Journal of Clinical Densitometry最新文献_第2页

Analyzing the effect of osteoporosis drug treatments on femoral strength using 3D-DXA finite elements modelling 采用3D-DXA有限元模型分析骨质疏松药物治疗对股骨强度的影响。

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2026-01-01 DOI: 10.1016/j.jocd.2025.101663

Carlos Ruiz Wills , Muhammad Qasim , Renaud Winzenrieth , Silvana Di Gregorio , Luis Del Río , Ludovic Humbert , Jérôme Noailly

Osteoporotic hip fracture represents a high social and economic burden in western countries. Pharmacological treatments aim to limit/reverse the loss of bone mineral density (BMD). BMD is monitored through dual energy X-ray absorptiometry (DXA). Biomechanical analysis, through 3D-DXA finite element (FE) femur models, has been shown to potentially improve fracture risk prediction. Yet, the capability of 3D-DXA FE simulations to capture the effects of pharmacological treatments on bone strength remains unexplored. Thus, this study aims to evaluate simulated changes in bone strength in subjects with different osteoporosis treatments using 3D-DXA FE models. A cohort of 155 subjects was used to generate the patient-specific FE models. Osteoporosis treatments included Alendronate (AL, n = 54), Denosumab (DMAB, n = 33), Teriparatide (TPTD, n = 31), and Naïve (NAÏVE, n = 37). Bone was modelled as BMD-dependent elasto-plastic material. Lateral fall was simulated, and bone FE-strength changes from baseline were assessed. Integral FE-strength significantly increased by 3.1% and 4.0% in the AL and DMAB groups, respectively. Trabecular and cortical FE-strength significantly increased by 2.2% and 1.9%, respectively with DMAB. Load-bearing capacity increased in both the cortical and trabecular bone of the femoral neck with DMAB and AL, while it only increased in the trabecular bone with TPTD. 3D-DXA FE analysis might help clinicians to better monitor the effects of pharmacological treatments and potentially improve personalised treatment plans for subjects with osteoporosis.

骨质疏松性髋部骨折在西方国家是一个很高的社会和经济负担。药物治疗的目的是限制/逆转骨密度（BMD）的损失。通过双能x射线吸收仪（DXA）监测骨密度。通过3D-DXA有限元（FE）股骨模型进行生物力学分析，已被证明有可能改善骨折风险预测。然而，3D-DXA FE模拟捕捉药物治疗对骨强度的影响的能力仍未被探索。因此，本研究旨在利用3D-DXA FE模型评估不同骨质疏松治疗受试者骨强度的模拟变化。155名受试者被用于生成患者特异性FE模型。治疗骨质疏松的药物包括阿仑膦酸钠（AL, n = 54）、Denosumab （DMAB, n = 33）、特立帕肽（TPTD, n = 31）和Naïve （NAÏVE, n = 37）。骨被建模为依赖于骨密度的弹塑性材料。模拟侧落，评估骨fe强度从基线的变化。AL组和DMAB组整体fe强度分别显著提高3.1%和4.0%。添加DMAB后，骨小梁和皮质fe强度分别显著提高2.2%和1.9%。DMAB和AL组股骨颈皮质骨和股骨小梁骨的承重能力均有增加，而TPTD组仅股骨小梁骨的承重能力有增加。3D-DXA FE分析可以帮助临床医生更好地监测药物治疗的效果，并有可能改善骨质疏松症患者的个性化治疗计划。

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引用次数: 0

Osteoporosis prediction from Frontal Lumbar Spine X-rays 腰椎前位x线预测骨质疏松症

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2026-01-01 DOI: 10.1016/j.jocd.2025.101666

Ryusei Inamori , Tomoya Kobayashi , Eichi Takaya , Junya Iwazaki , Carlos Makoto Miyauchi , Saori Ikumi , Yoshikazu Okamoto , Cheng Wei Lin , Sheng Che Hsiao , Qingzong Tseng , Shinya Sonobe

Background: This study aimed to evaluate the performance of DeepXray™ Spina, a software that estimates bone mineral density (BMD) and T-scores from frontal lumbar spine X-ray (FLS-X), in predicting osteoporosis.

Methodology: Patients from a Japanese cohort who underwent both FLS-X and dual-energy X-ray absorptiometry (DXA) using Hologic systems within 30 days at Tohoku University Hospital (May 2014-April 2024) were included. BMD was estimated from FLS-X using DeepXray™ Spina, which was developed using dataset from a Taiwanese Cohort. BMD assessed by DXA (observed BMD) and BMD estimated from FLS-X by DeepXray™ Spina (estimated BMD) were compared using Pearson’s correlation coefficient (PCC) and normalized root mean square error (NRMSE). T-scores were converted to osteoporosis classifications as normal, osteopenia, or osteoporosis following the World Health Organization criteria. Classification performance was evaluated by accuracy, sensitivity, specificity, Cohen’s kappa, and quadratic-weighted Cohen’s kappa.

Results: The correlation between estimated and observed BMD was strong, with a PCC of 0.901 and an NRMSE of 0.070. For osteoporosis classification, the accuracy, sensitivity, specificity, and Cohen’s kappa were as follows: 0.902, 1.000, 0.842, and 0.803 for normal; 0.854, 0.729, 0.924, and 0.673 for osteopenia; 0.951, 0.810, 1.000, and 0.863 for osteoporosis. The quadratic-weighted Cohen’s kappa was 0.884.

Conclusion: This study evaluated the performance of Deep Xray™ Spina in predicting osteoporosis from FLS-X. The software is a practical and reliable tool for predicting osteoporosis, with high performance and robustness.

背景：本研究旨在评估DeepXray™Spina的性能，DeepXray™Spina是一种评估骨矿物质密度（BMD）和腰椎前位x线（FLS-X） t评分的软件，用于预测骨质疏松症。方法：纳入2014年5月至2024年4月在东北大学医院（Tohoku University Hospital）接受FLS-X和双能x线吸收仪（DXA） 30天内使用Hologic系统的日本队列患者。使用DeepXray™Spina从FLS-X中估计BMD，该数据集使用来自台湾队列的数据集开发。采用Pearson相关系数（PCC）和标准化均方根误差（NRMSE）对DXA评估的骨密度（观察骨密度）和DeepXray™Spina从FLS-X估计的骨密度（估计骨密度）进行比较。按照世界卫生组织的标准，将t评分转换为骨质疏松症分类为正常、骨质减少或骨质疏松症。通过准确性、敏感性、特异性、Cohen’s kappa和二次加权Cohen’s kappa来评估分类效果。结果：BMD估计值与实测值相关性强，PCC为0.901，NRMSE为0.070。骨质疏松症分类的准确性、敏感性、特异性和Cohen’s kappa值分别为：正常为0.902、1.000、0.842、0.803；骨质减少为0.854、0.729、0.924、0.673；骨质疏松率分别为0.951、0.810、1.000、0.863。二次加权Cohen’s kappa为0.884。结论：本研究评估了Deep Xray™Spina在预测FLS-X骨质疏松症中的作用。该软件是预测骨质疏松症的实用可靠的工具，具有高性能和鲁棒性。

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引用次数: 0

Reframing the BMI–BMD–TBS triad in type 2 diabetes: Clinical and policy implications 重塑2型糖尿病的BMI-BMD-TBS三联征：临床和政策意义

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-12-13 DOI: 10.1016/j.jocd.2025.101659

Amit Kumar Gupta, Anusha Putcha, Varshini Vadhithala, Sachin Kumar

引用次数: 0

Visual estimation of vertebral marrow fat on lumbar MRI as a screening tool for osteoporosis: A retrospective study 腰椎MRI上骨髓脂肪的视觉估计作为骨质疏松症的筛查工具：一项回顾性研究

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-12-11 DOI: 10.1016/j.jocd.2025.101658

Liqa A Rousan , Naser Obeidat , Nour Abdo , Tarek Ajam , Hamzeh Al-Zoubi , Leena Alshira’h , Hamad Saif , Abdulla Albaqshi , Khaled J Zaitoun

Background: Osteoporosis is the most common metabolic bone disease in the elderly. This study aimed to assess whether routine T1-weighted MR images can visually indicate the presence of osteoporosis by estimating vertebral bone marrow fat content.

Methods: Lumbar spine MRI and DEXA scans from 320 patients (performed within a 6-month interval) were retrospectively reviewed. Two radiologists independently graded the percentage of high T1 signal within the L4 vertebral body into <50 % or ≥50 %, representing marrow fat content. Visual fat scores were compared with T-scores from DEXA scans. Inter-reader agreement was assessed using Cohen's and Fleiss' kappa statistics. Spearman’s correlation was used to evaluate the association between MRI grading and DEXA scores.

Results: Of the 320 patients (mean age 56.8 years; 80.3 % female), 48.4 % had osteopenia or osteoporosis. Visual MRI grading yielded 141 patients with <50 % and 179 with ≥50 % marrow fat. A weak but statistically significant correlation was observed between MRI visual fat scores and DEXA T-scores (ρ = 0.139, p = 0.013). Inter-reader agreement was moderate (Cohen’s kappa = 0.509, 95 % CI: 0.415 to 0.603).

Conclusion: Routine T1-weighted lumbar spine MRI may serve as an opportunistic screening tool for osteoporosis. Visual estimation of vertebral marrow fat content shows potential to identify patients who may benefit from further DEXA evaluation.

背景：骨质疏松症是老年人最常见的代谢性骨病。本研究旨在评估常规t1加权MR图像是否可以通过估计椎体骨髓脂肪含量来直观地显示骨质疏松症的存在。方法：回顾性分析320例患者的腰椎MRI和DEXA扫描（间隔6个月）。两名放射科医师独立将L4椎体内高T1信号的百分比分为<； 50%或≥50%，代表骨髓脂肪含量。将视觉脂肪评分与DEXA扫描的t评分进行比较。使用Cohen和Fleiss的kappa统计来评估读者间的一致性。Spearman相关用于评估MRI分级与DEXA评分之间的关系。结果：320例患者（平均年龄56.8岁，80.3%为女性）中，48.4%有骨质减少或骨质疏松症。视觉MRI分级显示141例患者骨髓脂肪含量为50%，179例患者骨髓脂肪含量≥50%。MRI视觉脂肪评分与DEXA t评分之间存在微弱但有统计学意义的相关性（ρ = 0.139, p = 0.013）。读者间一致性中等（Cohen’s kappa = 0.509, 95% CI: 0.415 ~ 0.603）。结论：常规t1加权腰椎MRI可作为骨质疏松症的机会性筛查工具。椎骨骨髓脂肪含量的目视估计显示了识别可能从进一步DEXA评估中受益的患者的潜力。

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引用次数: 0

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