Journal of Clinical Densitometry最新文献_第8页

Fracture prediction by bone trait dis-integration using DXA among a clinical cohort of adults with cerebral palsy DXA在成年脑瘫患者临床队列中的骨性状崩解预测骨折

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-09-08 DOI: 10.1016/j.jocd.2025.101625

Daniel G. Whitney , Michelle S. Caird , Edward A. Hurvitz , Karl J. Jepsen

Introduction/background: Multi-trait vs. single trait approaches, such as dis-integration patterns of key size-mass traits, may better capture the heterogeneity of bone strength profiles for skeletally complex populations like adults with cerebral palsy (CP). The objective was to assess if dis-integration of dual-energy x-ray absorptiometry (DXA)-derived bone traits predict fracture incidence among adults with CP.

Methodology: This was a retrospective cohort study including n=75 adults with CP with a hip DXA from 01/01/2012-03/05/2021 from a single Medical Center; individuals were followed through 9/12/2023 for fracture incidence. Logistic regression estimated the odds ratio (OR) of fracture by the exposure, an interaction between (1) the residual of the BMC-area linear regression and (2) bone area, after adjusting for confounders. Discrimination (c-statistic) was assessed to compare whether the primary exposure or BMD better predicted incident fracture.

Results: Femoral neck BMC-area residual was associated fracture incidence (n=19 fractures) but was conditional on bone area (P-for-interaction, 0.026-0.067). A lower residual was associated with increased OR for smaller areas (e.g., at 10^th percentile of area, OR = 1.18; 95 %CI = 0.96-1.45), but a lower OR for larger areas (e.g., at 90^th percentile of area, OR = 0.88; 95 %CI = 0.77-1.02). The primary exposure had higher discrimination of incident fracture compared to BMD across all unadjusted and adjusted models (c-statistic range 0.69-0.84 vs. 0.49-0.79, respectively).

Conclusions: Dis-integration of key size-mass bone traits was associated with incident fracture and was a stronger predictor of fracture compared to BMD in this clinical cohort of adults with CP.

介绍/背景：多性状与单性状方法，如关键尺寸-质量性状的分解模式，可能更好地捕捉骨骼复杂人群（如脑瘫（CP）成人）骨强度谱的异质性。目的是评估双能x线吸收仪（DXA）衍生的骨骼特征的瓦解是否能预测成年CP患者的骨折发生率。方法：这是一项回顾性队列研究，包括n=75名患有髋关节DXA的成年CP患者，时间为2012年1月1日至2021年3月5日，来自单一医疗中心；随访至2023年9月12日，观察骨折发生率。在调整混杂因素后，Logistic回归通过暴露估计骨折的优势比（OR），这是(1)BMC-area线性回归的残差和(2)骨面积之间的相互作用。判别性（c-statistic）被评估来比较初次暴露或骨密度是否能更好地预测骨折。结果：股骨颈BMC-area残差与骨折发生率相关（n=19例骨折），但与骨面积有关（相互作用p值为0.026-0.067）。较低的残留与增加或较小的地区(例如,在第十百分位的区域,或 = 1.18;95 CI  % = 0.96 - -1.45),但较低的或更大的区域(例如,在第90个百分位的区域,或 = 0.88;95 CI  % = 0.77 - -1.02)。在所有未调整和调整的模型中，与骨密度相比，初次暴露对意外骨折的辨别能力更高（c-统计范围分别为0.69-0.84比0.49-0.79）。结论：在成年CP患者的临床队列中，关键尺寸-质量骨特征的解体与偶发性骨折有关，与骨密度相比，它是骨折的更强预测因子。

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引用次数: 0

Bone Health ECHO Case Report: Optimizing Bone Health in Low Fracture Risk Patient after Renal Transplant Treated with Chronic Glucocorticoids: A Case Study 骨健康ECHO病例报告：慢性糖皮质激素治疗肾移植后低骨折风险患者优化骨健康：一个病例研究

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-08-26 DOI: 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.

骨健康ECHO（扩展社区医疗保健结果）是新墨西哥大学于2015年建立的虚拟学习模型，旨在通过支持临床医生之间基于病例的讨论和最佳实践分享来增强全球骨骼医疗保健。本病例报告强调了与骨健康ECHO参与者的报告和讨论，该患者患有狼疮性肾炎并在12年前进行了肾移植，并持续使用慢性全身糖皮质激素。尽管肾功能和骨转换指标正常，但由于骨密度低于年龄预期，关于长期骨骼管理的最佳方法出现了问题。讨论提供了管理此类复杂病例的见解，强调了具有骨骼脆弱独特风险因素的患者个性化护理策略的重要性。

引用次数: 0

Graves' disease and bone mineral density: a scoping review of the impact of graves’ disease on spinal health Graves病与骨矿物质密度：Graves病对脊柱健康影响的范围综述

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-08-05 DOI: 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。

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引用次数: 0

Composite Indices of Femoral Neck Strength in Young Adult Male Volleyball Players 青年男子排球运动员股骨颈力量综合指标研究

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-07-30 DOI: 10.1016/j.jocd.2025.101622

Ibrahim Fayad, Antonio Pinti, Hassane Zouhal, Rawad El Hage

引用次数: 0

Assessing the effect of DXA scanner drift on misclassification of bone density change: The Manitoba BMD registry 评估DXA扫描仪漂移对骨密度变化误分类的影响：马尼托巴骨密度登记

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-07-22 DOI: 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.

采用双能x线骨密度仪（DXA）测量骨密度（BMD）被广泛用于评估骨质疏松症和监测未治疗和治疗个体的骨密度。DXA扫描仪可能出现系统性的误差来源，包括校准漂移。出版物建议漂移容忍度在0.5 %至1.5 %之间，但没有证据依据。本研究旨在直接确定不同程度的模拟DXA校准漂移如何影响常规临床实践中BMD变化的错误分类。使用来自马尼托巴骨密度计划的数据，我们访问了14942名年龄在40岁及以上的个体的结果，这些个体在1-5年的间隔内进行了基线和重复的全髋扇形束DXA测量。少量的模拟漂移（绝对0.003 g/cm2或相对0.25 %）影响不大，导致小于5 %的BMD变化误分类。当绝对骨密度漂移大于0.006 g/cm2或相对漂移大于0.75 %时，误分类率超过10 %；当绝对骨密度漂移大于0.024 g/cm2时，误分类率大于35 %。当根据抗骨质疏松药物的使用、改变最不显著变化（LSC）和评估腰椎骨密度变化对结果进行分层时，也可以看到类似的趋势。综上所述，相对较小程度的DXA校准漂移可能对BMD变化的错误分类产生很大影响。我们的结果支持0.006 g/cm2或0.5 %的校准漂移公差。这些发现可能有助于指导DXA扫描仪维修和修复的时机。

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引用次数: 0

Relationships between physical activity and bone mineral content and lean mass in Mexican adolescents 墨西哥青少年体力活动与骨矿物质含量和瘦体重的关系。

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-07-16 DOI: 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.

介绍/背景：骨骼的机械环境显著影响骨骼和瘦骨量健康的获得和维持，其中体力活动是一个重要因素。我们的假设提出，高强度的体育活动可以改善健康青少年的骨矿物质含量和瘦质量关系，这取决于性别、青春期成熟度和骨骼位置。方法：我们评估了墨西哥儿童和青少年的骨矿物质含量、全身和四肢瘦质量与闲暇时间体育活动之间的关系。我们使用来自“墨西哥儿童和青少年身体成分参考值研究”的数据进行了分析，这是一项基于人群的横断面研究。采用标准化方案，使用Lunar iDXA仪器测量全身骨矿物质含量和瘦质量。使用一份适用于墨西哥人口的有效问卷，确定了休闲时间的身体活动水平和“不活跃”状态。采用方差分析（ANOVA）检验评价曲线的拟合性，得出最优拟合方程。此外，我们使用ANCOVA检验来评估曲线的斜率和截距之间的差异。结果：骨矿物质含量和瘦体重之间的所有关系在不同地区的所有Tanner阶段都非常显著(P 结论：这些结果强调了休闲时间体育活动和Tanner阶段对观察到的关系的细微影响，表明在青春期后期从事特定的体育活动对骨骼健康有潜在的好处。

{"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}

引用次数: 0

The interface of a leaky gut with neuromuscular junction degradation; implications for severe sarcopenia 伴有神经肌肉连接处退化的漏肠界面；对严重肌肉减少症的影响

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-07-16 DOI: 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.

导读：肠通透性或漏肠的病理增加最近与年龄相关的肌肉损失的发病机制有关，称为肌肉减少症。然而，相关的肌毒性作用尚不清楚。我们研究了在老年人严重肌肉减少症和功能损害的情况下，漏肠与神经肌肉接头（NMJ）退化的关系。方法：本研究纳入对照组（n=161，年龄=73.4±8.5岁）和重度肌少症男性（n=148，年龄=72.4±7.2岁），测量漏肠血浆标志物（zonulin）、NMJ降解（CAF22）和细菌负荷(脂多糖结合蛋白；LBP)。我们还分别测量了握力（HGS）、步态速度和短物理性能电池（SPPB）作为肌肉减少和功能损害的标志。结果：重度肌少症患者血浆zonulin、CAF22和LBP水平高于对照组，HGS、步态速度和SPPB评分低于对照组（p < 0.05）。我们发现血浆zonulin和CAF22在对照组和严重肌少症男性中存在显著相关性（p < 0.05）。存在严重的肌肉减少症和SPPB评分<；9例与zonulin与CAF22相关性增强相关（p < 0.05）。较高的血浆zonulin和CAF22与较高的血浆LBP、较低的HGS和步态速度以及较低的SPPB评分相关（均p < 0.05）。结论：肠道渗漏引起的严重肌肉减少症和功能损害可能与NMJ降解和血浆细菌负荷升高有关。未来的研究应该建立肠道渗漏和老年肌肉减少症之间的因果关系和机制联系。

{"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}

引用次数: 0

Bone health of underprivileged Indian children with type-1 diabetes one year after discontinuation of milk and pharmacological calcium supplementation: a follow-up study 贫困的印度1型糖尿病儿童在停止牛奶和药理学补钙一年后的骨骼健康：一项随访研究

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-07-08 DOI: 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

引用次数: 0

Development of AI model for dual detection of low bone mineral density in the femoral neck and lumbar vertebrae using chest radiographs 利用胸片双重检测股骨颈和腰椎低骨密度的AI模型的开发

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-07-08 DOI: 10.1016/j.jocd.2025.101604

Yukino Ohta , Kouichi Yamamoto , Yutaka Katayama , Takahiro Ideta , Hiroaki Matsuzawa , Takao Ichida , Akane Utsunomiya , Takayuki Ishida

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.

人工智能（AI）技术在胸部x线片上检测整体骨质疏松症的准确性很高，为快速和容易获得的骨质疏松症筛查提供了巨大的潜力。然而，由于骨质流失因生活方式和体型而异，检测特定部位的低骨密度（BMD）对于早期治疗至关重要。本研究开发并评估了两种深度学习模型，用于检测股骨颈和腰椎的低骨密度。方法：资料包括2,728名女性体检者的胸片和双能x线骨密度仪（DXA）测量的骨密度值[g/cm2]。胸片根据股骨颈（低：1358，正常：1370）和腰椎（低：562，正常：2166）分为低骨密度或正常。深度学习模型使用ResNet50架构进行训练，并进行微调和10倍交叉验证。性能指标包括灵敏度、特异性、总体准确度和曲线下面积（AUC）。使用可解释的人工智能生成的与低骨密度相关的可视化区域热图。结果：该模型对股骨颈检测的总准确率为75.3 % (AUC: 0.82)，腰椎检测的总准确率为89.3% % （AUC: 0.96）。腰椎检测的准确率比股骨颈高14.0 %。腰椎骨密度低的患者比单纯股骨颈骨密度低的患者表现出更严重的骨质流失。热图显示锁骨和胸椎附近的相关区域。结论：该模型能准确地检测胸片中的低骨密度，并识别骨质流失区域，在腰椎检测方面表现出特别高的性能。早期发现低骨密度可以简单、有效地进行筛查，并根据骨质流失的区域进行针对性的预防或治疗。

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引用次数: 0

The Relationship Between Antihypertensive Drugs and Osteoporosis in Postmenopausal Women: The ADiOS Study 绝经后妇女降压药与骨质疏松的关系：ADiOS研究

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-07-04 DOI: 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。

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引用次数: 0