Journal of Clinical Densitometry最新文献

Corrigendum to “Radiation therapy–Associated bone attenuation loss in anorectal cancer: Need for standardized imaging and clinical correlation” [Journal of Clinical Densitometry Volume 28 (2025) 101629] “肛肠癌放射治疗相关骨衰减损失：需要标准化成像和临床相关性”的勘误表[Journal of clinical density Volume 28 (2025) 101629]

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-11-28 DOI: 10.1016/j.jocd.2025.101655

Parth Aphale, Himanshu Shekhar, Shashank Dokania

引用次数: 0

Total-body versus knee-specific dual-energy X-ray absorptiometry scans for assessing bone mineral density surrounding the knee joint in collegiate athletes with and without an anterior cruciate ligament reconstruction 在有或没有前交叉韧带重建的大学生运动员中，全身与膝关节特异性双能x线吸收仪扫描评估膝关节周围骨密度

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-11-22 DOI: 10.1016/j.jocd.2025.101657

Keith A. Knurr , James P. Lyon , Neil C. Binkley , Tamara A. Scerpella , Bryan C. Heiderscheit

Following anterior cruciate ligament reconstruction (ACLR), athletes demonstrate reduced bone mineral density (BMD) surrounding the knee that persists for years. These changes have been identified using total-body and site-specific dual-energy X-ray absorptiometry (DXA) scans. It is unknown whether these two scan types provide comparable measures of BMD. This study assessed the agreement between total-body and knee-specific DXA scans for measuring BMD of the distal femur and proximal tibia in Division I collegiate athletes with and without an ACLR. We further assessed the influence of surgical hardware on BMD with and without the use of the manual artifact correction tool in athletes post-ACLR. Collegiate athletes (healthy: 46; post-ACLR: 20) were included. Regions of interest (ROI) were placed at the 5 % and 15 % lengths of the distal femur and the proximal tibia to assess BMD of each limb on total-body and knee-specific scans. BMD values for each limb and between-limb asymmetry were compared between scan types at each ROI using Bland-Altman analyses. Mean differences are reported as total-body minus knee-specific values. Total-body scans provided significantly lower BMD than knee-specific scans for all ROIs (-0.102 to -0.038 g/cm², all p-values < 0.01) except for the tibia 5 % (0.047 g/cm², p < 0.01) in healthy athletes. No differences in between-limb asymmetry were detected between scan types in healthy athletes (-0.78 % to 0.56 %; all p-values > 0.11). Athletes post-ACLR had more pronounced differences in BMD between scan types (-0.245 to -0.064 g/cm², all p-values < 0.02) and wider limits of agreement when surgical hardware was present, but this effect was mitigated when the manual artifact correction tool was used to exclude hardware (-0.122 to -0.008 g/cm², p-values from <0.01 to 0.57). Despite differences in absolute BMD, this study supports the use of total-body scans for assessing between-limb asymmetry in knee-specific regions in healthy athletes and in athletes post-ACLR when excluding hardware.

在前交叉韧带重建（ACLR）后，运动员表现出持续数年的膝关节周围骨密度（BMD）降低。这些变化已通过全身和特定部位双能x射线吸收仪（DXA）扫描确定。目前尚不清楚这两种扫描类型是否提供可比较的BMD测量。本研究评估了在有和没有ACLR的一级大学运动员中，全身和膝关节特异性DXA扫描测量股骨远端和胫骨近端骨密度之间的一致性。我们进一步评估了在aclr后使用和不使用人工人工校正工具时手术器械对运动员骨密度的影响。包括大学运动员（健康：46；aclr后：20）。感兴趣区域（ROI）分别位于股骨远端和胫骨近端长度的5%和15%处，以评估全身和膝关节特异性扫描中每个肢体的骨密度。使用Bland-Altman分析比较每个ROI扫描类型的每肢和肢间不对称性的BMD值。平均差异报告为全身减去膝盖特定值。除了健康运动员的胫骨5% （0.047 g/cm2, p < 0.01）外，全身扫描提供的骨密度显著低于膝关节特定扫描的所有roi（-0.102至-0.038 g/cm2，所有p值<； 0.01）。在健康运动员的不同扫描类型中，肢间不对称性没有差异（- 0.78%至0.56%；所有p值>； 0.11）。aclr后运动员在不同扫描类型之间的骨密度差异更明显（-0.245至-0.064 g/cm2，所有p值均为<； 0.02），当有手术器械存在时，这种差异更大，但当使用人工伪像校正工具排除器械时，这种影响减弱了（-0.122至-0.008 g/cm2， p值为<；0.01至0.57）。尽管绝对骨密度存在差异，但本研究支持使用全身扫描来评估健康运动员和aclr后运动员在排除硬件时膝关节特定区域的肢间不对称性。

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引用次数: 0

Treatment trends after hip fracture of veterans with osteoporosis 骨质疏松退伍军人髋部骨折后的治疗趋势。

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-11-20 DOI: 10.1016/j.jocd.2025.101656

Ashley McKenzie , Alvin Lee Day

Introduction: Osteoporosis is the most common metabolic bone disease in the United States. It is often underdiagnosed and undertreated resulting in additional fragility fractures. Hip fractures specifically can lead to 8-36 % excess mortality at 1 year. It has been found that 80-95 % of patients in certain practice settings are discharged with insufficient antifracture treatment. We were interested in determining the frequency of transition from oral bisphosphonate to parenteral osteoporosis therapy following hospitalization for a hip fracture in veterans aged 65 and older.

Methods: Utilizing the national Department of Veterans Affairs database, VA Informatics and Computing Infrastructure or VINCI, a cohort of patients aged 65 and older with a prior diagnosis of osteoporosis taking bisphosphonates who subsequently had a hip fracture was collected and analyzed. This created a cohort of 46,004 patients. This cohort was divided by gender and included 42,876 males and 3,128 females. The deidentified cohort records were reviewed to determine who received parenteral medications after the hip fracture.

Results: Based on the analysis, there were 1,459 patients on parenteral medications in the cohort of 46,004 after hip fracture. This resulted in a percentage of 3.17 % overall. The percentage of women placed on a parenteral medication was 1.66 % and for men was 3.28 %. The most used medication was zoledronic acid (Zoledronic Acid) with 1,190 uses of the 1,459 (81.6 %).

Conclusion: Hip fractures have a large impact on morbidity and mortality in the older population. Our study shows opportunity for increased utilization of parenteral therapies in patients who fractured on a background of oral bisphosphonate therapy. Delays may be the result of several issues including cost, recognition of fracture risk change, lack of communication, and comfort with therapies. The low percentage of parenteral medication use indicates some opportunity for more potent treatment. Future research directions could analyze civilian databases to get a more generalizable data set.

骨质疏松症是美国最常见的代谢性骨病。它经常被诊断和治疗不足，导致额外的脆性骨折。特别是髋部骨折可导致1年内8- 36%的额外死亡率。已经发现，在某些实践环境中，80- 95%的患者出院时抗骨折治疗不足。我们感兴趣的是确定65岁及以上退伍军人髋部骨折住院后从口服双膦酸盐转向肠外骨质疏松治疗的频率。方法：利用国家退伍军人事务部数据库，VA信息和计算基础设施或VINCI，收集并分析了65岁及以上的骨质疏松症患者，这些患者先前诊断为服用双磷酸盐，随后发生髋部骨折。这创建了一个46004名患者的队列。该队列按性别划分，包括42,876名男性和3,128名女性。对未确定的队列记录进行回顾，以确定髋部骨折后接受肠外药物治疗的患者。结果：通过分析，在46004例髋部骨折后的队列中，有1459例患者接受了肠外药物治疗。这导致了3.17%的总体百分比。接受肠外药物治疗的女性比例为1.66%，男性为3.28%。使用最多的药物是唑来膦酸（唑来膦酸），在1459种药物中使用1190种（81.6%）。结论：髋部骨折对老年人群的发病率和死亡率有很大影响。我们的研究表明，在口服双膦酸盐治疗的背景下，骨折患者有机会增加肠外治疗的使用。延迟可能是由于一些问题，包括费用、对骨折风险变化的认识、缺乏沟通和对治疗的舒适度。低比例的肠外药物使用表明有机会进行更有效的治疗。未来的研究方向可能是分析民用数据库，以获得更一般化的数据集。

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引用次数: 0

The Danish Nationwide osteoporosis cohort trials environment (NOCTE) – a DXA dataset for the 1900-1960 birth cohort 丹麦全国骨质疏松队列试验环境(NOCTE) - 1900-1960年出生队列的DXA数据集

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-11-12 DOI: 10.1016/j.jocd.2025.101653

Benjamin Bakke Hansen , Bryan Haddock , Niklas Rye Jørgensen , Peter Vestergaard , Uffe Kock Wiil , Lars Folkestad , Sören Möller , Nicholas Fuggle , Bente Langdahl , Katrine Hass Rubin , Bo Abrahamsen

Background: Osteoporosis is a common, underdiagnosed condition causing increased risk of fracture. While dual-energy X-ray absorptiometry (DXA) is the diagnostic standard, this may not be successfully targeted to individuals at the highest risk. This study presents an extensive nationwide dataset characterizing DXA-scanning practices in Denmark.

Methodology: In this study, we identified all Danish residents from the birth cohort 1900-1960, with a first DXA scan between 2010-2022 to form the Nationwide Osteoporosis Cohort Trials Environment (NOCTE) dataset. These individuals were matched 1:5 to a non-scanned reference population by birth year, sex, and region of residence. Individual data were linked to national registers for comprehensive sociodemographic and clinical information.

Results: The final cohort included 263,651 individuals who underwent DXA scanning. At their first scan, 33% of women and 17% of men had osteoporosis. Compared to the matched reference, the scanned cohort had similar socioeconomic profiles but substantially different clinical profiles. Scanned individuals had a much higher prevalence of prior major osteoporotic fractures, prior systemic glucocorticoid exposure, and overall comorbidity burden.

Conclusion: Referral for DXA in Denmark is driven by clinical risk rather than socioeconomic status, reflecting an equitable resource allocation. However, a significant diagnostic gap persists, as many high-risk individuals with prior fractures did not receive a DXA. The NOCTE cohort is a new, powerful resource for developing strategies to help close this gap.

背景：骨质疏松症是一种常见的未被诊断的疾病，会增加骨折的风险。虽然双能x线吸收仪（DXA）是诊断标准，但它可能无法成功地针对高危人群。本研究提出了一个广泛的全国性数据集，描述了丹麦的dxa扫描实践。方法：在这项研究中，我们从1900-1960年出生队列中确定了所有丹麦居民，并在2010-2022年间进行了第一次DXA扫描，形成了全国骨质疏松症队列试验环境（NOCTE）数据集。根据出生年份、性别和居住地区，这些个体与未扫描的参考人群的匹配比例为1:5。个人数据与国家综合社会人口统计和临床信息登记册相关联。结果：最终队列包括263,651名接受DXA扫描的个体。在第一次扫描时，33%的女性和17%的男性患有骨质疏松症。与匹配的参考相比，扫描队列具有相似的社会经济概况，但临床概况有很大不同。扫描的个体有更高的患病率，既往的主要骨质疏松性骨折，既往的系统性糖皮质激素暴露，以及总体合并症负担。结论：丹麦的DXA转诊是由临床风险而不是社会经济地位驱动的，反映了公平的资源分配。然而，显著的诊断差距仍然存在，因为许多先前骨折的高危患者没有接受DXA。note队列是制定有助于缩小这一差距的战略的一个新的、强大的资源。

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引用次数: 0

The relationship between changes in calcium concentration and bone mineral density by anti-bone resorptive therapy 抗骨吸收治疗后钙浓度变化与骨密度的关系。

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-11-03 DOI: 10.1016/j.jocd.2025.101642

Akira Horikawa , Yuji Kasukawa , Michio Hongo , Akihisa Sano , Naohisa Miyakoshi

Background: Hypocalcemia after initiating antiresorptive therapy is well documented, but the association between early changes in serum-corrected calcium (Ca) concentration and long-term bone mineral density (BMD) response in osteoporosis remains unclear. This study compared early Ca changes and BMD outcomes in patients treated with zoledronic acid or denosumab.

Methodology: In this retrospective study, 67 outpatients with osteoporosis received either zoledronic acid (n = 25) or denosumab (n = 42). Baseline BMD, serum-corrected Ca concentration, bone turnover markers, estimated glomerular filtration rate (eGFR), and 25-hydroxyvitamin D [25(OH)D] were recorded. Serum-corrected Ca concentration and eGFR were reassessed at 1 week, 6 months, and 12 months and BMD was measured at baseline, 6 months, and 12 months. To prevent hypocalcemia, patients received different vitamin D regimens according to standard practice (active vitamin D3 for zoledronic acid and combined natural and active vitamin D for denosumab). Multivariate regression has been adjusted for age, baseline BMD, 25(OH)D, eGFR, and TRACP-5b.

Results: A significant decrease in serum-corrected Ca at 1 week was observed in both groups. The magnitude of this decrease was negatively associated with lumbar spine BMD change at 12 months (zoledronic acid: r = −0.59, p = 0.0077; denosumab: r = −0.52, p = 0.0067). This association remained significant after multivariate adjustment. ROC analysis showed that Ca decrease predicted greater BMD gains (AUC 0.909 for zoledronic acid and AUC 0.81 for denosumab), but these results should be interpreted with caution due to the small sample size and different vitamin D regimens.

Conclusions: Early decreases in serum-corrected Ca concentration after antiresorptive therapy were associated with greater BMD gains at 12 months, independent of baseline vitamin D, renal function, and bone turnover markers. This study is exploratory and preliminary in nature, and its findings should be interpreted with caution.

背景：开始抗吸收治疗后的低钙血症有充分的文献记载，但骨质疏松症患者血清校正钙（Ca）浓度的早期变化与长期骨密度（BMD）反应之间的关系尚不清楚。该研究比较了接受唑来膦酸或地诺单抗治疗的患者的早期钙变化和BMD结果。方法：在这项回顾性研究中，67例骨质疏松症门诊患者接受唑来膦酸（n = 25）或地诺单抗（n = 42）治疗。记录基线骨密度、血清校正钙浓度、骨转换标志物、估计肾小球滤过率（eGFR）和25-羟基维生素D [25(OH)D]。在1周、6个月和12个月时重新评估血清校正Ca浓度和eGFR，在基线、6个月和12个月时测量BMD。为了预防低钙血症，患者根据标准惯例接受不同的维生素D方案（唑来膦酸治疗活性维生素D3，地诺单抗治疗天然和活性维生素D联合治疗）。对年龄、基线BMD、25(OH)D、eGFR和TRACP-5b进行了多因素回归校正。结果：两组患者1周时血清校正钙均显著降低。这种下降的幅度与12个月时腰椎骨密度变化呈负相关（唑来膦酸：r = -0.59, p = 0.0077；地诺单抗：r = -0.52, p = 0.0067）。在多变量调整后，这种关联仍然显著。ROC分析显示，钙降低预示着更大的骨密度增加（唑来膦酸的AUC为0.909，地诺单抗的AUC为0.81），但由于样本量小和不同的维生素D方案，这些结果应谨慎解释。结论：抗吸收治疗后血清校正钙浓度的早期降低与12个月时更高的骨密度增加相关，与基线维生素D、肾功能和骨转换标志物无关。本研究是探索性的、初步的，研究结果应谨慎解读。

{"title":"The relationship between changes in calcium concentration and bone mineral density by anti-bone resorptive therapy","authors":"Akira Horikawa , Yuji Kasukawa , Michio Hongo , Akihisa Sano , Naohisa Miyakoshi","doi":"10.1016/j.jocd.2025.101642","DOIUrl":"10.1016/j.jocd.2025.101642","url":null,"abstract":"<div><div><em>Background:</em> Hypocalcemia after initiating antiresorptive therapy is well documented, but the association between early changes in serum-corrected calcium (Ca) concentration and long-term bone mineral density (BMD) response in osteoporosis remains unclear. This study compared early Ca changes and BMD outcomes in patients treated with zoledronic acid or denosumab.</div><div><em>Methodology:</em> In this retrospective study, 67 outpatients with osteoporosis received either zoledronic acid (n = 25) or denosumab (n = 42). Baseline BMD, serum-corrected Ca concentration, bone turnover markers, estimated glomerular filtration rate (eGFR), and 25-hydroxyvitamin D [25(OH)D] were recorded. Serum-corrected Ca concentration and eGFR were reassessed at 1 week, 6 months, and 12 months and BMD was measured at baseline, 6 months, and 12 months. To prevent hypocalcemia, patients received different vitamin D regimens according to standard practice (active vitamin D3 for zoledronic acid and combined natural and active vitamin D for denosumab). Multivariate regression has been adjusted for age, baseline BMD, 25(OH)D, eGFR, and TRACP-5b.</div><div><em>Results:</em> A significant decrease in serum-corrected Ca at 1 week was observed in both groups. The magnitude of this decrease was negatively associated with lumbar spine BMD change at 12 months (zoledronic acid: r = −0.59, p = 0.0077; denosumab: r = −0.52, p = 0.0067). This association remained significant after multivariate adjustment. ROC analysis showed that Ca decrease predicted greater BMD gains (AUC 0.909 for zoledronic acid and AUC 0.81 for denosumab), but these results should be interpreted with caution due to the small sample size and different vitamin D regimens.</div><div><em>Conclusions:</em> Early decreases in serum-corrected Ca concentration after antiresorptive therapy were associated with greater BMD gains at 12 months, independent of baseline vitamin D, renal function, and bone turnover markers. This study is exploratory and preliminary in nature, and its findings should be interpreted with caution.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"29 1","pages":"Article 101642"},"PeriodicalIF":1.6,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

The Q-BONE system: A novel dual-energy X-ray diagnostic method for osteoporosis Q-BONE系统：一种新的双能x线骨质疏松症诊断方法。

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-10-26 DOI: 10.1016/j.jocd.2025.101638

Takahiro Kawamura , Tomoyuki Takahashi , Kayo Okano , Masahiko Yamada , Toshiko Iidaka , Sakae Tanaka , Noriko Yoshimura

Background

Osteoporosis is a prevalent and growing public health issue, particularly in aging populations, due to its association with fragility fractures, reduced mobility, and increased healthcare burden. Dual-energy X-ray absorptiometry (DXA) remains the clinical gold standard for assessing bone mineral density (BMD), but it requires dedicated equipment. DXA is separately required from the radiography system for fracture diagnosis, making DXA difficult to access depending on the facility and region.

Purpose

To address these limitations, we developed the quantitative bone (Q-BONE) system, a novel diagnostic tool that updates existing radiography system to utilize dual energy in a single X-ray irradiation to produce BMD (Q-BONE score) and high-resolution X-ray images (Q-BONE images).

Methods

We evaluated the correlation between the Q-BONE score of Q-BONE system and the BMD of the DXA for the DXA measurement phantom and the 200 people, and the degree of agreement among them by Bland-Altman analysis. Further, fracture detectability was compared between Q-BONE images and radiographs using predefined radiological criteria.

Results

The correlation between bone mineral density and Q-BONE score for 200 individuals was as high as 0.91 with good linearity; however, these two values were statistically inconsistent mainly because of body fat percentage (P < 0.05). Q-BONE images significantly improved visualization of cortical and trabecular bone structures (P < 0.01) and improved detection of fractures and structural abnormalities compared with conventional radiographs.

Conclusions

The Q-BONE system has the potential that achieves comprehensive osteoporosis assessment by combining BMD measurement and fracture evaluation in a single efficient procedure. Its implementation could improve diagnostic efficiency and accessibility, particularly in settings where DXA is unavailable. Further technical improvement on body fat issues, and studies are warranted to assess its clinical utility across broader populations and skeletal sites.

背景：骨质疏松症是一个普遍且日益严重的公共卫生问题，特别是在老龄化人群中，因为它与脆性骨折、活动能力降低和医疗负担增加有关。双能x线吸收仪（DXA）仍然是评估骨矿物质密度（BMD）的临床金标准，但它需要专用设备。骨折诊断需要单独使用DXA，这使得DXA很难根据设施和地区获得。目的：为了解决这些局限性，我们开发了定量骨（Q-BONE）系统，这是一种新的诊断工具，它更新了现有的放射照相系统，利用单次x射线照射的双重能量来产生BMD （Q-BONE评分）和高分辨率x射线图像（Q-BONE图像）。方法：采用Bland-Altman分析方法对200例DXA测量幻影和DXA测量幻影的Q-BONE评分与DXA骨密度的相关性进行评价，并对二者的契合度进行分析。此外，使用预定义的放射学标准比较Q-BONE图像和x线片的骨折可检测性。结果：200例个体骨密度与Q-BONE评分相关性高达0.91，线性良好；然而，这两个值在统计上不一致，主要是因为体脂率（P < 0.05）。与常规x线片相比，Q-BONE图像显著提高了骨皮质和骨小梁结构的可视性（P < 0.01），提高了骨折和结构异常的检出率。结论：Q-BONE系统具有实现综合骨质疏松症评估的潜力，它将骨密度测量和骨折评估结合在一个单一有效的程序中。它的实现可以提高诊断效率和可访问性，特别是在无法使用DXA的环境中。对体脂问题的进一步技术改进和研究是有必要的，以评估其在更广泛的人群和骨骼部位的临床应用。

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引用次数: 0

Comparative diagnostic performance of dual-energy X-ray absorptiometry and other radiological modalities in osteoporosis detection: a systematic review 双能x线吸收仪和其他放射方式在骨质疏松症检测中的比较诊断性能：系统综述。

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-10-26 DOI: 10.1016/j.jocd.2025.101637

Siraj Fahad Wally , Muwaffaq F. Wali , Osama Adnan Hariri , Rasha E. Alotiabi , Badr K Waked , Najla M. Almudayni , Faisal M. Khashab , Batool A. Alshahrani , Khalid M. Aljaaly , Abdulrahman O. Alzahrani

A serious worldwide health issue, osteoporosis is characterized by weakened bones and a higher risk of fracture. Though alternative imaging modalities like quantitative ultrasound (QUS), radiographic absorptiometry (RA), quantitative computed tomography (QCT), and radiofrequency echographic multispectrometry (REMS) have emerged as viable diagnostic or screening tools, dual-energy X-ray absorptiometry (DEXA) is still the gold standard for measuring bone mineral density (BMD). The purpose of this systematic review was to evaluate the clinical usefulness, diagnostic accuracy, and dependability of different radiographic modalities for osteoporosis detection. In order to find papers published between 2001 and 2023 comparing DEXA with other radiographic modalities for osteoporosis diagnosis, a thorough search of the PubMed, Scopus, and ScienceDirect databases was undertaken. There were ten studies that qualified. Study design, demographic characteristics, imaging methods, diagnostic thresholds, and performance metrics (sensitivity, specificity, and correlation coefficients) were among the data that were extracted. Across studies, DEXA consistently demonstrated high precision and strong correlation with fracture risk, confirming its role as the reference standard. QUS showed moderate agreement with DEXA, supporting its use as a screening tool but not for diagnostic confirmation. RA provided good reproducibility but lower sensitivity compared with DEXA. QCT exhibited superior sensitivity (up to 91%) and early trabecular bone detection but was limited by higher cost and radiation exposure. Emerging evidence for REMS demonstrated strong correlation with DEXA (r = 0.85–0.90), comparable diagnostic accuracy, and the advantage of being radiation-free and portable. DEXA remains the gold standard for osteoporosis diagnosis; however, QCT and REMS show promising diagnostic accuracy and may complement DEXA for early detection and longitudinal monitoring. QUS and RA can serve as cost-effective screening tools, particularly in settings where DEXA is unavailable. Further large-scale, prospective studies with standardized diagnostic thresholds are needed to validate these findings and optimize imaging strategies for osteoporosis management.

骨质疏松症是一个严重的全球性健康问题，其特点是骨骼变弱和骨折风险较高。虽然定量超声（QUS）、放射吸收仪（RA）、定量计算机断层扫描（QCT）和射频超声多光谱法（REMS）等替代成像方式已经成为可行的诊断或筛查工具，但双能x射线吸收仪（DEXA）仍然是测量骨矿物质密度（BMD）的金标准。本系统综述的目的是评估骨质疏松症不同影像学检查的临床有效性、诊断准确性和可靠性。为了找到2001年至2023年间发表的比较DEXA与其他骨质疏松症放射诊断方式的论文，我们对PubMed、Scopus和ScienceDirect数据库进行了全面的搜索。有10项研究符合条件。提取的数据包括研究设计、人口统计学特征、成像方法、诊断阈值和性能指标（敏感性、特异性和相关系数）。在所有研究中，DEXA始终表现出高精度和与骨折风险的强相关性，证实了其作为参考标准的作用。QUS与DEXA表现出中度一致，支持其作为筛查工具，但不用于诊断确认。RA重复性好，但灵敏度较DEXA低。QCT表现出更高的灵敏度（高达91%）和早期小梁骨检测，但受到较高成本和辐射暴露的限制。新出现的证据表明REMS与DEXA （r = 0.85-0.90）、相当的诊断准确性以及无辐射和便携的优势有很强的相关性。DEXA仍然是骨质疏松症诊断的金标准；然而，QCT和REMS显示出有希望的诊断准确性，可以补充DEXA进行早期检测和纵向监测。QUS和RA可以作为具有成本效益的筛查工具，特别是在没有DEXA的情况下。需要进一步的大规模、具有标准化诊断阈值的前瞻性研究来验证这些发现，并优化骨质疏松症管理的影像学策略。

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引用次数: 0

Bone density, structure, and estimated strength in children with congenital heart disease. A CHAMPS* cohort study 先天性心脏病儿童的骨密度、结构和估计强度。一项champ *队列研究。

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-10-25 DOI: 10.1016/j.jocd.2025.101636

Marta C. Erlandson , Matthew S. Chapelski , Chantelle L. Baril , Charissa Pockett , Scott Pharis , Kristi D. Wright , Corey R. Tomczak

Introduction: Children with congenital heart disease (CHD) have lower levels of physical activity, lower birth weights, and lower nutrient intake compared to their typically developing peers (TDP); which can put children with CHD at increased risk of impaired skeletal development. Therefore, the purpose of this study was to assess the bone architecture of children with CHD compared to TDP. Our secondary objective was to evaluate differences between CHD lesion complexity.

Methods: Forty-two children with CHD 7 to 15 years of age (10.9±2.5) were age and sex-matched to 41 TDP. Peripheral quantitative computed tomography (pQCT) scans were obtained at the distal (4%) and shaft (65%, 66%) sites for the radius and tibia, respectively. pQCT bone parameters were compared between groups using multiple analysis of covariance (MANCOVA), using sex, age, height, weight, maturity, and physical activity as covariates.

Results: There were no significant differences between children with CHD and TDP at the distal radius or distal tibia (p>0.05). Children with CHD had significantly lower total area, cortical content, cortical area, cortical thickness, and polar stress-strain index at the radial and tibial shaft compared to TDP (p<0.05). When sub-dividing children with CHD by lesion severity, the complex CHD group had significantly lower cortical content, cortical area, cortical thickness, and polar stress-strain index at the radius and tibia shaft when compared to TDP (p<0.05). Additionally, children with complex lesions had greater cortical density at the radius and tibia shaft when compared to TDP (p<0.05). Finally, children with simple lesions had greater cortical density at the radius shaft when compared to TDP (p<0.05).

Conclusion: Children with complex CHD had worse bone parameters when compared to TDP. Children with complex CHD lesions may be at increased risk of impaired bone density, structure, and estimated strength at both the radius and tibia shaft.

与正常发育的同龄人（TDP）相比，患有先天性心脏病（CHD）的儿童身体活动水平较低，出生体重较低，营养摄入量较低；这会增加患有冠心病的儿童骨骼发育受损的风险。因此，本研究的目的是评估与TDP相比，CHD儿童的骨结构。我们的次要目的是评估冠心病病变复杂性的差异。方法：7 ~ 15岁（10.9±2.5）例冠心病患儿42例，年龄、性别匹配41例。周围定量计算机断层扫描（pQCT）分别在桡骨和胫骨的远端（4%）和轴端（65%,66%）进行扫描。采用多元协方差分析（MANCOVA），以性别、年龄、身高、体重、成熟度和体力活动为协变量，比较各组间pQCT骨骼参数。结果：冠心病患儿桡骨远端和胫骨远端TDP差异无统计学意义（p < 0.05）。与TDP相比，冠心病患儿桡骨和胫骨干的总面积、皮质含量、皮质面积、皮质厚度和极性应力-应变指数均显著降低(p)。结论：复杂型冠心病患儿的骨参数较TDP差。患有复杂冠心病病变的儿童在桡骨和胫骨干的骨密度、结构和估计强度受损的风险可能会增加。

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引用次数: 0

Adherence and persistence of daily and twice-weekly teriparatide treatment in postmenopausal women with high-risk of fracture 绝经后骨折高危妇女每日和每周两次特立帕肽治疗的依从性和持久性。

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-10-24 DOI: 10.1016/j.jocd.2025.101641

Takeshi Mochizuki , Koichiro Yano , Katsunori Ikari , Ken Okazaki

Background: This study aimed to determine the differences in adherence and persistence between a daily and twice-weekly teriparatide regimens in postmenopausal women at high risk of fracture.

Methods: Ninety-eight postmenopausal women diagnosed with a high risk for fractures were enrolled and randomized into two groups to receive daily (D-TPTD) or twice-weekly (TW-TPTD) teriparatide. Adherence, measured using the medication possession ratio (MPR), and persistence were measured for both groups. MPR was calculated as the number of days the patient was actually covered by the administered medication divided by the number of days of the study period, which was theoretically 24 months.

Results: The persistence rates at 24 months in the d-TPTD and TW-TPTD groups were 66.7 % and 59.6 %, respectively, with no significant difference between the two. Additionally, adherence and persistence in patients without vertebral fracture at baseline were lower than those with vertebral fracture. In the Cox proportional hazards analysis, treatment persistence in patients without vertebral fracture was lower than that in patients with vertebral fracture (p = 0.027; hazard ratio, 0.369; 95 % confidence intervals, 0.15–0.89).

Conclusion: There was no difference in adherence and persistence between the two groups at 24 months after treatment initiation. High adherence and retention to teriparatide can be expected in postmenopausal women at a high risk of vertebral fractures.

背景：本研究旨在确定绝经后骨折高风险妇女每日服用特立帕肽和每周服用两次特立帕肽方案的依从性和持久性的差异。方法：入选98名确诊为骨折高危的绝经后妇女，随机分为每日（D-TPTD）和每周（TW-TPTD）两次特立帕肽两组。使用药物占有比（MPR）测量依从性，并测量两组的持久性。MPR的计算方法是患者实际接受药物治疗的天数除以研究周期的天数，理论上为24个月。结果：d-TPTD组和TW-TPTD组24个月的持续率分别为66.7%和59.6%，两者差异无统计学意义。此外，基线时无椎体骨折患者的依从性和持久性低于有椎体骨折患者。在Cox比例风险分析中，无椎体骨折患者的治疗坚持度低于有椎体骨折患者（p = 0.027；风险比0.369；95%可信区间0.15-0.89）。结论：治疗开始后24个月，两组患者的依从性和持久性无差异。绝经后椎体骨折高风险的妇女对特立帕肽的高依从性和保留性是可以预期的。

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引用次数: 0

Correlation between body mass index, bone mineral density and trabecular bone score in patients with Type 2 diabetes 2型糖尿病患者体重指数、骨密度与骨小梁评分的相关性

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-10-22 DOI: 10.1016/j.jocd.2025.101640

Lili Zhuang , Song Zou

Objective: To investigate the relationship between body mass index (BMI) and areal bone mineral density (BMD) as well as trabecular bone score (TBS) in adults with type 2 diabetes mellitus (T2DM) and to determine whether age or sex modifies these relationships.

Methods: We retrospectively identified 762 community-dwelling adults aged ≥ 50 years (257 with T2DM and 505 non-diabetic controls) who underwent dual-energy X-ray absorptiometry at our centre between August 2023 and May 2024. Lumbar-spine and femoral-neck BMD as well as TBS were extracted. Associations were evaluated with Spearman’s ρ and multiple linear regression, adjusting for age and sex.

Results: In men, BMI, BMD and TBS did not differ between diabetic and non-diabetic participants in any age stratum (all P > 0.05). Women aged 50–60 y with T2DM exhibited higher LS-BMD but lower TBS than non-diabetic peers (both P < 0.05), indicating early dissociation between density and micro-architecture. Correlation analysis shows a positive association between BMI and LS-BMD (ρ=0.286, P= 0.002). Multivariate linear regression confirmed that BMI was an independent positive predictor of LS-BMD (β = 0.276, P < 0.001) and an independent negative predictor of TBS (β = −0.069, P = 0.043).

Conclusion: In T2DM, higher BMI is independently associated with greater BMD but poorer trabecular micro-architecture. This paradox is most evident in post-menopausal women, underscoring TBS as an early warning tool when BMD remains normal.

目的：探讨成人2型糖尿病（T2DM）患者身体质量指数（BMI）与骨密度（BMD）及骨小梁评分（TBS）的关系，并探讨年龄和性别是否会改变这种关系。方法：我们回顾性地确定了762名年龄≥50岁的社区居民（257名T2DM患者，505名非糖尿病对照组），他们于2023年8月至2024年5月在我们的中心接受了双能x线吸收仪检查。提取腰椎、股骨颈骨密度及TBS。采用Spearman ρ和多元线性回归评估相关性，调整年龄和性别。结果：在男性中，糖尿病和非糖尿病参与者在任何年龄段的BMI、BMD和TBS均无差异（均P >； 0.05）。50-60岁的女性T2DM患者的LS-BMD高于非糖尿病患者，但TBS低于非糖尿病患者（P < 0.05），表明密度与微结构之间的早期分离。相关分析显示BMI与LS-BMD呈正相关（ρ=0.286， P= 0.002）。多元线性回归证实BMI是LS-BMD的独立阳性预测因子（β = 0.276, P < 0.001），是TBS的独立阴性预测因子（β = - 0.069, P = 0.043）。结论：在T2DM中，较高的BMI与较高的BMD和较差的小梁微结构独立相关。这种矛盾在绝经后妇女中最为明显，强调TBS是骨密度保持正常的早期预警工具。

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引用次数: 0