Archives of Osteoporosis最新文献

Background

Osteoporosis and subsequent fractures not only seriously threaten the health of the aging but also escalate healthcare costs and social burdens. Undoubtedly, it is necessary to constantly optimize the diagnosis and treatment of osteoporotic fractures, and further understanding and investigation of the related studies is indispensable. However, the research on osteoporotic fractures is difficult to summarize, with complicated content and multiple disciplines involved. Consequently, this bibliometric analysis was conducted to gain a comprehensive understanding and grasp the hot topic of osteoporosis worldwide, which is beneficial to precisely guide research trends and demonstrate emerging treatments and preventive strategies.

Methods

The literature published between January 2014 and October 2024 was systematically searched in the Web of Science Core Collection (WoSCC). Visualization software, including Vosviewer and CiteSpace, was used to conduct the analysis.

Results

A total of 6682 publications were obtained from 2014 to 2024 for bibliometric analysis. The USA is far ahead of other countries in both the number of publications and frequency of citations, with extensive co-authorship collaborations with nearly all other countries. Cyrus Cooper is the most influential author, and the University of Sheffield is the most influential organization in the related fields. The keywords are categorized as 6 clusters, including “hip fracture,” “bone turnover,” “denosumab,” “atypical femoral fracture,” “vitamin D,” and “bone strength”. The ongoing hotspots include “teriparatide,” “hip,” “fragility fractures,” and “outcome”.

Conclusion

This study comprehensively summarizes the topic trends and developments in the field of osteoporotic fractures using bibliometric analysis over the past decade. The hotspots and frontiers mainly focused on the prediction of osteoporosis and fractures, drug treatment, and clinical management. The intersection of multiple disciplines and various emerging frontiers has provided great potential for the management of osteoporotic fractures. Further investigation and more clinical translation are necessary.

Summary

This study examined whether fatty liver increases the risk of osteoporosis. Over 12 years, people with nonalcoholic fatty liver disease had a significantly higher risk of developing osteoporosis. These findings highlight the importance of bone health monitoring in middle-aged adults with fatty liver.

Background

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, resulting in increased bone fragility and fracture risk. Recent studies have suggested a potential association between nonalcoholic fatty liver disease (NAFLD) and osteoporosis; however, findings have been inconsistent. The aim of this study was to investigate the longitudinal association between NAFLD and osteoporosis in a middle-aged Korean population.

Methods

A total of 5,149 individuals (2,386 men and 2,763 women) aged 40–60 years were included in the Korean Genome and Epidemiology Study, after excluding those with liver disease, heavy alcohol consumption, or osteoporosis at baseline. Osteoporosis was defined as a T-score ≤ -2.5 at any site, and normal bone density as a T-score ≥ -1.0, based on World Health Organization criteria. Participants were categorized into three groups according to their fatty liver index (FLI): non-NAFLD (< 30), intermediate (30–59), and NAFLD (≥ 60). Multivariable Cox proportional hazards regression was used to assess the risk of osteoporosis across FLI categories. Propensity score (PS) matching was performed to further assess the association between NAFLD and osteoporosis.

Results

Over a 12-years follow-up, the incidence of osteoporosis was 10.52% in the non-NAFLD group, 13.79% in the intermediate group, and 13.03% in the NAFLD groups, showing a significant linear trend (p for trend = 0.002). After adjusting for potential confounders, the hazard ratios (95% confidence interval) were 1.36 (1.09–1.70) in the intermediate group and 1.80 (1.30–2.49) in the NAFLD group, compared with the non-NAFLD group. In postmenopausal women, the association between NAFLD and increased risk of osteoporosis remained significant after adjusting for confounders. Furthermore, among the PS-matched participants (449 pairs), the NAFLD group showed a significantly higher risk of osteoporosis than the non-NAFLD group.

Conclusion

NAFLD was independently associated with an increased risk of developing osteoporosis. These findings suggest that osteoporosis screening may be warranted in middle-aged adults with NAFLD.

Summary

Hip fracture poses a major public health burden in aging populations. The relationship between long-term air pollution exposure and hip fracture risk remains unclear. In our study, long-term exposure to PM_2.5, PM₁₀, and NO₂ was associated with increased hip fracture risk, while ozone exposure showed a protective effect.

Purpose

This study aimed to evaluate the associations between major air pollutants and incident hip fracture in a nationwide Chinese cohort.

Methods

We included 14,101 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study (2011–2020). Annual concentrations of PM_2.5, PM₁₀, O₃, and NO₂ were estimated using the CHAP dataset. Log-binomial regression models were applied to calculate relative risks (RRs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed to assess the robustness and consistency of the findings.

Results

During a 9-year follow-up, 474 participants (3.37%) experienced hip fracture. Each 10 µg/m³ increase in PM_2.5 and PM₁₀ concentrations was associated with a higher risk of hip fracture (PM_2.5: RR 1.129, 95% CI 1.071–1.191; PM₁₀: RR 1.052, 95% CI 1.024–1.081). In contrast, ozone exposure showed an inverse association (RR 0.518, 95% CI 0.458–0.585). No overall association was found for NO₂, although an elevated risk was observed in the third exposure quartile (RR 1.302, 95% CI 1.012–1.675). Subgroup analyses indicated stronger PM_2.5-related risks among participants with higher education levels, a more pronounced inverse association with ozone in adults aged < 60 years and current smokers, and greater NO₂-related risk among non-smokers.

Conclusions

Long-term exposure to PM_2.5 and PM₁₀ increased hip fracture risk, while ozone exposure appeared protective. Moderate NO₂ exposure may also affect bone fragility. These results highlight the need for pollutant-specific prevention strategies.

Summary

Over 14 years, hip fracture patients grew older, with shorter hospital stays. Femoral neck fractures were more common than intertrochanteric fractures, but the latter had worse functional outcomes and higher complications. Surgery was standard, with nailing for intertrochanteric and arthroplasty for femoral neck fractures. Older age increased adverse outcomes.

Aim

We aimed to investigate trends in patient characteristics and outcomes in patients after hip fractures.

Methods

We analyzed data from hip fracture patients treated at our trauma center between January 2009 and December 2022. Variables included fracture type, sex, age, BMI, admission/discharge times, anesthesia type, ASA classification, treatment methods, surgery duration, discharge activities of daily living, and complications.

Results

This retrospective study of 2965 hip fracture patients revealed a predominance of femoral neck fractures (56.6%) over intertrochanteric fractures (43.4%), with females comprising two-thirds of cases. Mean patient age increased significantly over time, particularly for intertrochanteric fractures (79.4 vs. 75.0 years for femoral neck). Hospital stays markedly decreased (25.5 to 9.1 days for intertrochanteric; 20.2 to 8.9 days for femoral neck). Intertrochanteric fractures were associated with worse functional outcomes (discharge ADL, 38.5 vs. 42.2, P = 0.009) and higher ICU admission (11.4% vs. 6.0%, P < 0.001). Surgical management dominated (92.3%), with intramedullary nailing for intertrochanteric fractures (86.3%) and arthroplasty for femoral neck fractures (73.7%). ASA classification indicated poorer physiological status in intertrochanteric fracture patients (P < 0.001). In-hospital mortality escalated with age and prolonged injury-to-admission time (P < 0.001).

Conclusion

During 2009–2022, the mean age of hip fracture patients increased significantly, while hospital stays decreased. Intertrochanteric fractures were associated with poorer functional outcomes and higher complication rates compared to femoral neck fractures. Surgical management, particularly intramedullary nailing and arthroplasty, predominated. Older adults exhibited the higher burden of adverse outcomes, with mortality and complications rising with age.

Summary

In 744 adults from Pune (Western India) and nearby villages, osteoporosis prevalence was higher in rural women than urban (43% vs 18%). Advancing age, location, height, tobacco use and sunlight were key determinants. These findings emphasize urgent need for preventive and management strategies in rural population to reduce osteoporosis burden.

Background

About 150 million older adults (age > 60y) live in India presently, representing ~ 14% of the global older population. The population is expected to reach 324 million by 2050, leading to higher healthcare burden from conditions like osteoporosis. However, there is limited knowledge about bone health and its determinants in middle-aged rural and urban Indian adults.

Methods

This study included 744 adults (398 women) aged > 40y from urban and rural areas of Pune, India. We assessed areal bone mineral density (aBMD) at lumbar spine and femur using dual energy x-ray absorptiometry and volumetric bone parameters by peripheral quantitative computed tomography. Socio-economic-status and lifestyle factors (diet, physical activity, tobacco use, sunlight) were evaluated. Differences in bone parameters were analysed and multiple linear regression was used to identify predictors of bone health.

Results

Significant differences observed in anthropometry and lifestyle factors in urban and rural population. Rural men and women had lower aBMD than urban, with osteoporosis more common in rural women (43%) than urban (18%), and in women compared to men (31% vs 8%). In both sexes, bone outcomes were influenced by anthropometric, residential, and lifestyle factors. Height and rural residence predicted bone density and geometry in men, while in women, age, height, rural residence, tobacco intake, and sunlight exposure were key determinants

Conclusion

Rural population showed poor bone health. Bone health in both sexes was influence by age, height, rural residence, lifestyle factors like tobacco use and sunlight exposure. Strategies targeting lifestyle modification may help improving bone health among Indians.

Summary

Hip fracture data were retrieved from the Iraqi government’s Ministry of Health and the Kurdistan region’s Ministry of Health for the years 2022–2023 and used to create a FRAX® model to facilitate fracture risk assessment. Hip fracture rates and probabilities were compared with estimates from neighboring countries.

Introduction

There are no published data on the epidemiology of osteoporotic fractures in Iraq. This paper describes the epidemiology of femoral fractures in Iraq and the development of the corresponding country-specific FRAX® tool for the prediction of fractures.

Methods

Femoral fracture data (ICD-10 S72) were retrieved from the Iraqi government’s Ministry of Health and the Kurdistan region’s Ministry of Health for the years 2022–2023 in Iraq. The age- and sex-specific incidence of hip fracture in Iraqi residents and national mortality rates were used to create a FRAX® model. Fracture probabilities were compared with those from neighboring countries having existing FRAX models.

Results

Fracture rates were low and comparable to those in neighboring countries, with hip fracture rates closest to estimates from Saudi Arabia at older ages. Ten-year fracture probabilities were lower in males than in females and were comparable to those in neighboring countries.

Conclusion

The FRAX model should enhance the accuracy of determining fracture probability among the Iraqi population and help guide treatment decisions.

Summary

W2TPD, a twice-weekly teriparatide administration regimen, was used on 163 patients. The continuation rate was 47%, with only one new fracture. Even after performing antiresorptive therapy, spine BMD increased significantly in the majority of groups. W2TPD demonstrated good efficacy and tolerability in a real-world sequential osteoporosis treatment model.

Purpose

Teriparatide is the most commonly administered daily, but there are also once-weekly and twice-weekly regimens. The former demonstrated high efficacy in increasing bone mineral density (BMD) and preventing new fractures; however, the continuation rate was reported to be low due to a high incidence of side effects. As a result, the twice-weekly teriparatide administration schedule (W2TPD) was created. In this study, we conducted a real-world clinical evaluation of its efficacy as part of a sequential osteoporosis treatment regimen.

Methods

The study included 163 patients with osteoporosis who were treated with W2TPD. Patients treated with W2TPD were divided into five groups based on their prior medication use: treatment-naïve (N), post-denosumab (post-D), post-bisphosphonate (post-B), post-romosozumab (post-R), and post-SERM (post-S). We examined treatment continuation rates, adverse events, and changes in BMD.

Results

The overall treatment continuation rate was 47.9%, with only one patient developing a new fracture during treatment. Gastrointestinal side effects, such as heartburn, nausea, and vomiting, were common. The percent changes in spine BMD were 10%, 5.2%, 5%, − 1.5%, and 12.3% in the N, post-D, post-B, post-R, and post-S groups, respectively. Meanwhile, hips were found in 3.1%, 0.4%, 1.5%, 0%, and 2.2%, respectively. In terms of spine BMD, all groups except post-R had responder rates greater than 50%.

Conclusion

The continuation rate of W2TPD was 47% and resulted in particularly favorable BMD gains in the spine. It was also discovered to be effective in increasing BMD even when following bisphosphonate treatment.

Summary

In alignment with previous studies using the densitometric vertebral fracture assessment tool, the prevalence of radiographic moderate-severe vertebral fractures in rural postmenopausal women was 34%. FRAXplus could bring one additional woman to treatment intervention thresholds who may have otherwise been missed had additional risk factors not been captured.

Purpose

To study the prevalence of radiographic vertebral fractures and the utility of FRAXplus® and FRAX® in predicting prevalent vertebral fractures in rural southern India.

Methods

This cross-sectional study involved 150 rural postmenopausal women, and they were assessed for radiographic vertebral fractures. FRAX® and FRAXplus® were utilized for computing a 10 year risk of major osteoporotic fractures (MOF) and hip fractures (HF) based on clinical risk factors.

Results

The mean (SD) age of the patients was 66.1 (6.5) years and BMI (kg/m²) was 23.1 (4.4). The prevalence of moderate to severe vertebral fractures was 34%. Forty-four subjects had FRAX-MOF cutoff ≥ 10.5 and 57 had FRAX-HF cutoff ≥ 3.5. FRAXplus® correction was utilized in 34 subjects (23%) for falls (n = 30) and glucocorticoids (N = 4). One additional patient reached the treatment threshold for FRAX-MOF and FRAX-HF when FRAXplus® was utilized. On ROC analysis, a cutoff of 6 had a sensitivity of 80% and 40% specificity for FRAX-MOF, and a cutoff of 1.5 for FRAX-HF had a sensitivity of 76% and 40% specificity.

Conclusion

One-third of rural postmenopausal women had fragility fractures detected on a lateral spine X-ray. Although FRAX® at established Indian cut-offs does help in identifying most women who require anti-osteoporotic treatment, the utilization of FRAX plus® will help in further detecting women who are at borderline risk and may otherwise miss out on treatment if additional risk factors are not captured.

Summary

This study examined whether bisphosphonate treatment can reduce fragility fractures in patients with osteoporosis in Jordan. We found significantly fewer fractures and better quality of life in treated patients, supporting the importance of early treatment in routine care settings.

Introduction

Osteoporosis is a major public health concern in aging populations, with fragility fractures contributing to significant morbidity, mortality, and healthcare burden. While bisphosphonates are widely used to reduce fracture risk, data from real-life clinical settings in the Middle East remain limited. This study aimed to evaluate the clinical outcomes associated with bisphosphonate therapy among osteoporotic patients in Jordan.

Methods

We conducted a retrospective, matched case–control study of 1,202 patients aged ≥ 50 years with confirmed osteoporosis across multiple hospitals in Jordan. Patients were grouped based on bisphosphonate treatment status. Clinical and functional outcomes—including fragility fractures, bone mineral density (BMD), FRAIL score, EQ-5D, and self-rated bone health—were compared between groups.

Results

Of 1,202 patients included, 604 received bisphosphonates and 598 did not. The bisphosphonate group had a significantly lower prevalence of fragility fractures (13.1% vs. 36.8%, p < 0.001) and multiple fractures (4.1% vs. 15.1%, p < 0.001). Mean lumbar spine and proximal femur BMD values were higher among treated patients (0.815 ± 0.090 g/cm² and 0.715 ± 0.080 g/cm², respectively) compared with non-treated patients (0.760 ± 0.10 g/cm² and 0.675 ± 0.093 g/cm², p < 0.05). Corresponding mean T-scores were − 2.3 ± 0.4 vs. − 2.6 ± 0.5 (p = 0.04). Treated patients also had lower mean FRAIL scores (1.3 ± 1.1 vs. 2.1 ± 1.3, p < 0.001) and higher EQ-5D quality of life scores (0.73 ± 0.2 vs. 0.59 ± 0.2, p < 0.001). Self-rated bone health was more favorable in the treatment group (good/very good in 49.3% vs. 21.1%, p < 0.001). These findings were consistent across both clinical and patient-reported outcomes.

Conclusion

Bisphosphonate therapy in routine clinical practice was associated with reduced fracture burden and better functional and quality of life outcomes among osteoporotic patients in Jordan. These results highlight the need for improved screening, timely treatment, and comprehensive osteoporosis care strategies in the region.