Tanaka H, Tarasawa K, Mori Y
… +3 more, Fushimi K, Fujimori K, Aizawa T
J Bone Miner Metab
· 2025 Sep · PMID 40494978
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INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, and mortality increases in elderly patients with comorbidities. This study aims to examine the in-hospital complications and mortality for elderl...INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, and mortality increases in elderly patients with comorbidities. This study aims to examine the in-hospital complications and mortality for elderly patients with proximal femur fractures during the COVID-19 pandemic or countermeasure periods. MATERIALS AND METHODS: The proximal femur fractures undergoing surgery during the COVID-19 pandemic or countermeasure period were compared with the pre-pandemic in a Japanese national inpatient data. The assessed outcomes were the development of pneumonia, deep vein thrombosis (DVT), pulmonary embolism (PE), and mortality during hospitalization in two periods, and those for COVID-19-positive patients. RESULTS: A total of 284,922 proximal femur fractures aged over 65 years were included. In the COVID-19 pandemic period compared to the pre-pandemic, the odds of pneumonia, DVT, PE, and mortality decreased to 0.942 (95% confidence interval [CI]: 0.901 - 0.986, P = 0.0102) and 0.839 (95% CI: 0.745 - 0.946, P = 0.004), increased to 1.153 (95% CI: 1.112 - 1.195, P < 0.001), and 1.048 (95% CI: 0.982 - 1.118, P = 0.1554), respectively. For COVID-19 positivity at admission, the odds of PE increased significantly to 12.95 (95% CI: 8.795 - 19.06, P < 0.001). For COVID-19 positivity during hospitalization, the odds of pneumonia and mortality were increased to 2.896 (95% CI: 1.820 - 4.608, P < 0.001) and 6.303 (95% CI: 3.440 - 11.55, P < 0.001), respectively. CONCLUSION: These findings alert healthcare professionals and patients to the elevated complications, especially PE rate for proximal femoral fracture with COVID-19 positive.
INTRODUCTION: Sarcopenia is closely related to osteoporosis, but the causal direction of these associations remains unclear. This study aims to explore these potential causal associations from the perspective of gene reg...INTRODUCTION: Sarcopenia is closely related to osteoporosis, but the causal direction of these associations remains unclear. This study aims to explore these potential causal associations from the perspective of gene regulation. MATERIALS AND METHODS: Differentially expressed genes between sarcopenia and control, were identified as exposure factors, with osteoporosis serving as outcome variable, to identify key genes that had potential causal association with osteoporosis. Further analysis was conducted to investigate the causal links between key genes and sarcopenia-related characteristics. Moreover, enrichment analyses, ceRNA and Gene-Gene Interaction network were studied. RESULTS: Only SCD1 demonstrated a potential causal association with osteoporosis (OR = 0.9970, P = 0.0217), acting as a protective factor against the disease. The potential causal links between SCD1 and sarcopenia-related characteristics are executed. SCD1 was identified as a risk factor for low hand grip strength (OR = 1.1397, P = 0.0290), while being pinpointed as a protective factor for appendicular lean mass (OR = 0.8777, P = 0.0147), usual walking pace (OR = 0.9834, P = 0.0290), whole body fat-free mass (OR = 0.9412, P = 0.0227), and trunk fat-free mass (OR = 0.9425, P = 0.0257). All analyses passed Steiger directional test, indicating a unidirectional causal association. Moreover, indicated that SCD1 was significantly associated with metabolic pathways related to lipid biosynthesis and regulation. CONCLUSION: SCD1 was identified as a protective factor for osteoporosis and a risk factor for sarcopenia. This research provides new insights for the study of sarcopenia and osteoporosis, and offers theoretical backing for the positive effects of exercise in the elderly.
INTRODUCTION: With the population aging, musculoskeletal disorders increasingly impair older adults' quality of life and escalating healthcare costs, necessitating effective prevention strategies. Locomotive syndrome (LS...INTRODUCTION: With the population aging, musculoskeletal disorders increasingly impair older adults' quality of life and escalating healthcare costs, necessitating effective prevention strategies. Locomotive syndrome (LS), characterized by mobility decline due to musculoskeletal dysfunction, is closely linked to these disorders. However, its role in predicting future musculoskeletal conditions remains unclear. This study examined the association between LS and the incidence of newly diagnosed musculoskeletal disorders. MATERIAL AND METHODS: This prospective study included 367 community-dwelling adults aged ≥ 40 years who were independent in daily activities. LS was assessed using the five-question Geriatric Locomotive Function Scale (GLFS-5). The primary outcome was the incidence of musculoskeletal disorders, including osteoarthritis, lumbar spinal stenosis, and osteoporosis. Cox proportional hazards regression analyzed associations between LS and future diagnoses, while receiver operating characteristic (ROC) analysis determined the GLFS-5 cutoff score for risk prediction. RESULTS: At baseline, 19.1% of participants had LS. Over four years, musculoskeletal disorders occurred more frequently in participants with LS than in those without (22.2 vs. 8.8 per 100 person-years, p < 0.001). After adjusting for covariates, LS remained a significant risk factor (hazard ratio 1.98, 95% confidence interval 1.16-3.36, p = 0.011). ROC analysis identified a GLFS-5 cutoff score of 2 (sensitivity: 62.0%, specificity: 62.0%). CONCLUSIONS: LS nearly doubled the risk of musculoskeletal disorders, with a GLFS-5 score ≥ 2 serving as an early risk indicator. Proactive screening and targeted interventions may mitigate this risk in aging populations.
INTRODUCTION: The roles of exosomes in osteoblast differentiation has been widely investigated. Low exosome production from donor cells constitutes the greatest challenges in exosome-based therapies. Spexin (SPX) is a ne...INTRODUCTION: The roles of exosomes in osteoblast differentiation has been widely investigated. Low exosome production from donor cells constitutes the greatest challenges in exosome-based therapies. Spexin (SPX) is a neuropeptide that is involved in various biological activities including osteogenic differentiation and bone regeneration. Therefore, the purpose of this study was to investigate the effects of SPX on exosome production in osteogenic medium (OM)-treated MC3T3-E1 cells and SPX induced MC3T3-E1 cell-derived exosomes (OM + SPX-Exos) on osteoblast differentiation. MATERIALS AND METHODS: To evaluate exosome yield, MC3T3-E1 cells were treated with SPX. Exosome marker expression and particle number were validated via reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) and nanoparticle tracking analysis (NTA), respectively. MC3T3-E1 cells were then treated with various concentrations of OM + SPX-Exos and osteogenic medium treated MC3T3-E1 derived exosomes (OM-Exos). Cell proliferation, osteogenic differentiation marker expression, alkaline phosphatase (ALP) activity, and mineralization were evaluated using the CCK-8 assay, RT-qPCR, ALP staining, and alizarin red S staining, respectively. RESULTS: SPX significantly increased exosome production and the expression of the exosome markers; Cd63, Rab27a and Alix in MC3T3E1 cells. Furthermore, OM + SPX-Exos significantly increased in the expression of runt-related transcription factor 2 (Runx2), alkaline phosphatase, biomineralized associated (Alpl), collagen type I alpha 1 (Col1a1), secreted phosphoprotein 1 (Spp1) and Integrin-binding sialoprotein (Ibsp) at a concentration of 5 µg/ml. ALP staining and alizarin red S staining also revealed that OM + SPX-Exos (5 µg/ml) resulted in more ALP-positive cells and markedly promoted mineralization, respectively. CONCLUSION: In general, these results indicate that SPX stimulates exosome production. OM + SPX-Exos enhances MC3T3-E1 cells proliferation, osteogenic differentiation and mineralization.
Kubo R, Tajiri R, Yamada H
… +2 more, Nakayama H, Miyamoto T
J Bone Miner Metab
· 2025 Jul · PMID 40434545
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INTRODUCTION: Medication-Related Osteonecrosis of the Jaw (MRONJ) is a condition marked by osteonecrosis of the jaw bone and other symptoms seen following invasive surgical procedures in patients administered bone-modify...INTRODUCTION: Medication-Related Osteonecrosis of the Jaw (MRONJ) is a condition marked by osteonecrosis of the jaw bone and other symptoms seen following invasive surgical procedures in patients administered bone-modifying agents. Once disease develops, a patient's ADL levels are significantly compromised. However, the pathogenesis of this disease is not clearly understood. Bisphosphonates (BPs) are bone resorption inhibitors commonly used to treat osteoporosis. Although not confirmed, it is generally believed that MRONJ risk is higher in the presence of injectable rather than oral formulations. Here, we assessed risk of developing ONJ in mice in the presence of 3 different BPs-zoledronate, ibandronate, or alendronate-that are administered clinically intravenously or via infusion. MATERIALS AND METHODS: Eight-week-old wild-type mice were administered zoledronate, alendronate, ibandronate or PBS vehicle subcutaneously once a week for 2 weeks. Then the right first molars in the mandible were extracted. Six-weeks later, osteonecrosis development was analyzed by histochemistry. RESULTS: Among mice administered BPs, mice treated with zoledronate exhibited the highest frequency of osteocytes exhibiting osteonecrosis. Bone mineral density was higher in mice receiving zoledronate, alendronate, or ibandronate than in PBS control mice, but effects of the 3 drugs were comparable. Moreover, formation of multi-nuclear osteoclasts in vitro was most strongly inhibited by zoledronate, followed by alendronate and ibandronate. CONCLUSION: Administration of BPs with high osteoclastogenesis inhibitory potential, such as zoledronate, increases risk of ONJ development after tooth extraction more than treatment with other agents tested, even at equivalent dosage.
Takahashi K, Ideo K, Uragami M
… +7 more, Fukuma Y, Koga T, Yoshiura K, Boku S, Kajitani N, Takebayashi M, Miyamoto T
J Bone Miner Metab
· 2025 Jul · PMID 40434544
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INTRODUCTION: The increase in the older population is a serious concern in developed countries, and how to maintain independence of these individuals is now an urgent issue. Various factors are known to put older people...INTRODUCTION: The increase in the older population is a serious concern in developed countries, and how to maintain independence of these individuals is now an urgent issue. Various factors are known to put older people at risk for needing long-term care, but it is not clear to what extent each factor is associated with that need. MATERIALS AND METHODS: In a cohort of 1577 community-dwelling older persons, we excluded 40 persons whose long-term care insurance certification was unknown and then divided the remaining 1537 into two groups: dependent group (134 persons) certified as requiring assistance or long-term care, and an independent group (1403 persons). We extracted 7 factors and created a scoring system from these factors based on regression coefficients. RESULTS: Among 92 factors initially evaluated, 7 were significantly associated with the need for assistance or long-term care, namely walking speed, age, grip strength, mobility (EQ5D), ability to use public transportation by oneself (IADL), ability to perform usual activities (EQ5D), and serum albumin levels. Based on these 7, we constructed a scoring system and calculated a cutoff value of 8 points with an area under curve as high as 0.949. CONCLUSION: We determined the cutoff value for dependency risk to be 8, but no single factor scored 8 or higher, suggesting that a combination of these factors promotes the need for nursing care in older people.
Hosoi T, Yunoki M, Tanaka S
… +4 more, Hagino H, Mori S, Soen S, Ogawa S
J Bone Miner Metab
· 2025 Jul · PMID 40425867
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INTRODUCTION: The fracture prevention effects of teriparatide (TPTD) and alendronate (ALN) were evaluated in frail patients using data from the JOINT-05 trial. In addition, predictors of adherence-related treatment disco...INTRODUCTION: The fracture prevention effects of teriparatide (TPTD) and alendronate (ALN) were evaluated in frail patients using data from the JOINT-05 trial. In addition, predictors of adherence-related treatment discontinuation were evaluated for TPTD and ALN. MATERIALS AND METHODS: Japanese women aged ≥ 75 years with primary osteoporosis and high fracture risk were randomized to either sequential therapy (TPTD for 72 weeks followed by ALN for 48 weeks) or ALN monotherapy for 120 weeks. Cognitive frailty was defined as an MMSE score ≤ 27, and physical frailty as requiring support or nursing care. Vertebral, non-vertebral, and all fractures were assessed. Adherence-related discontinuations were identified, and baseline predictors were analyzed using multiple regression to calculate odds ratios. RESULTS: A total of 514 patients with cognitive frailty (254 with TPTD, 260 with ALN) and 204 patients with physical frailty (109 with TPTD, 95 with ALN) were identified. In patients with cognitive frailty, vertebral fracture incidence tended to be lower with TPTD (rate ratio 0.72), but not significantly. In patients with physical frailty, the incidence was significantly lower with TPTD (rate ratio 0.50, p < 0.01). Dyslipidemia and serum calcium levels were significant predictors of TPTD discontinuation, whereas cognitive impairment and dyslipidemia were predictors for ALN discontinuation. CONCLUSION: In patients with physical frailty, TPTD reduced vertebral fractures significantly more than ALN. However, in cases with cognitive impairment, the results of the JOINT-05 study may not necessarily apply. Assessing the presence of dyslipidemia and cognitive decline may be useful for predicting adherence-related discontinuation. TRIAL REGISTRATION: jRCTs031180235 and UMIN000015573, March 12, 2019.
INTRODUCTION: The systemic immune-inflammation index (SII) may influence bone homeostasis through inflammatory modulation. Although bone marrow adipocytes regulate bone metabolism via adipokine secretion, their interacti...INTRODUCTION: The systemic immune-inflammation index (SII) may influence bone homeostasis through inflammatory modulation. Although bone marrow adipocytes regulate bone metabolism via adipokine secretion, their interaction with SII remains unexplored. We investigated the SII-marrow adiposity relationship in postmenopausal women. MATERIALS AND METHODS: This retrospective study included 187 postmenopausal women. Lumbar spine MRI using chemical shift encoding generated proton density fat fraction (PDFF) maps, with bone mineral density (BMD) measured by dual x-ray absorptiometry. The relationship between SII and marrow PDFF was evaluated through multivariable-adjusted linear regression, smooth curve fittings, and threshold analysis. RESULTS: The results revealed a negative correlation between marrow PDFF values and BMD (r = - 0.438, P < 0.001). After accounting for age, time since menopause, body mass index, physical activity, C-reactive protein, interleukin (IL)-1β, IL-6, tumor necrosis factor-α, and BMD in the regression analysis, each unit increase in SII was found to be inked to an increase of 0.247 (β = 0.247; 95% confidence interval [CI], 0.212 to 0.281; P <0.001) in PDFF. After converting SII to a categorical variable (quartiles), participants in the highest SII quartile had a 16.8% higher vertebral marrow PDFF than those in the lowest SII quartile (β = 16.753, 95% CI: 11.036-18.522, P <0.001). Furthermore, a curvilinear relationship and threshold effect were also identified. Turning point was identified at the SII value of 441 on the adjusted smooth curve. CONCLUSIONS: SII levels were positively associated with marrow adiposity in postmenopausal women.
Yashima N, Minamizono W, Matsunaga H
… +6 more, Lyu J, Fujikawa K, Suito H, Okunuki T, Nakai S, Ohsako M
J Bone Miner Metab
· 2025 Jul · PMID 40301161
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INTRODUCTION: We investigated the effects of non-contact electrical stimulation via a Vector-potential (VP) transformer, a novel physical therapy device, on bone healing in drill-hole injury models. MATERIALS AND METHODS...INTRODUCTION: We investigated the effects of non-contact electrical stimulation via a Vector-potential (VP) transformer, a novel physical therapy device, on bone healing in drill-hole injury models. MATERIALS AND METHODS: Six-week-old male Wistar rats, after a one-week acclimation period, were divided into three groups: the control group (CO), the bone injury group (BI), in which a drill-hole injury was created, and the VP stimulation group (VP), which received non-contact electrical stimulation via a VP transformer after bone injury. In the VP group, rats underwent stimulation at 200 kHz for 30 minutes per day, seven days per week. RESULTS: The VP group exhibited increased bone formation as early as day 7 post-injury, with significantly higher bone volume than the BI group at all time points (day 7: p = 0.0003; day 14: p = 0.0024; day 21: p = 0.0001). By day 21, the VP group showed lighter toluidine blue staining and reduced biglycan immunoreactivity compared to the BI group. Bone mineral density also increased (p = 0.0008). Osteoblasts in the VP group displayed abundant cytoplasm and a high capacity for osteocalcin synthesis. Additionally, the VP group demonstrated increased expression of Bglap (day 5: p = 0.0068; day 7: p = 0.0096) and Ctsk (day 7: p = 0.0329; day 14: p = 0.0171), along with a higher number of TRAP-positive osteoclasts (day 21: p = 0.0159) compared to the BI group. CONCLUSION: Non-contact electrical stimulation via a VP transformer promotes bone healing in drill-hole injury models.
AIM: This study aimed to evaluate the effects of Limosilactobacillus reuteri (LR) and its combination with menaquinone-7 (MK-7; K) on ovariectomy-induced bone loss in mice and on bacterial growth in vitro. METHODS: In th...AIM: This study aimed to evaluate the effects of Limosilactobacillus reuteri (LR) and its combination with menaquinone-7 (MK-7; K) on ovariectomy-induced bone loss in mice and on bacterial growth in vitro. METHODS: In the in vivo study, animals were divided into five groups: sham-operated (SHAM); ovariectomy (OVX); OVX-LR; OVX-K; OVX-LR-K. After 4 weeks of treatment, femur cortical biomechanical properties, vertebral microarchitecture, osteocalcin levels, Occludin and Jam3 expression, and intestinal histomorphometry were evaluated. In vitro, microbial growth was assessed by incubating L. reuteri with MK-7. After incubation, optical densities were measured, and bacteria were cultured on MRS agar for the colony-forming unit (CFU/ml) counting. RESULTS: L. reuteri, MK-7, and their combination significantly improved femur intrinsic biomechanical properties and cortical vertebral thickness. The combined treatment exhibited a synergistic effect on the modulus of elasticity, and increased cortical vertebral volume and the villus/crypt ratio in comparison to OVX. L. reuteri and its combination with MK-7 restored vertebral trabecular microarchitecture values to SHAM levels. However, no significant differences were observed in serum levels of osteocalcin, Occludin or Jam3 expression among groups. In vitro, a significant increase in optical density and viable cell count was observed after 4 h of incubation. CONCLUSION: L. reuteri and its combination with MK-7 improved bone biomechanical and microarchitecture properties. We propose a synergistic preventive action of L. reuteri and MK-7 in estrogen-deficient mice. Additionally, the enhanced survival of L. reuteri in the presence of MK-7 may partially explain the observed benefits of the combined treatment in vivo.
INTRODUCTION: This study aimed to evaluate fracture incidence in patients with rheumatoid arthritis (RA) over 13 years in the Institute of Rheumatology Rheumatoid Arthritis (IORRA) cohort study. MATERIALS AND METHODS: Th...INTRODUCTION: This study aimed to evaluate fracture incidence in patients with rheumatoid arthritis (RA) over 13 years in the Institute of Rheumatology Rheumatoid Arthritis (IORRA) cohort study. MATERIALS AND METHODS: The IORRA is a prospective observational cohort study of Japanese patients with RA. Between 2011 and 2023, 10,257 patients with RA were enrolled. Clinical parameters and data on fractures were collected biannually using self-reported questionnaires. The fracture incidence, standardized by sex, age, and Japanese Health Assessment Questionnaire score, was calculated for each two-year period. RESULTS: From 2011 to 2023, the proportions of patients achieving Disease Activity Score in 28 joints remission, using biologic disease-modifying antirheumatic drugs, and taking osteoporosis medications increased (38.0% to 64.7%, 14.2% to 42.2%, and 31.6% to 38.3%, respectively), while the proportion of glucocorticoid use decreased (38.3% to 22.2%). The incidence of all and non-vertebral fractures increased from 47.2 and 36.7/1000 person-years in 2011 to 52.8 and 43.0/1000 person-years in 2023, respectively. Using 2023 as the reference, the standardized incidence ratios for all and non-vertebral fractures were: 2011-2012, 0.90 [95% confidence interval (CI) 0.82-0.98] and 0.86 (95% CI 0.78-0.95); 2013-2014, 0.88 (95% CI 0.81-0.96) and 0.84 (95% CI 0.76-0.93); 2015-2016, 0.94 (95% CI 0.86-1.02) and 0.89 (95% CI 0.80-0.98); 2017-2018, 0.97 (95% CI 0.88-1.07) and 0.94 (95% CI 0.84-1.05); 2019-2020, 0.95 (95% CI 0.84-1.07) and 0.93 (95% CI 0.81-1.06); 2021-2022, 1.00 (95% CI 0.89-1.13) and 0.99 (95% CI 0.86-1.13). CONCLUSION: Despite advancements in RA management over 13 years, fracture incidence may have increased in patients with RA.
INTRODUCTION: Although numerous studies have highlighted the involvement of Wnt-mediated signaling in Mg ion-enhanced bone healing, whether Wnt-stimulated signaling is essential for the Mg ion-triggered bone repair and m...INTRODUCTION: Although numerous studies have highlighted the involvement of Wnt-mediated signaling in Mg ion-enhanced bone healing, whether Wnt-stimulated signaling is essential for the Mg ion-triggered bone repair and mass accrual is not yet completely understood. MATERIALS AND METHODS: We generated Wls wild-type (WT) control and their corresponding mutant (MT), Col2.3-Cre;Wls mice of osteoblastic Wntless (Wls) ablation and explored how supplemental magnesium gluconate (MgG) affects bone mass accrual and defected bone healing in relation to the Wls ablation. RESULTS: Osteoblastic Wls ablation impaired bone mass accrual and bone healing along with age-related degenerative complications in bone marrow (BM) and BM cells. Oral supplementation of WT mice with MgG did not change natural bone mass accrual, but enhanced regenerative bone healing in femoral defects and the functionalities of BM cells. Supplemental MgG suppressed the Wls ablation-related bone loss and also stimulated new bone formation in the defects of MT mice. The MgG-induced beneficial effects in the MT mice were orchestrated with its potencies to ameliorate senescence, oxidative damage, and functional loss of BM and BM adherent cells, as well as to stimulate osteogenic activity. CONCLUSION: This study demonstrates that supplemental MgG is able to improve bone homeostatic maintenance by recovering age-related degenerative complications even at the lack of osteoblastic Wnt-stimulated signaling.
INTRODUCTION: Patients with rheumatoid arthritis (RA) are at an increased risk of osteoporosis and vertebral fractures. We investigated the risk factors for vertebral fractures and severe vertebral fractures in patients...INTRODUCTION: Patients with rheumatoid arthritis (RA) are at an increased risk of osteoporosis and vertebral fractures. We investigated the risk factors for vertebral fractures and severe vertebral fractures in patients with RA, including comorbidities and urinary pentosidine levels. MATERIALS AND METHODS: This study included 637 patients with available clinical data on urinary pentosidine levels, vertebral fractures, and comorbidities. Vertebral fractures were evaluated using plain X-ray imaging. Comorbidities considered relevant to osteoporosis were type 2 diabetes mellitus, chronic kidney disease, and lung diseases. RESULTS: The prevalence of vertebral fractures in this cohort was 30.1%. Patients with vertebral fracture Patients with vertebral fractures were significantly more likely to be older [odds ratio (OR) 1.075; 95% confidence interval (CI) 1.049-1.1.03], had higher prevalence of comorbidities (OR 1.770; 95% CI 1.138-2.753), higher urinary pentosidine levels (OR 1.028; 95% CI 1.013-1.044), higher history of non-vertebral fractures (OR 2.084; 95% CI 1.222-3.557), and lower total hip T-score (OR 0.526; 95% CI 0.329-0.841) than patients without vertebral fractures. Among patients with vertebral fractures, 54.2% had severe vertebral fractures. Patients with severe vertebral fractures were more likely to have lower lumbar spine T-scores (OR 0.768; 95% CI 0.622-0.949) than patients with non-severe vertebral fractures. CONCLUSIONS: This study identified factors associated with vertebral fractures and severe vertebral fractures in patients with RA. Notably, vertebral fractures were associated with comorbidities and urinary pentosidine levels. In patients with RA and vertebral fractures, low BMD in the lumbar spine was a significant factor associated with severe vertebral fractures.
J Bone Miner Metab
· 2025 Jan · PMID 40119935
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The use of medications in sequence is recommended in several osteoporosis guidelines to afford the best protection for the patient at very high risk of fracture. Sequential therapy following once-weekly as well as daily...The use of medications in sequence is recommended in several osteoporosis guidelines to afford the best protection for the patient at very high risk of fracture. Sequential therapy following once-weekly as well as daily teriparatide treatment is a potent option for those patients.
INTRODUCTION: The prevalence of osteoporosis (OP) is steadily rising, leading to a higher risk of mortality. This study assessed the impact of the Weight-Adjusted Waist Index (WWI) on osteoporosis-related mortality. MATE...INTRODUCTION: The prevalence of osteoporosis (OP) is steadily rising, leading to a higher risk of mortality. This study assessed the impact of the Weight-Adjusted Waist Index (WWI) on osteoporosis-related mortality. MATERIALS AND METHODS: Data from NHANES 2005-2010, 2013-2014, and 2017-2018 were analyzed to evaluate the relationship between WWI and mortality in osteoporotic patients using weighted proportional hazards model and Kaplan-Meier survival analysis. A subgroup analysis was performed to ensure the stability of the findings. RESULTS: The study included 1324 participants. The findings indicated a positive correlation between WWI and OP (OR 1.65, 95% CI 1.45-1.89). Among patients with OP, WWI showed a positive association with all-cause mortality (HR 1.28, 95% CI 1.10-1.48). There was no observed correlation between varying WWI levels and mortality due to cardiovascular disease or cancer. CONCLUSIONS: Maintaining a lower WWI is associated with a reduced risk of all-cause mortality among individuals with OP.
Ali DS, Khan AA, Mirza RD
… +37 more, Appelman-Dijkstra NM, Brandi ML, Carpenter TO, Chaussain C, Imel EA, de Beur SMJ, Florenzano P, Morrison A, Alrob HA, Alexander RT, Alsarraf F, Beck-Nielsen SS, Biosse-Duplan M, Cohen-Solal M, Crowley RK, Dandurand K, Filler G, Fukumoto S, Gagnon C, Goodyer P, Grasemann C, Grimbly C, Hussein S, Javaid MK, Khan S, Khan A, Lehman A, Lems WF, Lewiecki EM, McDonnell C, Morgante E, Portale AA, Rhee Y, Siggelkow H, Tosi L, Ward LM, Guyatt G
J Bone Miner Metab
· 2025 May · PMID 40119067
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The guideline panel, comprising international experts in X-linked hypophosphatemia (XLH), patient partners from the XLH patient population, and guideline methodologists, held 18 teleconferences between January 2023 and J...The guideline panel, comprising international experts in X-linked hypophosphatemia (XLH), patient partners from the XLH patient population, and guideline methodologists, held 18 teleconferences between January 2023 and July 2024 to develop comprehensive guidelines for the diagnosis and management of XLH in children and adults. For a subset of our questions, we utilized the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology, assessed the certainty of evidence and formulated GRADEd recommendations. For these questions, the panelists and methodologists collaboratively framed PICO (Population, Intervention, Control, and Outcomes) questions and conducted four systematic reviews assessing the impact of medical therapy-using either burosumab or phosphate and active vitamin D-on patient-important outcomes in the XLH population as well as the impact of medical intervention compared to no treatment. We assessed the risk of bias and transparently generated summary of findings tables using MAGICApp. The panel developed three GRADEd treatment recommendations for adults and two for children. Each GRADEd recommendation was linked to an underlying body of evidence, reflecting judgments on the certainty of evidence, recommendation strength, values, preferences, and considerations of costs, feasibility, acceptability, and equity. Due to the paucity of evidence, the panel developed very low-quality GRADEd recommendations on monitoring patients with XLH based on an expert clinical practice survey. Using a rigorous narrative literature review, the panel developed non-GRADEd recommendations including guidance for pregnant women, patients with dental complications, and other areas where evidence is limited. This article summarizes the methodology utilized for the development of both GRADEd and non-GRADEd recommendations for patients with XLH.