Pub Date : 2025-08-26DOI: 10.1016/j.jocd.2025.101624
Asma Aljaberi , S. Bobo Tanner , E. Michael Lewiecki
Bone Health ECHO (Extension for Community Healthcare Outcomes) is a virtual learning model established by University of New Mexico in 2015 to enhance global skeletal healthcare by supporting case-based discussions and best-practice sharing among clinicians. This case report highlights the presentation and discussion with Bone Health ECHO participants of a young patient with a history of lupus nephritis and a renal transplant 12 years prior, and maintained on chronic systemic glucocorticoids. Despite normal renal function and bone turnover markers, questions arose regarding the optimal approach to long-term skeletal management as the bone mass density is below expected for age. The discussion provided insights into managing such complex cases, emphasizing the importance of individualized care strategies in patients with unique risk factors for skeletal fragility.
{"title":"Bone Health ECHO Case Report: Optimizing Bone Health in Low Fracture Risk Patient after Renal Transplant Treated with Chronic Glucocorticoids: A Case Study","authors":"Asma Aljaberi , S. Bobo Tanner , E. Michael Lewiecki","doi":"10.1016/j.jocd.2025.101624","DOIUrl":"10.1016/j.jocd.2025.101624","url":null,"abstract":"<div><div>Bone Health ECHO (Extension for Community Healthcare Outcomes) is a virtual learning model established by University of New Mexico in 2015 to enhance global skeletal healthcare by supporting case-based discussions and best-practice sharing among clinicians. This case report highlights the presentation and discussion with Bone Health ECHO participants of a young patient with a history of lupus nephritis and a renal transplant 12 years prior, and maintained on chronic systemic glucocorticoids. Despite normal renal function and bone turnover markers, questions arose regarding the optimal approach to long-term skeletal management as the bone mass density is below expected for age. The discussion provided insights into managing such complex cases, emphasizing the importance of individualized care strategies in patients with unique risk factors for skeletal fragility.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101624"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104410","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}
Pub Date : 2025-08-05DOI: 10.1016/j.jocd.2025.101621
Mira Al Shoufy , Jamil Nasrallah , Kholoud Al Jebawi , Hady El Etry , Murtaja Satea Shafeea , Ibrahim Hassan , Haya Mohamed , Naseeb Danaf , Hossam Tharwat Ali
Graves' disease, an autoimmune hyperthyroid disorder, negatively affects bone health by increasing osteoclast activity, leading to decreased bone mineral density (BMD) and heightened osteoporosis risk. Bone loss may persist even after thyroid levels normalize, possibly due to thyroid-stimulating hormone receptor antibodies (TRAb). This scoping review evaluates the impact of Graves' disease and its treatment on BMD, focusing on TRAb's role in bone loss. Using Arksey and O’Malley's framework, we searched Medline/PubMed, Scopus, Web of Science, and Cochrane Library for English-language studies on the effects of Graves' disease on adult spine-related bone health. From 2,226 records, 16 studies met the inclusion criteria after screening titles, abstracts, and full texts. Studies focusing primarily on postmenopausal women and older men consistently showed reduced BMD in patients with Graves' disease, especially in the lumbar spine. Elevated TRAb levels correlated with lower BMD, suggesting that TRAb contributes to ongoing bone loss despite achieving an euthyroid state. Anti-thyroid drug therapy partially improved BMD, but bone loss often persisted. Combining bisphosphonates with anti-thyroid therapy enhanced BMD recovery more than anti-thyroid therapy alone. Graves' disease affects bone health through thyroid hormone excess and TRAb-mediated autoimmunity, with persistent bone loss even after achieving an euthyroid state. High-risk groups like postmenopausal women and older men require targeted strategies addressing both thyroid and skeletal health. Future research should focus on therapies targeting TRAb and improving osteoporosis prevention to enhance outcomes.
Graves病是一种自身免疫性甲状腺功能亢进疾病，通过增加破骨细胞活性，导致骨密度（BMD）下降和骨质疏松症风险增加，对骨骼健康产生负面影响。即使甲状腺水平恢复正常，骨质流失仍可能持续存在，这可能是由于促甲状腺激素受体抗体（TRAb）所致。本综述评估了Graves病及其治疗对骨密度的影响，重点关注TRAb在骨质流失中的作用。使用Arksey和O ' malley的框架，我们检索了Medline/PubMed、Scopus、Web of Science和Cochrane Library，查找有关Graves病对成人脊柱相关骨骼健康影响的英语研究。从2226条记录中，筛选标题、摘要和全文后，有16项研究符合纳入标准。主要针对绝经后女性和老年男性的研究一致表明，Graves病患者的骨密度降低，尤其是腰椎。TRAb水平升高与较低的骨密度相关，表明TRAb有助于持续的骨质流失，尽管达到了甲状腺功能正常的状态。抗甲状腺药物治疗部分改善了骨密度，但骨质流失往往持续存在。双膦酸盐联合抗甲状腺治疗比单独抗甲状腺治疗更能促进骨密度恢复。Graves病通过甲状腺激素过量和trab介导的自身免疫影响骨骼健康，即使在达到甲状腺功能正常状态后也会持续骨质流失。像绝经后妇女和老年男性这样的高危人群需要针对甲状腺和骨骼健康的针对性策略。未来的研究应侧重于针对TRAb的治疗和改善骨质疏松症的预防，以提高疗效。
{"title":"Graves' disease and bone mineral density: a scoping review of the impact of graves’ disease on spinal health","authors":"Mira Al Shoufy , Jamil Nasrallah , Kholoud Al Jebawi , Hady El Etry , Murtaja Satea Shafeea , Ibrahim Hassan , Haya Mohamed , Naseeb Danaf , Hossam Tharwat Ali","doi":"10.1016/j.jocd.2025.101621","DOIUrl":"10.1016/j.jocd.2025.101621","url":null,"abstract":"<div><div>Graves' disease, an autoimmune hyperthyroid disorder, negatively affects bone health by increasing osteoclast activity, leading to decreased bone mineral density (BMD) and heightened osteoporosis risk. Bone loss may persist even after thyroid levels normalize, possibly due to thyroid-stimulating hormone receptor antibodies (TRAb). This scoping review evaluates the impact of Graves' disease and its treatment on BMD, focusing on TRAb's role in bone loss. Using Arksey and O’Malley's framework, we searched Medline/PubMed, Scopus, Web of Science, and Cochrane Library for English-language studies on the effects of Graves' disease on adult spine-related bone health. From 2,226 records, 16 studies met the inclusion criteria after screening titles, abstracts, and full texts. Studies focusing primarily on postmenopausal women and older men consistently showed reduced BMD in patients with Graves' disease, especially in the lumbar spine. Elevated TRAb levels correlated with lower BMD, suggesting that TRAb contributes to ongoing bone loss despite achieving an euthyroid state. Anti-thyroid drug therapy partially improved BMD, but bone loss often persisted. Combining bisphosphonates with anti-thyroid therapy enhanced BMD recovery more than anti-thyroid therapy alone. Graves' disease affects bone health through thyroid hormone excess and TRAb-mediated autoimmunity, with persistent bone loss even after achieving an euthyroid state. High-risk groups like postmenopausal women and older men require targeted strategies addressing both thyroid and skeletal health. Future research should focus on therapies targeting TRAb and improving osteoporosis prevention to enhance outcomes.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"29 1","pages":"Article 101621"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435550","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}
Pub Date : 2025-07-30DOI: 10.1016/j.jocd.2025.101622
Ibrahim Fayad, Antonio Pinti, Hassane Zouhal, Rawad El Hage
{"title":"Composite Indices of Femoral Neck Strength in Young Adult Male Volleyball Players","authors":"Ibrahim Fayad, Antonio Pinti, Hassane Zouhal, Rawad El Hage","doi":"10.1016/j.jocd.2025.101622","DOIUrl":"10.1016/j.jocd.2025.101622","url":null,"abstract":"","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101622"},"PeriodicalIF":1.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810445","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}
Pub Date : 2025-07-22DOI: 10.1016/j.jocd.2025.101620
William D. Leslie , Sajjad Aftabi , John T. Schousboe , Diane Krueger , Neil Binkley
Bone mineral density (BMD) measurement with dual-energy X-ray absorptiometry (DXA) is widely used to assess osteoporosis and monitor BMD in untreated and treated individuals. Systematic sources of error can occur with DXA scanners, including calibration drift. Publications suggest a drift tolerance in the range 0.5 % to 1.5 %, but are not evidence- based. The current study was performed to directly determine how varying degrees of simulated DXA calibration drift would affect misclassification of BMD change in routine clinical practice. Using data from the Manitoba Bone Density Program, we accessed results for 14,942 individuals age 40 years and older undergoing baseline and repeat fan-beam DXA measurements of the total hip within an interval of 1-5 years. A small amount of simulated drift (absolute 0.003 g/cm2 or relative 0.25 %) had little effect, and resulted in less than 5 % BMD change misclassification. Misclassification exceeded 10 % with absolute BMD drift greater than 0.006 g/cm2 or relative drift over 0.75 %, and was greater than 35 % for absolute BMD drift of 0.024 g/cm2. Similar trends were seen when results were stratified according to use of anti-osteoporosis medication, when varying the least significant change (LSC), and for evaluating lumbar spine BMD change. In summary, relatively small degrees of DXA calibration drift can have large effects on misclassifying BMD change. Our results support a calibration drift tolerance of 0.006 g/cm2 or 0.5 %. These findings may help to guide timing for DXA scanner servicing and repair.
{"title":"Assessing the effect of DXA scanner drift on misclassification of bone density change: The Manitoba BMD registry","authors":"William D. Leslie , Sajjad Aftabi , John T. Schousboe , Diane Krueger , Neil Binkley","doi":"10.1016/j.jocd.2025.101620","DOIUrl":"10.1016/j.jocd.2025.101620","url":null,"abstract":"<div><div>Bone mineral density (BMD) measurement with dual-energy X-ray absorptiometry (DXA) is widely used to assess osteoporosis and monitor BMD in untreated and treated individuals. Systematic sources of error can occur with DXA scanners, including calibration drift. Publications suggest a drift tolerance in the range 0.5 % to 1.5 %, but are not evidence- based. The current study was performed to directly determine how varying degrees of simulated DXA calibration drift would affect misclassification of BMD change in routine clinical practice. Using data from the Manitoba Bone Density Program, we accessed results for 14,942 individuals age 40 years and older undergoing baseline and repeat fan-beam DXA measurements of the total hip within an interval of 1-5 years. A small amount of simulated drift (absolute 0.003 g/cm<sup>2</sup> or relative 0.25 %) had little effect, and resulted in less than 5 % BMD change misclassification. Misclassification exceeded 10 % with absolute BMD drift greater than 0.006 g/cm<sup>2</sup> or relative drift over 0.75 %, and was greater than 35 % for absolute BMD drift of 0.024 g/cm<sup>2</sup>. Similar trends were seen when results were stratified according to use of anti-osteoporosis medication, when varying the least significant change (LSC), and for evaluating lumbar spine BMD change. In summary, relatively small degrees of DXA calibration drift can have large effects on misclassifying BMD change. Our results support a calibration drift tolerance of 0.006 g/cm<sup>2</sup> or 0.5 %. These findings may help to guide timing for DXA scanner servicing and repair.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101620"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771374","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}
Pub Date : 2025-07-16DOI: 10.1016/j.jocd.2025.101619
Edgar Denova-Gutiérrez , Desiree López-González , Patricia Clark , Paloma Muñoz-Aguirre , Ricardo Francisco Capozza , Jose Luis Ferretti , Gustavo Roberto Cointry
Introduction/Background: The acquisition and maintenance of bone and lean mass health are significantly influenced by the mechanical environment of the skeleton, with physical activity emerging as an important factor. Our hypothesis proposes that high-impact physical activity improves bone mineral content and lean mass relationship in healthy adolescents depending on gender, pubertal maturity and skeletal location.
Methodology: We assessed the relation between bone mineral content, and lean mass in whole-body and limbs and leisure-time physical activity in Mexican children and adolescents. We conducted an analysis using data from the “Reference values of body composition in Mexican children and adolescents’ study”, which is a population-based, cross-sectional study. Using standardized protocols, Lunar iDXA instrumentation was used to measure whole-body bone mineral content and lean mass. Using a validated questionnaire, adapted for the Mexican population, the leisure-time physical activity level and the “inactive” condition were determined. ANOVA test was conducted to evaluate curve fitness and produce best-fit equations. Additionally, we used ANCOVA test to evaluate the differences between slopes and intercepts of the curves.
Results: All relationships between bone mineral content and lean mass across various regions were highly significant for all Tanner stages (P < 0.001), irrespective of the type of physical activity. Examining all regions (whole-body bone mineral content vs. whole-body lean mass and lower limbs bone mineral content and lean mass, and upper limbs bone mineral content and lean mass) intercepts were significantly higher in Tanner stage 3-5 compared to Tanner stage 1-2 for both genders (P < 0.001).
Conclusion: These results underscore the nuanced impact of leisure-time physical activity and Tanner stage on the observed relationships, suggesting potential benefits of engaging in specific physical activities during adolescence for bone health during the later stages of puberty.
{"title":"Relationships between physical activity and bone mineral content and lean mass in Mexican adolescents","authors":"Edgar Denova-Gutiérrez , Desiree López-González , Patricia Clark , Paloma Muñoz-Aguirre , Ricardo Francisco Capozza , Jose Luis Ferretti , Gustavo Roberto Cointry","doi":"10.1016/j.jocd.2025.101619","DOIUrl":"10.1016/j.jocd.2025.101619","url":null,"abstract":"<div><div><em>Introduction/Background:</em> The acquisition and maintenance of bone and lean mass health are significantly influenced by the mechanical environment of the skeleton, with physical activity emerging as an important factor. Our hypothesis proposes that high-impact physical activity improves bone mineral content and lean mass relationship in healthy adolescents depending on gender, pubertal maturity and skeletal location.</div><div><em>Methodology:</em> We assessed the relation between bone mineral content, and lean mass in whole-body and limbs and leisure-time physical activity in Mexican children and adolescents. We conducted an analysis using data from the “Reference values of body composition in Mexican children and adolescents’ study”, which is a population-based, cross-sectional study. Using standardized protocols, Lunar iDXA instrumentation was used to measure whole-body bone mineral content and lean mass. Using a validated questionnaire, adapted for the Mexican population, the leisure-time physical activity level and the “inactive” condition were determined. ANOVA test was conducted to evaluate curve fitness and produce best-fit equations. Additionally, we used ANCOVA test to evaluate the differences between slopes and intercepts of the curves.</div><div><em>Results:</em> All relationships between bone mineral content and lean mass across various regions were highly significant for all Tanner stages (<em>P</em> < 0.001), irrespective of the type of physical activity. Examining all regions (whole-body bone mineral content vs. whole-body lean mass and lower limbs bone mineral content and lean mass, and upper limbs bone mineral content and lean mass) intercepts were significantly higher in Tanner stage 3-5 compared to Tanner stage 1-2 for both genders (<em>P</em> < 0.001).</div><div><em>Conclusion:</em> These results underscore the nuanced impact of leisure-time physical activity and Tanner stage on the observed relationships, suggesting potential benefits of engaging in specific physical activities during adolescence for bone health during the later stages of puberty.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101619"},"PeriodicalIF":1.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769224","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}
Pub Date : 2025-07-16DOI: 10.1016/j.jocd.2025.101618
Rizwan Qaisar , Asima Karim , Tahir Muhammad , Shaea A Alkahtani , Firdos Ahmad
Introduction: A pathological increase in intestinal permeability or leaky gut is recently implicated in the pathogenesis of age-associated muscle loss, termed sarcopenia. However, the associated myotoxic effects are poorly known. We investigated the associations of a leaky gut with neuromuscular junction (NMJ) degradation in the context of severe sarcopenia and functional compromise in older adults.
Methodology: This study includes controls (n=161, age=73.4±8.5 years) and severe sarcopenic men (n=148, age=72.4±7.2 years) for measurements of plasma markers of a leaky gut (zonulin), NMJ degradation (CAF22), and bacterial load (lipopolysaccharides-binding protein; LBP). We also measured handgrip strength (HGS), gait speed, and short physical performance battery (SPPB) as sarcopenic and functional compromise markers, respectively.
Results: Severe sarcopenic patients had higher plasma zonulin, CAF22, and LBP levels and lower HGS, gait speed, and SPPB scores than controls (all p<0.05). We found significant correlations between plasma zonulin and CAF22 in controls and severe sarcopenic men (both p<0.05). The presence of severe sarcopenia and SPPB scores < 9 were associated with strengthening the correlation between zonulin and CAF22 (p<0.05). Higher plasma zonulin and CAF22 were associated with higher plasma LBP, lower HGS and gait speed, and lower SPPB scores (all p<0.05).
Conclusion: Collectively, severe sarcopenia and functional compromise due to intestinal leak may involve NMJ degradation and higher plasma bacterial load. Future studies should establish the causal and mechanistic associations between intestinal leak and sarcopenia in old age.
{"title":"The interface of a leaky gut with neuromuscular junction degradation; implications for severe sarcopenia","authors":"Rizwan Qaisar , Asima Karim , Tahir Muhammad , Shaea A Alkahtani , Firdos Ahmad","doi":"10.1016/j.jocd.2025.101618","DOIUrl":"10.1016/j.jocd.2025.101618","url":null,"abstract":"<div><div><em>Introduction:</em> A pathological increase in intestinal permeability or leaky gut is recently implicated in the pathogenesis of age-associated muscle loss, termed sarcopenia. However, the associated myotoxic effects are poorly known. We investigated the associations of a leaky gut with neuromuscular junction (NMJ) degradation in the context of severe sarcopenia and functional compromise in older adults.</div><div><em>Methodology:</em> This study includes controls (n=161, age=73.4±8.5 years) and severe sarcopenic men (n=148, age=72.4±7.2 years) for measurements of plasma markers of a leaky gut (zonulin), NMJ degradation (CAF22), and bacterial load (lipopolysaccharides-binding protein; LBP). We also measured handgrip strength (HGS), gait speed, and short physical performance battery (SPPB) as sarcopenic and functional compromise markers, respectively.</div><div><em>Results:</em> Severe sarcopenic patients had higher plasma zonulin, CAF22, and LBP levels and lower HGS, gait speed, and SPPB scores than controls (all p<0.05). We found significant correlations between plasma zonulin and CAF22 in controls and severe sarcopenic men (both p<0.05). The presence of severe sarcopenia and SPPB scores < 9 were associated with strengthening the correlation between zonulin and CAF22 (p<0.05). Higher plasma zonulin and CAF22 were associated with higher plasma LBP, lower HGS and gait speed, and lower SPPB scores (all p<0.05).</div><div><em>Conclusion:</em> Collectively, severe sarcopenia and functional compromise due to intestinal leak may involve NMJ degradation and higher plasma bacterial load. Future studies should establish the causal and mechanistic associations between intestinal leak and sarcopenia in old age.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101618"},"PeriodicalIF":1.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712936","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}
Pub Date : 2025-07-08DOI: 10.1016/j.jocd.2025.101616
Dr. Chirantap Oza, Dr. Anuradha Khadilkar, Dr. Neha Kajale, Dr. Shital Bhor, Dr. Dipali Ladkat, Dr. Raja Padidela, Dr. Zulf Mughal
{"title":"Bone health of underprivileged Indian children with type-1 diabetes one year after discontinuation of milk and pharmacological calcium supplementation: a follow-up study","authors":"Dr. Chirantap Oza, Dr. Anuradha Khadilkar, Dr. Neha Kajale, Dr. Shital Bhor, Dr. Dipali Ladkat, Dr. Raja Padidela, Dr. Zulf Mughal","doi":"10.1016/j.jocd.2025.101616","DOIUrl":"10.1016/j.jocd.2025.101616","url":null,"abstract":"","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101616"},"PeriodicalIF":1.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695169","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}
Introduction: Artificial intelligence (AI) technologies have demonstrated high accuracy in detecting overall osteoporosis on chest radiographs, offering significant potential for rapid and accessible osteoporosis screening. However, as bone loss varies by lifestyle and body shape, detecting low bone mineral density (BMD) in specific parts is crucial for early treatment. This study developed and evaluated two deep learning models to detect low BMD in the femoral neck and lumbar vertebrae.
Methods: Data included chest radiographs and dual-energy X-ray absorptiometry (DXA)-measured BMD values [g/cm2] of 2,728 female examinees. Chest radiographs were categorized into low BMD or normal based on the femoral neck (low: 1,358, normal: 1,370) and lumbar vertebrae (low: 562, normal: 2,166). Deep learning models were trained using the ResNet50 architecture with fine-tuning and 10-fold cross-validation. Performance metrics included sensitivity, specificity, overall accuracy, and area under the curve (AUC). Heatmaps generated using Explainable AI visualized regions related to low BMD.
Results: The model achieved 75.3 % overall accuracy (AUC: 0.82) for femoral neck detection and 89.3 % (AUC: 0.96) for lumbar vertebrae detection. Lumbar vertebrae detection showed 14.0 % higher accuracy than the femoral neck. Patients with lumbar vertebrae low BMD exhibited more advanced bone loss compared to those with femoral neck low BMD alone. Heatmaps indicated relevant regions near the clavicle and thoracic vertebrae.
Conclusion: The proposed model accurately detected low BMD in chest radiographs and identified areas of bone loss, demonstrating particularly high performance in lumbar vertebrae detection. Early identification of low BMD enables simple, effective screening and targeted prevention or treatment based on areas of bone loss.
{"title":"Development of AI model for dual detection of low bone mineral density in the femoral neck and lumbar vertebrae using chest radiographs","authors":"Yukino Ohta , Kouichi Yamamoto , Yutaka Katayama , Takahiro Ideta , Hiroaki Matsuzawa , Takao Ichida , Akane Utsunomiya , Takayuki Ishida","doi":"10.1016/j.jocd.2025.101604","DOIUrl":"10.1016/j.jocd.2025.101604","url":null,"abstract":"<div><div><em>Introduction:</em> Artificial intelligence (AI) technologies have demonstrated high accuracy in detecting overall osteoporosis on chest radiographs, offering significant potential for rapid and accessible osteoporosis screening. However, as bone loss varies by lifestyle and body shape, detecting low bone mineral density (BMD) in specific parts is crucial for early treatment. This study developed and evaluated two deep learning models to detect low BMD in the femoral neck and lumbar vertebrae.</div><div><em>Methods:</em> Data included chest radiographs and dual-energy X-ray absorptiometry (DXA)-measured BMD values [g/cm<sup>2</sup>] of 2,728 female examinees. Chest radiographs were categorized into low BMD or normal based on the femoral neck (low: 1,358, normal: 1,370) and lumbar vertebrae (low: 562, normal: 2,166). Deep learning models were trained using the ResNet50 architecture with fine-tuning and 10-fold cross-validation. Performance metrics included sensitivity, specificity, overall accuracy, and area under the curve (AUC). Heatmaps generated using Explainable AI visualized regions related to low BMD.</div><div><em>Results:</em> The model achieved 75.3 % overall accuracy (AUC: 0.82) for femoral neck detection and 89.3 % (AUC: 0.96) for lumbar vertebrae detection. Lumbar vertebrae detection showed 14.0 % higher accuracy than the femoral neck. Patients with lumbar vertebrae low BMD exhibited more advanced bone loss compared to those with femoral neck low BMD alone. Heatmaps indicated relevant regions near the clavicle and thoracic vertebrae.</div><div><em>Conclusion:</em> The proposed model accurately detected low BMD in chest radiographs and identified areas of bone loss, demonstrating particularly high performance in lumbar vertebrae detection. Early identification of low BMD enables simple, effective screening and targeted prevention or treatment based on areas of bone loss.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101604"},"PeriodicalIF":1.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713041","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}
Pub Date : 2025-07-04DOI: 10.1016/j.jocd.2025.101607
Pelin Analay , Murat Kara , Hatice Gülgün Fırat , Ahmet Furkan Çolak , Kübra Erdoğan , Mahmud Fazıl Aksakal , Berkay Yalçınkaya , Kübranur Demirel , Hazal Sevinç , Sena Küçüktoksöz , Hilmi Berkan Abacıoğlu , Mustafa Güngör Albayrak , Alpaslan Fatih Kaynar , Orhun Tunahan Cingöz , Ahmad Jasem Abdulsalam , Özgür Kara , Ahmet Sertçelik , Bayram Kaymak , Banu Çakır , Levent Özçakar
Introduction: Hypertension (HT) and osteoporosis (OP) are common chronic diseases that often coexist in postmenopausal women. This study aimed to investigate the association between the use of antihypertensive medications and the presence of OP.
Methods: We retrospectively analyzed the medical records of 4166 postmenopausal women. Demographic data, age, weight, height, comorbidities, medications and bone mineral density values were collected for all patients screened/followed for OP between 2023 and 2024.
Results: Out of 4166 postmenopausal women, 1659 (39.8 %) were diagnosed with OP. After adjusting for potential confounders using binary logistic regression, diabetes mellitus [OR=0.785 (95 % CI=0.667-0.925) p = 0.004] and hyperlipidemia [OR=0.826 (95 % CI=0.698-0.978) p = 0.026] were negatively associated with OP. Among the antihypertensive medications (N = 2144); furosemide use [OR=1.918 (95 % CI=1.157-3.182) p = 0.012] was positively associated with OP, while thiazide use showed a negative association [OR=0.769 (95 % CI=0.619-0.954) p = 0.017].
Conclusions: Thiazide use was associated with a lower likelihood of OP, while furosemide use was linked to increased odds (about 1.9 times). Further research with larger samples and stratified analyses of antihypertensive classes is warranted to better understand these associations.
高血压（HT）和骨质疏松症（OP）是绝经后妇女常见的慢性疾病。本研究旨在探讨降压药的使用与op的关系。方法：回顾性分析4166例绝经后妇女的医疗记录。收集2023年至2024年间所有OP筛查/随访患者的人口统计学数据、年龄、体重、身高、合并症、药物和骨密度值。结果：在4166名绝经后妇女中，1659名（39.8%）被诊断为op。使用二元logistic回归校正潜在混杂因素后，糖尿病[OR=0.785 (95% CI=0.667-0.925) p = 0.004]和高脂血症[OR=0.826 (95% CI=0.698-0.978) p = 0.026]与op呈负相关。降压药物（N = 2144）；速尿使用与OP呈正相关[OR=1.918 (95% CI=1.157 ~ 3.182) p = 0.012]，噻嗪类药物使用与OP呈负相关[OR=0.769 (95% CI=0.619 ~ 0.954) p = 0.017]。结论：噻嗪类药物的使用与OP的可能性降低有关，而速尿的使用与OP的可能性增加有关（约1.9倍）。为了更好地了解这些关联，有必要进一步研究更大的样本和降压药类别的分层分析。
{"title":"The Relationship Between Antihypertensive Drugs and Osteoporosis in Postmenopausal Women: The ADiOS Study","authors":"Pelin Analay , Murat Kara , Hatice Gülgün Fırat , Ahmet Furkan Çolak , Kübra Erdoğan , Mahmud Fazıl Aksakal , Berkay Yalçınkaya , Kübranur Demirel , Hazal Sevinç , Sena Küçüktoksöz , Hilmi Berkan Abacıoğlu , Mustafa Güngör Albayrak , Alpaslan Fatih Kaynar , Orhun Tunahan Cingöz , Ahmad Jasem Abdulsalam , Özgür Kara , Ahmet Sertçelik , Bayram Kaymak , Banu Çakır , Levent Özçakar","doi":"10.1016/j.jocd.2025.101607","DOIUrl":"10.1016/j.jocd.2025.101607","url":null,"abstract":"<div><div><em>Introduction:</em> Hypertension (HT) and osteoporosis (OP) are common chronic diseases that often coexist in postmenopausal women. This study aimed to investigate the association between the use of antihypertensive medications and the presence of OP.</div><div><em>Methods:</em> We retrospectively analyzed the medical records of 4166 postmenopausal women. Demographic data, age, weight, height, comorbidities, medications and bone mineral density values were collected for all patients screened/followed for OP between 2023 and 2024.</div><div><em>Results:</em> Out of 4166 postmenopausal women, 1659 (39.8 %) were diagnosed with OP. After adjusting for potential confounders using binary logistic regression, diabetes mellitus [OR=0.785 (95 % CI=0.667-0.925) <em>p = </em>0.004] and hyperlipidemia [OR=0.826 (95 % CI=0.698-0.978) <em>p = </em>0.026] were negatively associated with OP. Among the antihypertensive medications (<em>N = </em>2144); furosemide use [OR=1.918 (95 % CI=1.157-3.182) <em>p = </em>0.012] was positively associated with OP, while thiazide use showed a negative association [OR=0.769 (95 % CI=0.619-0.954) <em>p = </em>0.017].</div><div><em>Conclusions:</em> Thiazide use was associated with a lower likelihood of OP, while furosemide use was linked to increased odds (about 1.9 times). Further research with larger samples and stratified analyses of antihypertensive classes is warranted to better understand these associations.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101607"},"PeriodicalIF":1.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711872","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}
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