IF 3.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone

Pub Date : 2025-10-29 DOI: 10.1016/j.bone.2025.117692

Linyi Liu , Phuong T. Le , Victoria E. DeMambro , Tiange Fengª , Hanghang Liu , Wangyang Ying , Roland Baron , Clifford J. Rosen

引用次数: 0

Reconsidering bone–muscle interactions in obese older adults with type 2 diabetes: Methodological limitations and future directions 重新考虑肥胖老年2型糖尿病患者骨肌相互作用：方法学局限性和未来方向。

IF 3.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone

Pub Date : 2025-10-28 DOI: 10.1016/j.bone.2025.117699

Shangxuan Li

引用次数: 0

Revealing early subchondral bone structural changes in osteoarthritis progression in a collagenase-induced mouse model using microCT 在胶原酶诱导的小鼠模型中使用微ct揭示骨关节炎进展的早期软骨下骨结构变化。

IF 3.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone

Pub Date : 2025-10-27 DOI: 10.1016/j.bone.2025.117687

Han Liu , Zihui Li , Catherine E. Davey , Kathryn S. Stok

Osteoarthritis (OA) is the most prevalent joint disorder affecting millions of people worldwide, and involves deterioration to subchondral bone. This study aims to reveal the early bone microstructural changes at high temporal resolution in a small animal model of OA with joint laxity and inflammation.

Seventy-five male C57BI/10 mice aged nine weeks were recruited and assigned to three cross-sectional cohorts, baseline, control, and OA. Of these, forty-seven ten-week-old mice assigned to the OA cohort received intra-articular injection of collagenase on the right knee to destabilize the right tibiofemoral joint. Micro-computed tomography (microCT) scan was performed after humanely killing the mice at nine time points (eight weeks in total). Quantitative morphometric analysis (QMA) was performed to measure structure of subchondral cortical and epiphyseal femoral and tibial bone, and osteophyte activity.

Early pathological changes caused by collagenase-injection were characterized by bone morphometry measures and osteophyte detection. Compared to control joints, bone loss, lower bone volume fraction, thinner trabeculae, larger trabecular spacing, smaller trabecular number, thinner cortical bone, and osteophyte formation were observed in osteoarthritic joints at multiple time points, with changes detectable as early as one week post disease induction. Additionally, a non-linear pattern of structural changes was observed throughout the experiment, with a critical transition occurring within three weeks after disease induction. These findings underscore the necessity of early and frequent quantification to capture rapidly changing bone microstructure alterations in early stage of OA, potentially enabling earlier diagnosis, intervention, and treatment of OA.

骨关节炎（OA）是影响全世界数百万人的最常见的关节疾病，涉及软骨下骨的恶化。本研究旨在以高时间分辨率揭示骨性关节炎伴关节松弛和炎症的小动物模型的早期骨微结构变化。招募了75只9周龄雄性C57BI/10小鼠，并将其分配到三个横断面队列：基线组、对照组和OA组。其中，47只10周大的小鼠被分配到OA组，在右膝关节内注射胶原酶来破坏右胫股关节的稳定。在9个时间点（共8周）人道杀死小鼠后进行微计算机断层扫描（microCT）。采用定量形态学分析（QMA）测定软骨下皮质骨、骨骺、股骨和胫骨的结构及骨赘活性。采用骨形态测定和骨赘检测对胶原酶注射后的早期病理改变进行表征。与对照关节相比，骨关节炎关节在多个时间点观察到骨丢失、骨体积分数降低、小梁变薄、小梁间距变大、小梁数目变小、皮质骨变薄和骨赘形成，这些变化早在疾病诱发后一周就可以检测到。此外，在整个实验过程中观察到非线性结构变化模式，在疾病诱发后三周内发生关键转变。这些发现强调了早期和频繁量化的必要性，以捕获OA早期快速变化的骨微观结构改变，从而有可能实现OA的早期诊断、干预和治疗。

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引用次数: 0

Response to the letter to the editor: “Comparative effectiveness of romosozumab versus teriparatide for fracture prevention: A new-user, active comparator design” 对致编辑的信的回应：“在骨质疏松研究中使用日本索赔数据库作为真实证据的结构性挑战”。

IF 3.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone

Pub Date : 2025-10-27 DOI: 10.1016/j.bone.2025.117696

Ryoji Tominaga , Tatsuyoshi Ikenoue , Ryosuke Ishii , Noriaki Kurita , Masataka Taguri

引用次数: 0

In C57BL/6J mice, weight loss in previously obese mice reduced bone mass and shifted the cortical bone metabolome 在C57BL/6J小鼠中，先前肥胖小鼠的体重减轻减少了骨量并改变了皮质骨代谢组。

IF 3.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone

Pub Date : 2025-10-27 DOI: 10.1016/j.bone.2025.117690

Carolyn Chlebek , Casey McAndrews , Benjamin Aaronson , Hope D. Welhaven , Kanglun Yu , Samantha N. Costa , Joseph Shaver , Sophia Silvia , Victoria E. DeMambro , Ronald K. June , Meghan E. McGee-Lawrence , Clifford J. Rosen

Obesity is linked to increased fracture risk. Despite the negative effects of weight loss on the skeleton, patients with obesity are advised to lose weight via calorie restriction. Obesity and weight loss individually alter both whole-body and local metabolism. Little is known about changes to bone mass and metabolome following calorie restriction in obese preclinical models. We hypothesized that caloric restriction would reduce bone mass in obese mice and would alter the cortical bone metabolome. To induce obesity, 8-week-old male and female C57BL/6J mice received 60 % kCal high-fat diet for 12 weeks. From 20 to 30 weeks of age, mice either remained obese or lost weight through 30 % caloric restriction. Controls consumed 10 % kCal low-fat diet. Compared to obesity, calorie restriction elicited cortical bone loss and trabecular thinning. Weight loss also reduced bone formation. Both obesity and subsequent calorie restriction altered the cortical bone metabolome in a sex-dependent manner. Metabolic pathways altered with diet generally mapped to amino acid or fatty acid metabolism. In males, weight loss was associated with a downregulation of pathways related to tryptophan, tyrosine, ubiquinone, and fatty acids. In females, calorie restriction downregulated taurine and hypotaurine metabolism but upregulated pyrimidine metabolism, nicotinate and nicotinamide metabolism, and pantothenate and CoA biosynthesis. In summary, despite improvements in components of systemic metabolism, caloric restriction in obese preclinical models reduced bone mass and did not restore the cortical metabolome to control conditions.

肥胖与骨折风险增加有关。尽管减肥对骨骼有负面影响，但建议肥胖患者通过限制卡路里来减肥。肥胖和减肥分别改变了全身和局部的新陈代谢。在肥胖临床前模型中，对卡路里限制后骨量和代谢组的变化知之甚少。我们假设热量限制会减少肥胖小鼠的骨量，并改变皮质骨代谢组。为了诱导肥胖，8周龄的雄性和雌性C57BL/6 J小鼠给予60 % kCal高脂肪饮食12 周。从20到30 周龄，小鼠要么保持肥胖，要么通过30% %的热量限制减肥。对照组食用10 %千卡的低脂饮食。与肥胖相比，热量限制引起皮质骨丢失和小梁变薄。减肥也会减少骨骼的形成。肥胖和随后的卡路里限制都以性别依赖的方式改变了皮质骨代谢组。随饮食改变的代谢途径通常与氨基酸或脂肪酸代谢有关。在男性中，体重减轻与色氨酸、酪氨酸、泛醌和脂肪酸相关通路的下调有关。在女性中，热量限制下调了牛磺酸和次牛磺酸的代谢，但上调了嘧啶代谢、烟酸和烟酰胺代谢以及泛酸和辅酶a的生物合成。总之，尽管改善了全身代谢成分，但在肥胖临床前模型中，热量限制减少了骨量，并没有使皮质代谢组恢复到控制状态。

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引用次数: 0

The C-type lectin receptor mincle is functionally expressed by murine bone cells and can mediate inflammatory osteoblast responses to Staphylococcus aureus c型凝集素受体微环在小鼠骨细胞中功能性表达，可介导炎性成骨细胞对金黄色葡萄球菌的反应

IF 3.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone

Pub Date : 2025-10-25 DOI: 10.1016/j.bone.2025.117689

Erin L. Mills , Quinton A. Krueger , Aiza Noyal , M. Brittany Johnson , Ian Marriott

It is now apparent that osteoblasts and osteoclasts have immune functions that play a critical role in shaping host responses and the abnormal bone remodeling associated with staphylococcal infections. Both cell types express various pattern recognition receptors (PRRs) that enable them to perceive pathogens and initiate the production of mediators that can exacerbate infection-induced inflammatory bone loss. Macrophage-inducible C-type lectin (Mincle) is a tyrosine activation motif–coupled PRR that can recognize glycolipids from diverse pathogens to initiate inflammatory mediator production. In the lung, an important role for Mincle has been suggested in host defense against Gram positive bacteria. In the present study, we report that RNA Tag-Seq analysis of S. aureus infected murine osteoclasts and osteoblasts revealed enrichment of genes associated with C-type lectin receptor-mediated responses and elevated expression of mRNA encoding Mincle and its key downstream signaling components. We have found robust levels of Mincle protein in murine osteoclasts and osteoblasts, and demonstrated the inducible expression of this molecule in primary human osteoblasts. The functional nature of Mincle expression by osteoclasts and osteoblasts was confirmed by the ability of Mincle-specific agonists to elicit inflammatory cytokine production by these cells. Importantly, we have shown that the cytokine responses of S. aureus challenged murine and human osteoblasts are attenuated following Mincle blockade. Together, these studies support the assertion that bone cells functionally express Mincle and that this C-type lectin can mediate, at least in part, the inflammatory immune responses of osteoblasts to S. aureus challenge.

现在很明显，成骨细胞和破骨细胞具有免疫功能，在形成宿主反应和与葡萄球菌感染相关的异常骨重塑中起关键作用。这两种细胞类型都表达各种模式识别受体（PRRs），使它们能够感知病原体并启动可加剧感染诱导的炎症性骨质流失的介质的产生。巨噬细胞诱导的c型凝集素（Mincle）是一种酪氨酸激活基元偶联的PRR，可以识别来自不同病原体的糖脂，从而启动炎症介质的产生。在肺部，Mincle已被认为在宿主防御革兰氏阳性细菌中起重要作用。在本研究中，我们报告了对金黄色葡萄球菌感染的小鼠破骨细胞和成骨细胞的RNA Tag-Seq分析显示，与c型凝集素受体介导的应答相关的基因富集，编码Mincle及其关键下游信号成分的mRNA表达升高。我们在小鼠破骨细胞和成骨细胞中发现了强大的Mincle蛋白水平，并证明了该分子在原代人成骨细胞中的诱导表达。Mincle特异性激动剂能够诱导这些细胞产生炎性细胞因子，证实了破骨细胞和成骨细胞表达Mincle的功能性质。重要的是，我们已经表明，金黄色葡萄球菌挑战小鼠和人类成骨细胞的细胞因子反应在Mincle阻断后减弱。总之，这些研究支持骨细胞功能表达Mincle的断言，并且这种c型凝集素可以至少部分地介导成骨细胞对金黄色葡萄球菌攻击的炎症免疫反应。

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引用次数: 0

A review of bone fracture healing modelling: from mechanobiological theory to personalized rehabilitation protocols 骨折愈合模型的综述：从机械生物学理论到个性化康复方案。

IF 3.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone

Pub Date : 2025-10-21 DOI: 10.1016/j.bone.2025.117688

Lunjian Li , Minoo Patel , Lihai Zhang

Despite standard rehabilitation protocols, many patients still suffer from limited mobility, delayed union, or even non-union. This underscores the need for personalized rehabilitation protocols. Fracture healing is a dynamic process governed by the interplay of mechanical stimuli and biochemical signalling pathways. This review first summarizes current understanding of the biological and mechanobiological mechanisms that regulate bone repair. It also discusses different simulation models, including the finite element method (FEM), agent-based models (ABM), reaction–diffusion models (RDM), and machine learning (ML), and evaluates their respective strengths. Recent advances in patient-specific models are also reviewed, particularly those integrating CT-derived geometry, bone properties, and musculoskeletal (MSK) loading. These approaches enable individualized predictions of healing and can inform clinical rehabilitation strategies. Finally, the key challenges and future priorities for implementing these technologies in clinical practice are discussed, providing insights to support the development of more precise and patient-specific fracture care.

尽管有标准的康复方案，许多患者仍然受到活动受限，延迟愈合，甚至不愈合的困扰。这强调了个性化康复方案的必要性。骨折愈合是一个机械刺激和生化信号通路相互作用的动态过程。这篇综述首先总结了目前对调节骨修复的生物学和机械生物学机制的理解。它还讨论了不同的仿真模型，包括有限元法（FEM）、基于代理的模型（ABM）、反应扩散模型（RDM）和机器学习（ML），并评估了它们各自的优势。本文还回顾了患者特异性模型的最新进展，特别是那些整合了ct衍生几何、骨特性和肌肉骨骼（MSK）载荷的模型。这些方法可以实现个性化的康复预测，并可以为临床康复策略提供信息。最后，讨论了在临床实践中实施这些技术的关键挑战和未来的优先事项，为支持更精确和患者特异性骨折护理的发展提供了见解。

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引用次数: 0

Regional analysis of subtrochanteric femoral cortical bone microstructure in healthy adults using double-echo ultrashort echo time magnetic resonance imaging 双回波超短回波时间磁共振成像对健康成人股骨粗隆下皮质骨微观结构的区域分析。

IF 3.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone

Pub Date : 2025-10-19 DOI: 10.1016/j.bone.2025.117686

Yitong Li , Zheng Ran , Bowen Hou , Xiaolong Luo , Yongqiang Chu , Zhongyichen Huang , Xiaoming Li

<div><h3>Objective</h3><div>The subtrochanteric region of the femur is a common site for atypical femoral fracture (AFF), and the research of its cortical bone microstructure is important but currently lacking. Conventional whole-bone analysis may mask regional heterogeneities of cortical bone characteristics. This study aimed to utilize double-echo ultrashort echo time (UTE) MRI for in vivo regional investigation of subtrochanteric femoral cortical bone microstructure in healthy adults, exploring regional differences in microstructure at this site and the effects of various factors, thereby providing references for subsequent related research.</div></div><div><h3>Materials and methods</h3><div>Healthy adults without osteoporosis risk factors (n = 124) were enrolled and underwent double-echo UTE MRI of the non-dominant proximal femur. The delineation of the subtrochanteric femoral cortical bone region of interest (ROI) and the division of regions (anterior, medial, posterior, and lateral) were performed manually by two radiologists independently, and then the porosity index (PI) and cortical bone thickness (CbTh) were obtained using image processing software. The repeatability of regional measurements was evaluated using intra-class correlation coefficient (ICC) analysis. We used one-way repeated measures analysis of variance (RM-ANOVA) and Bonferroni post-hoc contrast tests to verify regional variations, analysis of covariance (ANCOVA) to verify global and regional sex differences, and finally a general linear model with repeated measures to investigate effects of various factors on cortical bone microstructure.</div></div><div><h3>Results</h3><div>A total of 110 healthy subjects (44 females, 66 males) aged 18–50 years were finally included, with no significant difference in age between sexes (<em>p</em> = 0.240) but males having a higher BMI than females (<em>p</em> < 0.001). The repeatability of regional measurements was good to excellent (ICC: 0.866 to 0.964). There were statistically significant regional differences in PI and CbTh in the subtrochanteric femoral cortex, regardless of sex (all <em>p</em> < 0.001), with the lateral region exhibiting the highest PI (+28.61 % from the global mean in all subjects) and the medial region exhibiting the largest CbTh (+11.09 % from the global mean in all subjects). Apart from CbTh in the lateral region (<em>p</em> = 0.930), both global and regional cortical bone microstructures showed statistically significant sex differences (all <em>p</em> < 0.01), with the most pronounced sex difference in PI in anterior region (−10.97 % in females compared to males) and CbTh in posterior region (−14.68 % in females compared to males). Cortical PI was affected by region (<em>p</em> = 0.003) and sex (<em>p</em> < 0.001), with sex being the most significant factor (η<sup>2</sup> = 13.8 %); CbTh was affected similarly by sex (<em>p</em> = 0.003) and BMI (<em>p</em> = 0.002), and also affected by interactio

目的：股骨粗隆下区是非典型股骨骨折（AFF）的常见部位，对其骨皮质微结构的研究很重要，但目前缺乏。传统的全骨分析可能掩盖了皮质骨特征的区域异质性。本研究旨在利用双回波超短回波时间（UTE） MRI对健康成人股骨粗隆下皮质骨微结构进行体内区域研究，探讨该部位微结构的区域差异及各种因素的影响，为后续相关研究提供参考。材料和方法：纳入无骨质疏松危险因素的健康成人（n = 124），并对非优势股骨近端进行双回波UTE MRI检查。由两名放射科医师独立手动圈取股骨粗隆下感兴趣的皮质骨区（ROI）并划分前、中、后、外侧区域，然后使用图像处理软件获取孔隙度指数（PI）和皮质骨厚度（CbTh）。使用类内相关系数（ICC）分析评价区域测量的可重复性。我们使用了单向重复测量方差分析（rmanova）和Bonferroni事后对比检验来验证区域差异，协方差分析（ANCOVA）来验证全球和区域性别差异，最后使用一个具有重复测量的一般线性模型来研究各种因素对皮质骨微观结构的影响。结果：最终纳入健康受试者110例（女性44例，男性66例），年龄在18 ~ 50岁 之间，性别间年龄差异无统计学意义（p = 0.240），但男性BMI高于女性（p 2 = 13.8 %）；CbTh同样受到性别（p = 0.003）和BMI （p = 0.002）的影响，也受到地区×性别（p = 0.003）和地区×年龄（p = 0.037）的相互作用的影响。结论：本研究为股骨粗隆下皮质骨微结构的体内评估提供了一种潜在可行的工具，并发现了健康成人皮质骨的区域异质性及潜在相关因素的影响，提示在评估皮质骨时应考虑区域差异，为后续的进一步研究提供参考。

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引用次数: 0

Familial determinants of bone health parameters- a dual X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT)-based parent and offspring study in rural Indian children 骨健康参数的家族决定因素——印度农村儿童的双x线吸收仪（DXA）和外周定量计算机断层扫描（pQCT）为基础的父母和后代研究。

IF 3.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone

Pub Date : 2025-10-17 DOI: 10.1016/j.bone.2025.117685

Sharvani Patil , Nikhil Shah , Alex Ireland , Vivek Patwardhan , Neha Sanwalka , Neha Kajale , Chidvilas More , Ketan Gondhalekar , Anuradha Khadilkar

Background

Skeletal health relationships in children and parents have been investigated over the years with contradictory results and often without accounting for the influence of modifiable factors. Limited data exist on sex specific relationships using advanced techniques like peripheral quantitative computed tomography (pQCT), especially in populations with generationally insufficient calcium intake, where nutritional insufficiency, gender differences and environmental constraints may override and influence heritability trends. We examined the effect of parental phenotype and shared environment on bone density and geometry parameters of rural children aged 8–10.

Methods

Healthy children aged 8–10 and their parents joined a multigenerational cohort. Bone health parameters were assessed for 689 and 428 triads using dual-energy x-ray absorptiometry (DXA) and pQCT (at the 4 % and 66 % radial site), respectively. Modifiable factors were recorded using standardized questionnaires. Hierarchical linear regression assessed parent-offspring relationships after accounting for these factors.

Results

The cohort had significant calcium inadequacy, with only 6.5 % having adequate dietary calcium intake. Even after accounting for modifiable factors, both parents' bone health parameters significantly (p < 0.05) influenced children's parameters, with a stronger effect in female children. The maternal-offspring relationship was stronger than the paternal-offspring relationship for total body bone mineral density (TBLHBMD) (β = 0.19 vs β = 0.12), anteroposterior lumbar spine BMD (β = 0.22 vs β = 0.16), cortical density (β = 0.39 vs β = 0.32), cortical thickness (β = 0.23 vs β = 0.17), periosteal (β = 0.23 vs β = 0.17), and endosteal circumference (β = 0.27 vs β = 0.23). Whereas, trabecular density showed a slightly higher influence from male parents (β = 0.17 vs β = 0.16). (all p < 0.01).

Conclusion

Maternal-paternal influence on bone health was significant for all parameters and stronger in female children, asserting the importance of sex-specific growth promotion interventions. Parental influence persisted after accounting for modifiable factors in a nutritionally inadequate population, suggesting a strong heritability component.

背景：多年来，人们一直在研究儿童和父母之间的骨骼健康关系，结果相互矛盾，而且往往没有考虑到可改变因素的影响。利用外围定量计算机断层扫描（pQCT）等先进技术，关于特定性别关系的数据有限，特别是在世代钙摄入量不足的人群中，营养不足、性别差异和环境限制可能凌驾并影响遗传趋势。我们研究了父母表型和共享环境对8-10岁农村儿童骨密度和几何参数的影响。方法：8-10岁的健康儿童及其父母加入多代队列。分别使用双能x线吸收仪（DXA）和pQCT（在4%和66%桡骨部位）评估689和428例三联体患者的骨健康参数。使用标准化问卷记录可改变的因素。在考虑了这些因素后，层次线性回归评估了亲子关系。结果：该队列有明显的钙缺乏，只有6.5%的人有足够的膳食钙摄入量。即使在考虑了可修改的因素后，父母双方的骨骼健康参数也显著（p ）结论：父母对骨骼健康的影响在所有参数中都是显著的，在女性儿童中更强，这表明了性别特异性生长促进干预的重要性。在考虑了营养不足人群中可改变的因素后，父母的影响仍然存在，这表明遗传因素很强。

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引用次数: 0

IF 3.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone

Pub Date : 2025-10-15 DOI: 10.1016/j.bone.2025.117678

Tse-Yu Chen , Ya-Lian Deng , I-Chieh Chen , Ching-Heng Lin , Jun-Fu Lin , Yi-Ming Chen , Hsu-Tung Lee , Hui-Chih Hung

Introduction

Medication-related osteonecrosis of the jaw (MRONJ) was first reported in cancer patients receiving high-dose intravenous bisphosphonates and later linked to other anti-resorptive agents such as denosumab and romosozumab. However, large-scale real-world data on MRONJ risk following these therapies remain limited. This study focuses on the widely used parenteral anti-resorptive agents—ibandronate, denosumab, and zoledronic acid—chosen for their clinical popularity, cost-effectiveness, and convenient dosing. We aimed to assess the risk of MRONJ associated with each agent using real-world data from a global healthcare network.

Methods

This retrospective cohort study was conducted using the TriNetX network. To clarify the causal relationship, cohorts were created to include patients treated with only one anti-resorptive medication. Propensity score matching was applied to adjust for known risk factors associated with MRONJ. Additionally, subgroup analyses were performed for cancer and non-cancer patient populations.

Results

Propensity score matching yielded balanced cohorts (n = 36,983 each) for comparing MRONJ risk. Among matched patients, 106 denosumab users and 41 zoledronic acid users developed MRONJ (HR: 0.378; 95 % CI: 0.264–0.543). No case occurred in the ibandronate group (n = 11,405), which showed substantially lower risk compared to zoledronic acid and denosumab. The incidence of inflammatory condition of jaws share similar trends compared to those of MRONJ among the three groups. In cancer patients, MRONJ risk was 0.294 % with denosumab and 0.525 % with zoledronic acid. Non-cancer patients had much lower risk.

Conclusions

This study used real-world data from the TriNetX platform to evaluate the risk of MRONJ associated with various anti-osteoporosis medications, excluding combination therapies for clarity. Our findings indicate that among the commonly used parenteral anti-resorptive agents, denosumab has been associated with the highest risk of MRONJ, followed by zoledronic acid, with ibandronate showing the lowest risk.

药物相关性颌骨骨坏死（MRONJ）首先在接受高剂量静脉注射双膦酸盐的癌症患者中被报道，后来与其他抗吸收药物如denosumab和romosozumab相关。然而，这些治疗后MRONJ风险的大规模真实数据仍然有限。本研究的重点是广泛使用的肠外抗吸收药物-依班膦酸盐，地诺单抗和唑来膦酸-选择它们的临床知名度，成本效益和方便的剂量。我们的目的是使用来自全球医疗保健网络的真实数据来评估与每种药物相关的MRONJ风险。方法：采用TriNetX网络进行回顾性队列研究。为了澄清因果关系，研究人员创建了包括仅接受一种抗吸收药物治疗的患者的队列。倾向评分匹配用于调整已知的与MRONJ相关的危险因素。此外，对癌症和非癌症患者群体进行了亚组分析。结果：倾向评分匹配产生平衡队列（n = 各36,983），用于比较MRONJ风险。在匹配的患者中，106名地诺单抗使用者和41名唑来膦酸使用者发生MRONJ （HR: 0.378; 95 % CI: 0.264-0.543）。依班膦酸组无病例发生（n = 11,405），与唑来膦酸和地诺单抗相比，其风险显著降低。与MRONJ相比，三组中下颌炎症状况的发生率有相似的趋势。在癌症患者中，denosumab组的MRONJ风险为0.294 %，唑来膦酸组的MRONJ风险为0.525 %。非癌症患者的风险要低得多。结论：本研究使用来自TriNetX平台的真实数据来评估与各种抗骨质疏松药物相关的MRONJ风险，为了清楚起见，不包括联合治疗。我们的研究结果表明，在常用的肠外抗再吸收药物中，denosumab与MRONJ的风险最高，其次是唑来膦酸，而伊班膦酸的风险最低。

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引用次数: 0

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