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Bone phenotype in patients with kidney failure with and without type 2 diabetes. 伴有和不伴有2型糖尿病的肾衰竭患者的骨表型。
IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-28 DOI: 10.1093/jbmr/zjag019
Sabina Chaudhary Hauge, Hanne Skou Jørgensen, Kathleen Claes, Anja Verhulst, Etienne Cavalier, Ditte Hansen, Pieter Evenepoel

Type 2 diabetes mellitus (T2DM) is common in patients with chronic kidney disease (CKD). Both conditions associate with an increased fracture risk, with proposed etiology including impaired bone quantity and quality. This cross-sectional study examined the bone phenotype in patients with T2DM and kidney failure and explored the role of glycemic control on the bone phenotype. To do so laboratory parameters of mineral metabolism (including sclerostin) and bone turnover markers (BTM) (bone-specific alkaline phosphatase (BALP), trimeric pro-collagen type I N-terminal propeptide (intact PINP) and tartrate-resistant acid phosphatase isoform 5b (TRACP5b)) were assessed in 647 patients with kidney failure, of which 102 had T2DM (median hemoglobin A1c (HbA1c) of 6.2%), at time of kidney transplantation. Patients with type 1 DM were excluded. Bone mineral density (BMD, n = 555) by densitometry, and bone histomorphometry (n = 188) were available for subsets, and correlations between HbA1c and both BTM and BMD were examined. This study found that intact PINP was lower (68 vs. 82 μg/L, p = .03) while sclerostin was higher (2.1 vs. 1.8 ng/mL, p = .04) in T2DM versus non-T2DM in unadjusted analysis. BMD at the lumbar spine (Z-score - 0.066 vs. -0.760, p < .001) and femoral neck (Z-score - 0.680 vs. -0.965, p = .04) were higher in T2DM, and T2DM was in multivariable regression analysis identified as a significant determinant of lumbar spine BMD, independent of age, sex, and BMI. Bone histomorphometric parameters did not differ between groups. A correlation between HbA1c and BTM and BMD was present, but only in non-T2DM (BALP (ρ = -0.12, p = .007), intact PINP (ρ = 0.14, p = .002), TRACP5b (ρ = -0.13, p = .003), BMD at lumbar spine (ρ = 0.12, p = .008), femoral neck (ρ = 0.11, p = .02), and total hip (ρ = 0.17, p < .001)). In conclusion, patients with kidney failure and T2DM have preserved BMD compared to patients without diabetes. Our findings suggest a role for hyperglycemia as a determinant of the bone phenotype.

2型糖尿病(T2DM)常见于慢性肾脏疾病(CKD)患者。这两种情况都与骨折风险增加有关,提出的病因包括骨数量和质量受损。本横断面研究检测了T2DM合并肾衰竭患者的骨表型,并探讨了血糖控制对骨表型的作用。为此,我们对647例肾衰竭患者进行了矿物质代谢(包括硬化蛋白)和骨转换标志物(BTM)(骨特异性碱性磷酸酶(BALP)、三聚体前胶原I型n端前肽(完整PINP)和抗酒石酸酸性磷酸酶5b (TRACP5b))的实验室参数评估,其中102例为T2DM(中位血红蛋白A1c (HbA1c)为6.2%),在肾移植时。排除1型糖尿病患者。亚组的骨密度测量(BMD, n = 555)和骨组织形态测量(n = 188)可用,并检查HbA1c与BTM和BMD之间的相关性。本研究发现,完整的PINP较低(68 vs. 82 μg/L, p =。2003),而硬化蛋白较高(2.1 vs. 1.8 ng/mL, p =。在未经调整的分析中,2型糖尿病与非2型糖尿病的差异(04)。腰椎骨密度(Z-score - 0.066 vs. -0.760, p
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引用次数: 0
Fracture Probability is Predictive of Fall-Associated Hospitalization: The Manitoba BMD Registry. 骨折概率预测跌倒相关住院:马尼托巴骨密度登记。
IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-28 DOI: 10.1093/jbmr/zjag020
Fatima Zarzour, Eugene V McCloskey, Helena Johansson, Nicholas C Harvey, John A Kanis, William D Leslie

The current version of FRAX® does not consider prior falls as a primary input variable. Limited data suggest that greater FRAX-derived fracture probability is associated with incident falls at least in elderly men. Our aim was to examine the association of FRAX-derived fracture probability with the risk for subsequent fall-associated hospitalizations. We identified individuals aged 40 years or older at the time of baseline DXA with FRAX-derived major osteoporotic fracture (MOF) probability assessed through the Manitoba BMD Program. We used linkage with population-based data to identify subsequent hospitalization that included a fall diagnosis code. Sensitivity analyses examined fall-associated hospitalizations unrelated to a concurrent fracture (diagnosed within 30 days). Cox regression was used to estimate hazard ratios (HR) for time to fall-associated hospitalization according to MOF probability without and with BMD (per SD increase and also for individual variables in the FRAX tool). The study comprised 88,684 individuals, mean age 64.6 years, 89.5% female. During mean 8.6 years observation (total 759,963 person-years), 9715 (11.0%) individuals experienced a fall-associated hospitalization; of these, 3363 (3.8%) were unrelated to concurrent fracture. Every SD increase in MOF fracture probability was strongly associated with fall-associated hospitalization (without BMD HR 2.47, 95%CI 2.41-2.52; with BMD HR 2.48, 95%CI 2.43-2.53). No significant interaction was seen between fracture probability and follow-up time (p=0.516). Findings were similar when restricted to individuals with falls unrelated to concurrent fracture, when adjusted for previous fall-associated hospitalization (last 3 years) or self-reported fall (last 12 months), when restricted to individuals without previous falls, and for FRAX-derived hip fracture probability. All FRAX variables except for parental hip fracture showed a positive relationship with fall-associated hospitalization. In conclusion, FRAX-derived fracture probability is strongly associated with risk for future fall-associated hospitalization, including falls unrelated to concurrent fracture.

当前版本的FRAX®不考虑先前的下跌作为主要的输入变量。有限的数据表明,至少在老年男性中,较高的frax衍生骨折概率与意外跌倒有关。我们的目的是检查frax衍生的骨折概率与随后跌倒相关住院风险的关系。我们通过曼尼托巴骨密度计划评估frax衍生的主要骨质疏松性骨折(MOF)概率,确定了基线DXA时年龄在40岁或以上的个体。我们使用基于人群的数据链接来识别包含跌倒诊断代码的后续住院。敏感性分析检查了与并发骨折无关的跌倒相关住院(30天内诊断)。使用Cox回归根据无骨密度和有骨密度的MOF概率(每SD增加,以及FRAX工具中的单个变量)估计与跌倒相关的住院时间的风险比(HR)。该研究包括88,684人,平均年龄64.6岁,89.5%为女性。在平均8.6年的观察期间(总共759,963人年),9715人(11.0%)经历了与跌倒相关的住院治疗;其中3363例(3.8%)与并发骨折无关。MOF骨折概率每增加一个SD,与跌倒相关住院密切相关(无BMD HR 2.47, 95%CI 2.41-2.52;有BMD HR 2.48, 95%CI 2.43-2.53)。骨折概率与随访时间无显著交互作用(p=0.516)。当局限于与并发骨折无关的跌倒个体,调整既往跌倒相关住院(最近3年)或自我报告跌倒(最近12个月),限制于既往没有跌倒的个体,以及frax衍生的髋部骨折概率时,结果相似。除父母髋部骨折外,所有FRAX变量均与跌倒相关住院呈正相关。总之,frax衍生的骨折概率与未来跌倒相关住院的风险密切相关,包括与并发骨折无关的跌倒。
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引用次数: 0
Response to Letter to the Editor for "Infigratinib low dose therapy is an effective strategy to treat hypochondroplasia". 关于“消炎替尼低剂量治疗是治疗软骨发育不良的有效策略”的致编辑信的回复。
IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-28 DOI: 10.1093/jbmr/zjag018
Laurence Legeai-Mallet, Bhavik Shah
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引用次数: 0
The Effects of Marine Fatty Acid Omega-3 Supplements on Incident Fractures and Bone Mineral Density in Generally Healthy Adults. 海洋脂肪酸-3补充剂对一般健康成人意外骨折和骨密度的影响
IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-28 DOI: 10.1093/jbmr/zjaf172
Meryl S LeBoff, Sharon H Chou, Dana M Ratnarajah, Nancy R Cook, Bharti Khurana, Eunjung Kim, Gregory Kotler, Peggy M Cawthon, Douglas C Bauer, Dennis Black, J Christopher Gallagher, I-Min Lee, Julie E Buring, JoAnn E Manson

Although preclinical studies suggest that omega-3 fatty acids may benefit skeletal health, there are few randomized controlled trials investigating effects of supplemental omega-3 on bone outcomes. This VITamin D and OmegA-3 TriaL (VITAL) ancillary study investigated effects of marine omega-3 (1 g/d; EPA + DHA in a 1.2:1 ratio) vs. placebo supplements on fracture risk and bone density/structure. VITAL is a 2x2 factorial randomized placebo-controlled trial that studied effects of supplemental marine omega-3 fatty acids and/or vitamin D3 vs. placebo on cancer and cardiovascular events. The intervention took place from November 2011 through December 2017; median follow-up was 5.3 yr. The study included 25 871 U.S. men (aged ≥50) and women (aged ≥55) without baseline cancer or cardiovascular disease, not selected for low bone density or fracture history. Primary outcomes were adjudicated incident total, nonvertebral, and hip fractures in the overall cohort. In a subcohort of 771 individuals, we measured 2-yr changes in areal bone mineral density (aBMD) by dual X-ray absorptiometry, and volumetric bone mineral density (vBMD), cortical thickness, and bone strength indices at the radius and tibia by peripheral quantitative computed tomography. Supplemental omega-3 vs. placebo had no effect on total (HR, 1.02; 95% CI, 0.92-1.13; p = .73), nonvertebral (HR, 1.01; 95% CI, 0.91-1.12; p = .80), or hip fractures (HR, 0.89; 95% CI, 0.61-1.30; p = .55). In the subcohort, omega-3 supplementation resulted in a small increase in whole body aBMD (+0.03% vs. -0.41%, p = .006) and no effect on aBMD at the spine or hip, or vBMD or bone strength indices at the radius or tibia. No serious adverse effects were observed. Supplementation with marine omega-3 fatty acids did not reduce incident fracture risk. It led to a small increase in whole body aBMD but had no other effects on BMD or bone strength measures compared to placebo in generally healthy midlife and older adults.

尽管临床前研究表明omega-3脂肪酸可能有益于骨骼健康,但很少有随机对照试验调查补充omega-3脂肪酸对骨骼结果的影响。这项维生素D和OmegA-3试验(VITAL)辅助研究调查了海洋OmegA-3 (1 g/ D; EPA + DHA以1.2:1的比例)与安慰剂补充剂对骨折风险和骨密度/结构的影响。VITAL是一项2x2因子随机安慰剂对照试验,研究了补充海洋omega-3脂肪酸和/或维生素D3与安慰剂对癌症和心血管事件的影响。干预发生在2011年11月至2017年12月;中位随访时间为5.3年。该研究包括25871名美国男性(≥50岁)和女性(≥55岁),无基线癌症或心血管疾病,未选择低骨密度或骨折史。在整个队列中,主要结果是确定了总发生率、非椎体骨折和髋部骨折。在771名个体的亚队列中,我们通过双x线吸收仪测量了2年的面骨矿物质密度(aBMD)变化,并通过外周定量计算机断层扫描测量了桡骨和胫骨的体积骨矿物质密度(vBMD)、皮质厚度和骨强度指标的变化。补充omega-3与安慰剂相比,对总剂量没有影响(HR, 1.02; 95% CI, 0.92-1.13; p =。73), nonvertebral (HR 1.01; 95%可信区间,0.91 - -1.12;p =。80)或髋部骨折(HR, 0.89; 95% CI, 0.61-1.30; p = 0.55)。在亚队列中,补充omega-3导致全身aBMD小幅增加(+0.03% vs -0.41%, p =。006)对脊柱或髋部的aBMD、桡骨或胫骨的vBMD或骨强度指标没有影响。未观察到严重的不良反应。补充海洋omega-3脂肪酸并不能降低骨折风险。在一般健康的中年和老年人中,与安慰剂相比,它导致全身aBMD小幅增加,但对骨密度或骨强度测量没有其他影响。
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引用次数: 0
Infigratinib is a weak inhibitor of the FGFR3-N540K mutant associated with hypochondroplasia. Infigratinib是与软骨发育不良相关的FGFR3-N540K突变体的弱抑制剂。
IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-26 DOI: 10.1093/jbmr/zjag017
Vlad-Constantin Ursachi, Zuzana Feketova, Aleksandra Anna Czyrek, Klara Sestakova, Katerina Svozilova, Gustavo Rico-Llanos, Pavel Krejci
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引用次数: 0
Adding to the cytomegalovirus crime sheet?: editorial on "osteonecrosis of the femoral head is associated with cytomegalovirus reactivation". 巨细胞病毒犯罪记录上又添一笔?:关于“股骨头骨坏死与巨细胞病毒再激活有关”的社论。
IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-26 DOI: 10.1093/jbmr/zjag016
Matthew Reeves
{"title":"Adding to the cytomegalovirus crime sheet?: editorial on \"osteonecrosis of the femoral head is associated with cytomegalovirus reactivation\".","authors":"Matthew Reeves","doi":"10.1093/jbmr/zjag016","DOIUrl":"https://doi.org/10.1093/jbmr/zjag016","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Marrow pyroptosis ignites the periosteal reaction. 骨髓焦下垂引起骨膜反应。
IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-26 DOI: 10.1093/jbmr/zjag015
Masayuki Tsukasaki
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引用次数: 0
Decreased Nonvertebral Fracture Incidence with Zoledronate Use For >3 Years: Post Hoc Analysis of an RCT. 使用唑来膦酸钠降低非椎体骨折发生率:一项随机对照试验的事后分析。
IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-22 DOI: 10.1093/jbmr/zjag012
Ian R Reid, Anne M Horne, Borislav Mihov, Sonja Bastin, Mark J Bolland, Gregory D Gamble

The anti-fracture efficacy of most osteoporosis drugs is assessed in trials of up to three years duration. However, treatment of osteoporosis is required long-term, so it is important to know whether effectiveness of treatment changes over time. To-date, this information has only been available from open extensions of the treatment groups from clinical trials. Such data are subject to selective loss of frailer patients from the cohort, and no placebo comparator group is available to permit reliable measurement of anti-fracture efficacy. The 6-year Auckland zoledronate RCT administered zoledronate or placebo every 18 months to 2000 osteopenic women aged >65 years. It is longer than most osteoporosis trials, and only 3.6% of participants withdrew or were lost to follow-up. Therefore, anti-fracture efficacy can be validly compared between the first and second halves of this study. There were 178 non-vertebral fractures in the placebo group and 108 in the zoledronate group (excluding fractures of the hands, feet and face). Fracture rates per 1000 women-years in the placebo group were 28 (95%CI 23, 35) and 32 (26, 40) in years 1-3 and years 4-6, respectively. In the zoledronate group, fracture rates were 23 (18, 30) and 13 (9, 18) per 1000 women-years in the first and second halves of the study. The rate ratios for non-vertebral fractures were 0.83 (0.60, 1.14) in years 1-3, and 0.40 (0.27, 0.58) in years 4-6 (between-period comparison, P<0.05). Rate ratios for total fragility fractures, which include vertebral fractures also, showed a similar pattern: years 1-3, 0.76 (0.56, 1.02); years 4-6, 0.39 (0.29, 0.53). These findings suggest that the efficacy for non-vertebral fracture prevention of anti-resorptive drugs has been underestimated because of the short-term evaluation of their effects. Further, it indicates that longer term treatment with these drugs may yield greater benefit to patients.

大多数骨质疏松药物的抗骨折疗效是在长达三年的试验中评估的。然而,骨质疏松症的治疗需要长期进行,因此了解治疗效果是否随时间变化是很重要的。迄今为止,这些信息只能从临床试验中治疗组的公开扩展中获得。这些数据受到队列中较弱患者选择性丢失的影响,并且没有安慰剂比较组可以可靠地测量抗骨折疗效。这项为期6年的奥克兰唑来膦酸盐随机对照试验每18个月给2000名年龄在50至65岁之间的骨质减少妇女服用唑来膦酸盐或安慰剂。它比大多数骨质疏松症试验都要长,只有3.6%的参与者退出或失去了随访。因此,可以有效地比较本研究前半部分和后半部分的抗骨折疗效。安慰剂组有178例非椎体骨折,唑来膦酸钠组有108例(不包括手、脚和面部骨折)。安慰剂组在1-3年和4-6年的骨折发生率分别为每1000名女性年28例(95%CI 23,35)和32例(26,40)。在唑来膦酸钠组中,在研究的前半段和后半段,每1000名女性的骨折率分别为23(18,30)和13(9,18)。1-3年非椎体骨折发生率比为0.83(0.60,1.14),4-6年为0.40(0.27,0.58)(期间比较,P
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引用次数: 0
Response to Letter to the Editor Regarding "The relationship between treatment-related changes in total hip BMD measured after 12, 18, and 24 mo and fracture risk reduction in osteoporosis clinical trials: the FNIH-ASBMR-SABER project". 关于“骨质疏松症临床试验中12、18和24个月后测量的全髋骨密度治疗相关变化与骨折风险降低之间的关系:FNIH-ASBMR-SABER项目”致编辑的回复。
IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-19 DOI: 10.1093/jbmr/zjag006
Tatiane Vilaca, Marian Schini, Li-Yung Lui, Susan K Ewing, Austin R Thompson, Eric Vittinghoff, Douglas C Bauer, Richard Eastell, Dennis M Black, Mary L Bouxsein
{"title":"Response to Letter to the Editor Regarding \"The relationship between treatment-related changes in total hip BMD measured after 12, 18, and 24 mo and fracture risk reduction in osteoporosis clinical trials: the FNIH-ASBMR-SABER project\".","authors":"Tatiane Vilaca, Marian Schini, Li-Yung Lui, Susan K Ewing, Austin R Thompson, Eric Vittinghoff, Douglas C Bauer, Richard Eastell, Dennis M Black, Mary L Bouxsein","doi":"10.1093/jbmr/zjag006","DOIUrl":"https://doi.org/10.1093/jbmr/zjag006","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Center for Promoting Treatment of Intractable Diseases, ISEIKAI International General Hospital. ISEIKAI国际总医院疑难杂症治疗促进中心。
IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-16 DOI: 10.1093/jbmr/zjag010
Keiichi Ozono
{"title":"Center for Promoting Treatment of Intractable Diseases, ISEIKAI International General Hospital.","authors":"Keiichi Ozono","doi":"10.1093/jbmr/zjag010","DOIUrl":"https://doi.org/10.1093/jbmr/zjag010","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145987362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Bone and Mineral Research
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