscle Strength in Trans Women: Yeoul Yun, Dongyoung Kim, Eun Sil Lee; J Bone Metab 2021;28(1):59-66.
Published online February 28, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.1.59

Background
Cross-sex hormone therapy (CHT) changes the physical characteristics of transgender women to match their gender identity and expression. This study aimed to determine the effects of feminizing cross-sex hormones on body composition, bone mineral density (BMD) and muscle strength in transgender women.
Methods
A prospective observational study assessed 11 participants who underwent feminizing CHT. Dual energy X-ray absorptiometry (DXA), and handgrip strength were measured before CHT and after 6-months of CHT. Fat mass, lean body mass (LBM), and BMD were measured by DXA and handgrip strength was measured by hand-dynamometer.
Results
Regional body fat in the trunk, legs, and gynoid region increased by 18%, 27.4%, and 27.2%, respectively after 6 months of CHT. Total body fat increased by 16.2%, while the fat mass ratio decreased by 7.2%. Although body fat increased, the android/gynoid fat ratio decreased; BMD in the lumbar spine significantly increased by 3.9% (P=0.0051), but changes in the femoral neck (P=0.1969) and total femur (P=0.4769) were not significant. Changes in LBM ranged from -3% (trunk) to -8% (arm region). Right-hand grip strength also significantly decreased by 7.7% (P=0.0467).
Conclusions
After 6 months of CHT, transgender women showed a general increase in fat mass and a decreased in overall LBM and handgrip strength. Increase in fat mass percentage were more remarkable in gynoid region, leading to a more “female” body fat distribution.

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Mathilde Kamp Nørlund, Louise Lehmann Christensen, Marianne Skovsager Andersen, Tine Taulbjerg Kristensen, Jan Frystyk, Jonas Mathiesen, Jakob Lindberg Nielsen, Dorte Glintborg
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Zoledronic Acid after Treatment with Denosumab is Associated with Bone Loss within 1 Year: Tarun Kadaru, Amal Shibli-Rahhal; J Bone Metab 2021;28(1):51-58.
Published online February 28, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.1.51

Background
Bone mineral density (BMD) declines when zoledronic acid (ZA) is administered. This case series describes the patterns of change in BMD when 1 or 2 doses of ZA are administered after denosumab.
Methods
Twelve patients who received at least 2 doses of denosumab followed by at least 1 dose of ZA and who had a dual energy X-ray absorptiometry (DXA) scan at the end of denosumab and 1 year after the first dose of ZA were included. We excluded patients with bone cancer or conditions affecting bone metabolism, including hyperparathyroidism, rickets, osteogenesis imperfecta, rheumatologic disorders, fibrous dysplasia, Paget’s disease of bone, untreated hyperthyroidism, chronic kidney disease, liver cirrhosis, malabsorption, ongoing corticosteroid therapy, and aromatase inhibitor use.
Results
There was a significant decline in BMD at the femoral neck within 1 year of the first ZA dose and a non-significant downward trend in the hip and lumbar spine. This trend was more severe in patients with osteoporosis at the time of drug transition. No increase in clinical vertebral fractures was observed. BMD seemed to stabilize in a smaller number of patients who received a second dose of ZA and had a DXA scan 1 year later.
Conclusions
A single dose of ZA administered approximately 6 months after denosumab leads to some BMD loss, mostly within 1 year of ZA administration, particularly in patients with osteoporosis at the time of denosumab discontinuation.

Citations

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1. Denosumab discontinuation in the clinic: implications of rebound bone turnover and emerging strategies to prevent bone loss and fractures
Shejil Kumar, Mawson Wang, Albert S Kim, Jacqueline R Center, Michelle M McDonald, Christian M Girgis
Journal of Bone and Mineral Research.2025; 40(9): 1017. CrossRef
2. Effectiveness of Sequential Treatment with Zoledronic Acid Following Discontinuation of Denosumab in Osteoporosis: A Narrative Review
Hong Ouyang, Fan Yang, Wenzuo Wei, Wei Wang
Drug Design, Development and Therapy.2025; Volume 19: 10013. CrossRef
3. Asia-Pacific consensus on long-term and sequential therapy for osteoporosis
Ta-Wei Tai, Hsuan-Yu Chen, Chien-An Shih, Chun-Feng Huang, Eugene McCloskey, Joon-Kiong Lee, Swan Sim Yeap, Ching-Lung Cheung, Natthinee Charatcharoenwitthaya, Unnop Jaisamrarn, Vilai Kuptniratsaikul, Rong-Sen Yang, Sung-Yen Lin, Akira Taguchi, Satoshi Mo
Osteoporosis and Sarcopenia.2024; 10(1): 3. CrossRef
4. Zoledronic acid relieves steroid-induced avascular necrosis of femoral head via inhibiting FOXD3 mediated ANXA2 transcriptional activation
Yu Lin, Min Chen, Wenbin Guo, Shengliang Qiu, Lihui Chen, Wenge Liu
Bone.2024; 188: 117222. CrossRef
5. A summary of the Russian clinical guidelines on the diagnosis and treatment of osteoporosis
Zhanna Belaya, Liudmila Rozhinskaya, Ivan Dedov, Oksana Drapkina, Valentin Fadeev, Olga Golounina, Olga Lesnyak, Elizaveta Mamedova, Galina Melnichenko, Alexey Petraikin, Svetlana Rodionova, Irina Skripnikova, Olga Tkacheva, Natalia Toroptsova, Svetlana Y
Osteoporosis International.2023; 34(3): 429. CrossRef
6. Therapeutic Treatments for Osteoporosis—Which Combination of Pills Is the Best among the Bad?
Christian Horst Tonk, Sarah Hani Shoushrah, Patrick Babczyk, Basma El Khaldi-Hansen, Margit Schulze, Monika Herten, Edda Tobiasch
International Journal of Molecular Sciences.2022; 23(3): 1393. CrossRef
7. Raloxifene Use After Denosumab Discontinuation Partially Attenuates Bone Loss in the Lumbar Spine in Postmenopausal Osteoporosis
Namki Hong, Sungjae Shin, Seunghyun Lee, Kyoung Jin Kim, Yumie Rhee
Calcified Tissue International.2022; 111(1): 47. CrossRef
8. Insufficient Mitigation of Bone Loss by Zoledronic Acid after Treatment with Denosumab
Jung-Wee Park
Journal of Bone Metabolism.2021; 28(4): 339. CrossRef

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Does Hip Bone Density Differ between Paretic and Non-Paretic Sides in Hemiplegic Stroke Patients? and Its Relationship with Physical Impairment: Hoo Young Lee, Jung Hyun Park, Hyanglim Lee, Tae-Woo Kim, Seung Don Yoo; J Bone Metab 2020;27(4):237-246.
Published online November 30, 2020; DOI: https://doi.org/10.11005/jbm.2020.27.4.237

Background
Bone loss after stroke escalates the risk of fractures, mainly in the hip, leading to further disability in individuals with stroke. We aimed to investigate the skeletal effect of bone mineral density (BMD) based on the duration of onset of stroke, compare the BMD of the paretic and non-paretic sides, and elucidate the relationship between BMD and disability variables.
Methods
The 31 male hemiplegic stroke patients between 20 and 70 years of age with cerebral infarction or hemorrhage were considered in this study. Subacute and chronic cases included 13 and 18 patients with lag time from the onset of 1 to 6 months and beyond 6 months, respectively. BMD in the lumbar, paretic, and non-paretic hip as well as the disability variables were analyzed retrospectively.
Results
The subacute group showed a significant reduction in the femoral neck BMD on the paretic side compared to that on the non-paretic side based on T-scores (P=0.013). Bone loss was significantly correlated with lower limb muscle strength and overall physical impairment (P<0.05). The chronic group demonstrated significant reduction in femur neck and total femur BMD on the paretic side compared to that on the non-paretic side based on T-scores (P=0.002 and P<0.001, respectively). T-scores of BMD in the chronic phase were not significantly associated with the clinical parameters.
Conclusions
Early screening of bilateral hip BMD in the early stages after stroke, monitoring, and timely implementation of prevention strategies are important to minimize subsequent bone loss and prevent possible complications in patients who experience stroke.

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1. The relationship between falls and hip bone mineral density of paretic and nonparetic limbs after stroke
Tugba Atan, Umay Ekinci, Ayca Uran San, Yasin Demir, Umut Guzelkucuk, Serdar Kesikburun, Sinem Uyar Koylu, Arif Kenan Tan
PM&R.2025; 17(5): 529. CrossRef
2. Association between bone mineral density and stroke: a meta-analysis
Peng Zhao, Huaxia Sun
Frontiers in Neurology.2025;[Epub] CrossRef
3. Bone biomarkers in post-polio clinic patients
Seyed Pezhman Madani, Richard Kremer, Ami Grunbaum, Shaddam Bagmar, Andrea Benedetti, Daria A. Trojan
Frontiers in Endocrinology.2025;[Epub] CrossRef
4. Discordance Between Spine-Hip and Paretic-Nonparetic Hip Bone Mineral Density in Hemiplegic Stroke Patients: A Multicenter Retrospective Study
Seung Don Yoo, Tae-Woo Kim, Byung-Mo Oh, Seung Ah Lee, Chanwoo Kim, Ho Yeon Chung, Jung Eun Son, Ji Yeon Lee, Hyunji Lee, Hoo Young Lee
Annals of Rehabilitation Medicine.2024; 48(6): 413. CrossRef
5. Trunk Impairment Scale for Predicting Lumbar Spine Bone Mineral Density in Young Male Patients With Subacute Stroke
Yeon Hee Cho, Hyun Seok, Sang-Hyun Kim, Seung Yeol Lee, Hyun Jung Kim
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6. Dual-mobility cup total hip arthroplasty improves the quality of life compared to internal fixation in femoral neck fractures patients with severe neuromuscular disease in the lower extremity after stroke: a retrospective study
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7. Nutritional Supplements and Neuroprotective Diets and Their Potential Clinical Significance in Post-Stroke Rehabilitation
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Nutrients.2021; 13(8): 2704. CrossRef

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The Effect of Denosumab on Bone Mass in Super Elderly Patients: Chaiho Jeong, Jeonghoon Ha; J Bone Metab 2020;27(2):119-124.
Published online May 31, 2020; DOI: https://doi.org/10.11005/jbm.2020.27.2.119

Background

Denosumab is a potent antiresorptive drug leading to significant reduction in the risk of vertebral and non-vertebral fractures in postmenopausal osteoporosis. The effect of denosumab in super-elderly patients lacks data to date and few literature has proven the efficacy to this specific group. The purpose of this study was to determine the effectiveness and safety of denosumab in the super-elderly.

Methods

We retrospectively evaluated 60 patients older than 80 with osteoporosis treated with denosumab. Patients were treated with denosumab every 6 months for 12 months 2017 to 2020. The primary endpoint was defined by the changes in bone mineral density (BMD) of 3 measurement sites: the lumbar spine, femoral neck, and total hip. Changes in bone turnover markers, serum calcium, serum phosphate, and 25-hydroxy-vitamin D were also observed.

Results

All 60 patients were female, and the mean age was 83.9±3.1, from age 80 to 94. After 12 months of denosumab treatment, significant increases in BMD were observed; 3.02±2.74% for the lumbar spine (P=0.000), 3.10±6.90% for the femoral neck (P=0.005), and 2.89±5.80% for the total hip (P=0.002) The bone turnover marker C-terminal telopeptide of type I collagen and osteocalcin significantly declined after 12 months of treatment (−34.8±45.9%; P=0.002 and −35.5±38.9%; P=0.004 respectively). Symptomatic hypocalcemia and serious adverse drug reactions that required drug discontinuation were not observed during treatment.

Conclusions

Denosumab is thought to be an anti-osteoporotic medication that is sufficiently effective and safe even for the super-elderly.

Citations

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1. Antiresorptive Therapy for Osteoporosis in Older Subjects
Anne Sophie Sølling, Natasha Amran Laursen, Torben Harsløf, Bente Lomholt Langdahl
Gerontology.2025; 71(4): 297. CrossRef
2. Incidence of Total Knee Arthroplasty in Older Females with Knee Osteoarthritis and Osteoporosis Treated with Denosumab Compared with Those Treated Using Bisphosphonates: A Population-Based Cohort Study
Tzai-Chiu Yu, Wen-Tien Wu, Ru-Ping Lee, Ing-Ho Chen, Jen-Hung Wang, Shu-Hui Wen, Kuang-Ting Yeh
Life.2024; 14(12): 1704. CrossRef
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Sung-Hyun Yoon, Karam Kim, Ki-Choul Kim
Journal of Bone Metabolism.2023; 30(3): 275. CrossRef
4. Efficacy of Antiresorptive Treatment in Osteoporotic Older Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Bernardo Abel Cedeno-Veloz, J. Erviti Lopez, M. Gutiérrez-Valencia, L. Leache Alegría, L.C. Saiz, A.M. Rodríguez García, M. Sánchez Latorre, R. Ramírez Vélez, M. Izquierdo, N. Martínez-Velilla
The Journal of nutrition, health and aging.2022; 26(8): 778. CrossRef

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Review Article

Position Statement: Exercise Guidelines to Increase Peak Bone Mass in Adolescents: Seok-Ki Min, Taewoong Oh, Sang Hyun Kim, Jinkyung Cho, Ho Yeon Chung, Dong-Ho Park, Chang-Sun Kim; J Bone Metab 2019;26(4):225-239.
Published online November 30, 2019; DOI: https://doi.org/10.11005/jbm.2019.26.4.225

Background

An increase in bone mineral density during adolescence increases resistance to fractures in older age. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology developed exercise guidelines to increase the peak bone mass (PBM) in adolescents based on evidence through a systematic review of previous research.

Methods

Articles were selected using the systematic method, and the exercise guidelines were established by selecting key questions (KQs) and defining the effects of exercises based on evidence through a literature review for selecting the final exercise method. There were 9 KQs. An online search was conducted on articles published since 2000, and 93 articles were identified.

Results

An increase in PBM in adolescence was effective for preventing osteoporosis and fractures in older age. Exercise programs as part of vigorous physical activity (VPA) including resistance and impact exercise at least 5 to 6 months were effective for improving PBM in adolescents. It is recommended that resistance exercise is performed 10 to 12 rep·set⁻¹ 1-2 set·region⁻¹ and 3 days·week⁻¹ using the large muscles. For impact exercises such as jumping, it is recommended that the exercise is performed at least 50 jumps·min⁻¹, 10 min·day⁻¹ and 2 days·week⁻¹.

Conclusions

Exercise guidelines were successfully developed, and they recommend at least 5 to 6 months of VPA, which includes both resistance and impact exercises. With the development of exercise guidelines, the incidence of osteoporosis and fractures in the aging society can be reduced in the future, thus contributing to improved public health.

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Astrid Kamilla Stunes, Cathrine Langlie Brobakken, Md Abu Jafar Sujan, Norun Aagård, Martin Siksjø Brevig, Eivind Wang, Unni Syversen, Mats Peder Mosti
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Andréa Bezerra, Laura Freitas, Leonardo Maciel, Hélder Fonseca
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Original Articles

Associations between Dietary Fiber Intake and Bone Mineral Density in Adult Korean Population: Analysis of National Health and Nutrition Examination Survey in 2011: Taehoon Lee, Heuy Sun Suh; J Bone Metab 2019;26(3):151-160.
Published online August 31, 2019; DOI: https://doi.org/10.11005/jbm.2019.26.3.151

Background

The correlations between the amount of daily fiber intake and bone mineral densities (BMDs) in Korean adult population were investigated in our study.

Methods

Utilizing the Korean National Health and Nutrition Examination Survey in 2011, multivariable linear regression was performed to explore the association between fiber consumption and BMD of lumbar vertebrae 1 to 4 (L1–4 total), L1, L2, L3, and L4 vertebrae, femur neck, femur total, and trochanter. All models were adjusted for age, body mass index, vitamin D level, smoking, physical activity, alcohol use, contraceptive use, hormonal replacement therapy, consumption of carbohydrate, protein, fat, calcium, phosphate, iron, thiamine, riboflavin, niacin, and vitamin C.

Results

In males aged between 18 and 45, fiber intake significantly increased BMDs of L1 (coefficient β=0.004, P=0.040) and L2 (β=0.004, P=0.038) while daily protein consumption significantly lowered BMDs of femur neck (β=−0.001, P=0.009), femur total (β=−0.001, P=0.008), and trochanter (β=−0.001, P=0.008). In males aged 65 and older, nutrient intake shows no significant correlations with BMDs except fat consumption was inversely associated with BMD of trochanter (β=−0.001, P=0.017). In females aged between 18 and 45, fiber intake shows no significant relationship with BMDs while daily fat consumption significantly increased BMDs of L1 (β=0.001, P=0.028), L2 (β=0.001, P=0.024), L3 (β=0.001, P=0.033), and L1–4 total (β=0.001, P=0.017).

Conclusions

Fiber intake was a protective factor of lumbar spine (L1 and L2) BMD in male aged between 18 and 45 but not in female participants of any age groups.

Citations

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1. Association between dietary fiber intake and total bone mineral density in adolescents: A cross-sectional analysis of the NHANES 2011–2018
Penghui Lv, Jincheng Bai, Lu Li, Chenglong Zhang, Shuaiwei Wei, Jianjun Chang
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Yuqi Pang, Zilan Chen, Ye Ju, Bin Yang, Jiaojiao Hou, Sirui Zheng, Zihao Li, Ting Liu, Hongxia Xia, Maoyao Xia, Yangdan Zhong, Jiayuan Li, Zhong Li, Xia Jiang
European Journal of Nutrition.2026;[Epub] CrossRef
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Malak Faraj, Giulia Leanza, Johannes Krug, Francesca Cannata, Viola Viola, Biagio Zampogna, Fabrizio Russo, Giuseppe Banfi, Giovanni Lombardi, Gianluca Vadalà, Laura Mangiavini, Rocco Papalia, Vincenzo Denaro, Björn Busse, Nicola Napoli
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Yu-Ao Tao, Ling Long, Jia-Xiang Gu, Pei-Yang Wang, Xi Li, Xiao-Long Li, Pan Fan, Yuntao Wang
European Spine Journal.2024; 33(9): 3343. CrossRef
6. Impact of Vitamin D Status and Nutrition on the Occurrence of Long Bone Fractures Due to Falls in Elderly Subjects in the Vojvodina Region of Serbia
Nemanja Gvozdenović, Ivana Šarac, Andrijana Ćorić, Saša Karan, Stanislava Nikolić, Isidora Ždrale, Jelena Milešević
Nutrients.2024; 16(16): 2702. CrossRef
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International Journal of Gynecology & Obstetrics.2022; 158(3): 663. CrossRef
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Yuchen Tang, Jinmin Liu, Xiaohui Zhang, Bin Geng
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Revista de Nutrição.2022;[Epub] CrossRef
16. Dietary Fiber, Genetic Variations of Gut Microbiota-derived Short-chain Fatty Acids, and Bone Health in UK Biobank
Tao Zhou, Mengying Wang, Hao Ma, Xiang Li, Yoriko Heianza, Lu Qi
The Journal of Clinical Endocrinology & Metabolism.2021; 106(1): 201. CrossRef
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Zahra Shahriarpour, Bita Nasrabadi, Sudiyeh Hejri-Zarifi, Seyedeh-Elaheh Shariati-Bafghi, Mahboobe Yousefian-Sanny, Mohsen Karamati, Bahram Rashidkhani
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R. Li, C. G. Boer, L. Oei, Carolina Medina-Gomez
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Kevin D. Seely, Cody A. Kotelko, Hannah Douglas, Brandon Bealer, Amanda E. Brooks
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Is There a Difference in Serum Vitamin D Levels and Bone Mineral Density According to Body Mass Index in Young Adult Women?: Hee-Sook Lim, Dong Won Byun, Kyo Il Suh, Hyeong Kyu Park, Hye Jeong Kim, Tae-Hee Kim, Hae-Hyeog Lee; J Bone Metab 2019;26(3):145-150.
Published online August 31, 2019; DOI: https://doi.org/10.11005/jbm.2019.26.3.145

Background

In the life cycle, bone mineral density (BMD) is the most optimal condition in the 20s. In Korea, vitamin D deficiency status is very serious in Korean women due to recent lack of activity, weight polarization, and inadequate nutritional intake. The purpose of this study was to compare serum vitamin D and BMD according to obesity status in Korean young adult women.

Methods

A total of 143 female college students participated in the research. Body fat and lean body status were analyzed using a body composition analyzer. Nutrient intakes of the subjects were assessed by 3-days food record method. The BMDs was measured by dual energy X-ray absorptiometry. The subjects were divided into normal weight group and obesity group on their body mass index.

Results

Obesity group showed significantly higher weight, body fat (%), and body fat (kg) than normal weight group and T-scores of lumbar-2 spines were significantly lower. Obesity group showed high triglyceride and low-density lipoprotein cholesterol levels and vitamin D levels were significantly lower. Physical fitness and activity status showed that sit and reach and sit up were significantly lower in obesity group. The intake of carbohydrates was higher in the obesity group than in the normal weight group, and the intake of vitamin C and vitamin D was significantly lower. Factors affecting serum vitamin D were analyzed as body fat (%), lumbar-2 T-score, triglyceride, and carbohydrate intake.

Conclusions

Obese women need more effort to manage their serum vitamin D status and balanced nutrition to prevent bone loss.

Citations

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Vivi F.H. Jensen, Anne-Marie Mølck, Majken Dalgaard, Fiona E. McGuigan, Kristina E. Akesson
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4. Bone Marrow Fat Measured by a Chemical Shift‐Encoded Sequence (IDEAL‐IQ) in Patients With and Without Metabolic Syndrome
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Jing Hou, Chen He, Wenzhen He, Mi Yang, Xianghang Luo, Changjun Li
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Review Article

Anorexia Nervosa and Osteoporosis: Pathophysiology and Treatment: Jeremy Steinman, Amal Shibli-Rahhal; J Bone Metab 2019;26(3):133-143.
Published online August 31, 2019; DOI: https://doi.org/10.11005/jbm.2019.26.3.133

Anorexia nervosa (AN) affects 2.9 million people, many of whom experience bone loss and increased fracture risk. In this article, we review data on the underlying pathophysiology of AN-related osteoporosis and possible approaches to disease management. Available research suggests that low body weight and decreased gonadal function are the strongest predictors of bone loss and fractures in patients with AN. Additionally, other metabolic disturbances have been linked to bone loss, including growth hormone resistance, low leptin concentrations, and hypercortisolemia, but those correlations are less consistent and lack evidence of causality. In terms of treatment of AN-related bone disease, weight gain has the most robust impact on bone mineral density (BMD). Restoration of gonadal function seems to augment this effect and may independently improve BMD. Bisphosphonates, insulin-like growth factor 1 supplementation, and teriparatide may also be reasonable considerations, however need long-term efficacy and safety data.

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Original Article

Influence of Thyroid-stimulating Hormone Suppression Therapy on Bone Mineral Density in Patients with Differentiated Thyroid Cancer: A Meta-analysis: Byung-Ho Yoon, Youjin Lee, Hyun Jin Oh, Sung Han Kim, Young-Kyun Lee; J Bone Metab 2019;26(1):51-60.
Published online February 28, 2019; DOI: https://doi.org/10.11005/jbm.2019.26.1.51

Background

The effects of subclinical hyperthyroidism on bone mineral density (BMD) induced by thyroid-stimulating hormone (TSH) suppression therapy in patients with differentiated thyroid cancer (DTC) remains unclear. We conducted a meta-analysis to determine the influence of TSH suppression therapy on BMD.

Methods

We performed a systematic search to identify studies which included BMD measurement of femoral neck, total hip or lumbar spine in patients on TSH suppression therapy for DTC. Main outcome measures were difference of BMD of femoral neck, total hip or lumbar spine measured by dual energy X-ray absorptiometry between patients and controls.

Results

A systematic search yielded a total of 11 published controlled cross-sectional studies (including about 571 patients and 836 controls). TSH suppression therapy was associated with the lower BMD of total hip (weighted mean difference [WMD], −0.023; 95% confidence interval [CI], −0.047 to 0.000; P=0.050) and spine (WMD, −0.041; 95% CI, −0.057 to −0.026; P<0.001) in postmenopausal women with DTC, while it was not associated with that in premenopausal women and men with DTC.

Conclusions

Although the included studies were limited by small numbers, results suggested possible association between chronic TSH suppression therapy and the lower BMD of spine and total hip in postmenopausal women (but not in premenopausal women and men) with DTC. A large, well-designed study with long-term follow-up would provide further insight into the influence of TSH suppression therapy and loss of BMD.

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2. Effects of vitamin D3 and calcium supplementation on bone of young adults after thyroidectomy of differentiated thyroid carcinoma
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