Bone Health Research Articles

Synthetic Data-Enhanced Classification of Prevalent Osteoporotic Fractures Using Dual-Energy X-Ray Absorptiometry-Based Geometric and Material Parameters.

Bone fracture risk assessment for osteoporotic patients is essential for implementing early countermeasures and preventing discomfort and hospitalization. Current methodologies, such as Fracture Risk Assessment Tool (FRAX), provide a risk assessment over a 5- to 10-year period rather than evaluating the bone's current health status. The database was collected by Ajou University Medical Center from 2017 to 2021. It included 9,260 patients, aged 55 to 99, comprising 242 femur fracture (FX) cases and 9,018 non-fracture (NFX) cases. To model the association of the bone's current health status with prevalent FXs, three prediction algorithms-extreme gradient boosting (XGB), support vector machine, and multilayer perceptron-were trained using two-dimensional dual-energy X-ray absorptiometry (2D-DXA) analysis results and subsequently benchmarked. The XGB classifier, which proved most effective, was then further refined using synthetic data generated by the adaptive synthetic oversampler to balance the FX and NFX classes and enhance boundary sharpness for better classification accuracy. The XGB model trained on raw data demonstrated good prediction capabilities, with an area under the curve (AUC) of 0.78 and an F1 score of 0.71 on test cases. The inclusion of synthetic data improved classification accuracy in terms of both specificity and sensitivity, resulting in an AUC of 0.99 and an F1 score of 0.98. The proposed methodology demonstrates that current bone health can be assessed through post-processed results from 2D-DXA analysis. Moreover, it was also shown that synthetic data can help stabilize uneven databases by balancing majority and minority classes, thereby significantly improving classification performance.

The Importance of Vitamin D and Magnesium in Athletes

Vitamin D and magnesium are essential nutrients that play key roles in an athlete’s performance, recovery, and overall health. Vitamin D is crucial for bone health (aiding calcium absorption and preventing stress fractures), muscle function (preventing weakness and injury), and reducing respiratory infections. Magnesium is fundamental in muscle function, adenosine triphosphate production for muscle contraction, electrolyte balance, bone strength, and cardiovascular health. The magnesium requirement of healthy adults is estimated at 300–400 mg/day, but there is evidence that athletes may have higher magnesium needs compared to sedentary persons. Magnesium and vitamin D are closely linked—vitamin D aids magnesium absorption, while magnesium is vital for vitamin D synthesis, transport, and activation. Given their importance in athletes, this article explores their functions, interactions, and the effects of deficiencies and supplementation in athletic populations.

Effectivity of Vitamin D in Preventing Breast Cancer and Evaluation of 25(OH)D Examination As A Laboratory Screening Tool

Vitamin D is currently associated with many diseases, not only bone health but also in autoimmune diseases, cancer, and neurological disorders. This study focuses on the mechanism relation vitamin D on breast cancer, especially with regard to estrogen receptor-positive (ER+) and human epidermal growth factor receptor 2-positive (HER 2+) cancers. Therapeutic supplementation is a commonly used approach to increase vitamin D levels. The effects of vitamin D have been investigated in various aspects, including regulation of cell growth and differentiation, apoptosis, intercellular contact, angiogenesis, immune function, as well as interaction with gut microbiota. In this study, the effects of vitamin D on breast cancer and its relationship with serum 25(OH)D levels were also researched. As a result, patients newly diagnosed with breast cancer were found to have low serum 25(OH)D levels. Vitamin D administration has been shown to induce apoptosis in breast cancer cells.

CT-Based Evaluation of Hounsfield Units—A Novel Screening Tool for Undiagnosed Osteoporosis in Patients with Fragility Fractures of the Pelvis

Background: This institutional, register-based analysis aimed to evaluate the feasibility of using CT-based sacral Hounsfield units (HUs) for assessing bone density in pelvic fragility fractures and to explore their potential correlation with DEXA measurements and osteological laboratory diagnostics. Methods: Patients aged > 80 years, admitted between 2003 and 2019 with pelvic ring fractures, were analyzed in this retrospective single-center study. CT scans were evaluated according to the classification of fragility fractures of the pelvis (FFPs), which guided treatment decisions (conservative or surgical). The diagnosis of a fragility fracture was based on both fracture morphology and patient history, including the presence of low-energy trauma. Bone health was assessed using standardized laboratory diagnostics including serum calcium, phosphate, alkaline phosphatase, and 25(OH)-vitamin D, in addition to DEXA scans and CT-derived Hounsfield units. Vitamin D levels and bone density evaluations were analyzed to identify possible correlations among these factors and with fracture patterns. Results: A total of 456 patients (mean age 87.3 years, 79.6% female) were included. The CT-based FFP classification identified Type II as the most common fracture type (66.7%). Conservative treatment was the predominant approach (84.9%). Serum 25(OH)-vitamin D deficiency was observed in 62.7% of the patients, while osteopenia and osteoporosis were found in 34.3% and 46.5% of cases, respectively. HU values at S1 showed significant correlation with femoral neck T-scores, highlighting the utility of CT scans for bone density assessment. Conclusions: This study emphasizes the complementary roles of CT-derived HU values and DEXA T-scores in evaluating bone quality and fracture severity in geriatric patients with FFP. While DEXA remains the gold standard, CT imaging offers valuable early insights, supporting the timely initiation of osteoporosis therapy. Given the high prevalence of fragility fractures in this age group, early CT-based screening may facilitate earlier initiation of osteoporosis-specific therapy, including anabolic agents where indicated. Further research is needed to explore the relationships between vitamin D levels, bone density assessments, and fracture types.

Monosodium Urate Crystal Depletion and Bone Erosion Response in Kidney Transplant Recipients With Uncontrolled Gout Treated With Pegloticase: PROTECT Serial Dual-Energy Computed Tomography Findings

Background. Hyperuricemia and gout are associated with poor outcomes in kidney transplant (KT) recipients, including graft failure. The PROspective sTudy of pEglotiCase in Transplant patients (PROTECT) trial showed high urate-lowering efficacy of pegloticase in immunosuppressed KT recipients with uncontrolled gout. Here, we report serial dual-energy computed tomography (DECT) findings in PROTECT participants. Methods. KT recipients with uncontrolled gout (serum urate [SU] ≥7 mg/dL, refractory to/intolerant of oral urate-lowering therapy, and symptoms [≥2 flares per year, tophi, and/or gouty arthritis]) and serial DECT imaging were included. Patients were required to have an estimated glomerular filtration rate ≥15 mL/min/1.73 m2 >1 y posttransplant. All patients received pegloticase for ≤24 wk (8 mg infusion every 2 wk) and underwent imaging (screening, week 14, week 24). DECT images were acquired with standard protocols and postprocessed for monosodium urate (MSU) volume (VMSU) using default settings. Regions (bilateral hands/wrists, feet/ankles, knees) with paired screening/week 24 images and screening VMSU ≥0.5 cm3 (minimized DECT-artifact influence) were included. Results. Eight patients underwent DECT imaging (all men; age: 52.3 ± 11.2 y, time since KT: 18.7 ± 6.9 y, estimated glomerular filtration rate: 45.6 ± 12.4 mL/min/1.73 m2, SU: 10.4 ± 2.1 mg/dL). Six patients (75%) completed the study and received 24 wk of pegloticase therapy, and 2 prematurely discontinued because of COVID-exposure concerns. Of the 6 patients, 4 met imaging inclusion criteria and were included in the analysis. All 4 patients had sustained SU-lowering during month 6 with marked VMSU reduction at week 24 (mean change in VMSU: –98.9%±1.7% [5 imaging regions]). Numerous bone erosions were present in all patients with MSU-adjacent, unknown mineral deposit-adjacent, and deposit-independent erosions. Imaging suggested osteopenia/osteomalacia in 5 patients (83%). After pegloticase treatment, MSU-adjacent erosions decreased in size in a single patient with no DECT evidence of osteopenia/osteomalacia. Conclusions. Consistent with prior studies in nontransplant populations, marked depletion of deposited MSU occurred in KT recipients with uncontrolled gout after pegloticase therapy. However, unlike transplant-naive patients, subsequent bone erosion remodeling was not widely observed in urate-adjacent erosions, perhaps due to overall poor bone health in this patient population. Clinical Trial Registration. ClinicalTrials.gov: NCT04087720.

Role of protein intake in maintaining muscle mass composition among elderly females suffering from sarcopenia

Dietary protein is crucial in preserving muscle mass and promoting long-term bone health, particularly in aging populations. The novelty of this study lies in evaluating the impact of varying protein intake levels (0.8 vs. 1.2 g/kg b.w/d) on muscle mass composition in elderly females suffering from sarcopenia. For this purpose, in this research trial, a total of 126 participants (60–75 years) were enrolled and equally divided into two groups: normal protein intake (0.8 g/kg b.w/d) and moderately high protein intake (1.2 g/kg b.w/d) for 12 weeks. The effects of dietary protein were assessed using anthropometric measurements, magnetic resonance imaging (MRI), handgrip, and knee flexion tests with baseline and post-intervention comparisons. Statistical analysis was conducted using SPSS, employing paired sample t-test at a significance level of p < 0.05. Results indicated a significant improvement in muscle mass composition with moderately high protein intake. Anthropometric parameters, including body mass (83.51 ± 4.23 kg) and waist circumference (113.90 ± 10.82 cm), showed notable enhancement in the moderately higher protein group. Muscle function and imaging assessments, such as handgrip strength and knee flexion, demonstrated improved functionality. MRI-derived measurements of the muscle composition of the calf (141.23 ± 4.87 MCSA, mm2 × 104) and thigh (258.04 ± 7.26 MCSA, mm2 × 104) further confirmed the positive impact of increased protein intake. The study concluded that a moderately high protein diet effectively supports muscle health in elderly females with sarcopenia. Therefore, an adequate protein intake may serve as a strategic nutritional intervention to mitigate muscle loss and improve overall physical function in aging women.

Osteoporosis Is Associated with Cerebral Small Vessel Disease in Stroke-Free Individuals: A Retrospective Observational Study

Objectives: This study aimed to investigate the relationship between osteoporosis and cerebral small vessel disease (CSVD) burden in stroke-free individuals, as well as its specific imaging markers, including lacunes, enlarged perivascular spaces (EPVSs), white matter hyperintensities (WMHs), and brain atrophy (BA). Methods: A total of 684 stroke-free patients who underwent both bone mineral density (BMD) assessments and brain MRI were included. Clinical data, CSVD burden scores, imaging markers of CSVD, and bone density parameters were collected. Logistic regression models were used to evaluate the relationship between BMD and CSVD burden and imaging markers. Results: Osteoporosis, including hip and vertebral osteoporosis, was independently associated with CSVD burden (OR = 2.332, 95%CI: [1.345, 4.039], p = 0.003; OR = 2.598, 95%CI: [1.540, 4.384], p < 0.001; OR = 1.515, 95%CI: [1.010, 2.272], p = 0.044). Increased BMD in the hip and spine correlated with reduced CSVD burden (OR = 0.929, 95%CI: [0.887, 0.972], p = 0.001; OR = 0.952, 95%CI: [0.917, 0.989], p = 0.012). Hip osteoporosis was a risk factor for lacunes (OR = 2.215, 95%CI: [1.197, 4.1], p = 0.011), multiple lacunes (OR = 2.274, 95%CI: [1.039, 4.980], p = 0.04), severe WMH (OR = 2.611, 95%CI: [1.171, 5.823], p = 0.019), and EPVS ≥ 2 (OR = 1.99, 95%CI: [1.133, 3.495], p = 0.017). No significant association was found between osteoporosis and BA (p = 0.928). In sex-stratified analyses, both hip and vertebral osteoporosis were independently associated with a higher CSVD burden in female patients (hip: OR = 2.529, 95%CI: [1.122, 5.703], p = 0.025; vertebral: OR = 3.129, 95%CI: [1.517, 6.455], p = 0.002; general osteoporosis: OR = 1.755, 95%CI: [1.057, 2.912], p = 0.03), whereas no significant association was observed in male patients (all p > 0.05). Conclusions: Osteoporosis was independently associated with an increased burden of CSVD, particularly evident in female patients. These findings suggest that bone health may be important in CSVD management, particularly for women.

Getting bone health right from the start: new tools for bone mineral density evaluation and determinants of BMD from pregnancy to 12 months of life

Getting bone health right from the start: new tools for bone mineral density evaluation and determinants of BMD from pregnancy to 12 months of life

Bone health in cleidocranial dysplasia: a large single-centre UK case series and literature review

Bone health in cleidocranial dysplasia: a large single-centre UK case series and literature review

Effects of different dietary patterns on bone health: mouse models

Effects of different dietary patterns on bone health: mouse models

Vitamin d replenishment and its effectiveness on bone health in children receiving antiepileptic drugs: a randomized controlled trial

Vitamin d replenishment and its effectiveness on bone health in children receiving antiepileptic drugs: a randomized controlled trial

Associations between multiple metals exposure and bone mineral density: a population-based study in U.S. children and adolescents

AimThis study examined the correlation between multi-metal exposure and bone mineral density (BMD) in U.S. children and adolescents.MethodsData from 1,591 participants (aged 8–19) were analyzed using the National Health and Nutrition Examination Survey (NHANES) 2011–2016. We measured serum copper (Cu), selenium (Se), zinc (Zn), and blood lead (Pb), cadmium (Cd), mercury (Hg), manganese (Mn). Dual-energy X-ray absorptiometry assessed lumbar and total BMD. Advanced statistical approaches including weighted quantile sum (WQS) regression and bayesian kernel machine regression (BKMR) were employed to evaluate complex exposure interactions.ResultsBlood Pb and serum Cu showed inverse associations with, while serum Se positively correlated with lumbar BMD (blood Pb: β: -0.013, serum Cu: β: -0.063, serum Se: 0.035) (all P < 0.05). The WQS index showed a significant association with both lumbar BMD(β = 0.019, P < 0.05) and total BMD (β = 0.019, P < 0.001). WQS analysis identified Cd, Se, and Hg as primary contributors to both lumbar and total BMD variations. BKMR models revealed nonlinear exposure–response relationships and synergistic effects between Cd and Mn.ConclusionThese findings highlight the importance of considering mixed metal exposures in bone health assessments, providing crucial insights for developing preventive strategies to protect skeletal development in pediatric populations.

Bone health index (BHI) in children with osteogenesis imperfecta: is it an accurate tool for predicting fracture risk?

Bone health index (BHI) in children with osteogenesis imperfecta: is it an accurate tool for predicting fracture risk?

Real-world bone health outcomes in surgical, medical, and monitored patients with primary hyperparathyroidism

Real-world bone health outcomes in surgical, medical, and monitored patients with primary hyperparathyroidism

Assessment of bone health, psychological wellbeing and clinical spectrum in turner syndrome: experience from a tertiary healthcare centre from north india

Assessment of bone health, psychological wellbeing and clinical spectrum in turner syndrome: experience from a tertiary healthcare centre from north india

Characterization of bone health in an adult population with turner syndrome: insights from a monocentric cross-sectional study

Characterization of bone health in an adult population with turner syndrome: insights from a monocentric cross-sectional study

Exploring Women’s Knowledge of Nutrition and Bone Health: A Preventive Focus on Osteoporosis

Exploring Women’s Knowledge of Nutrition and Bone Health: A Preventive Focus on Osteoporosis

Association between cardiometabolic index and bone mineral density among adolescents in the United States

ObjectivesThe cardiometabolic index (CMI) serves as a comprehensive metric for evaluating cardiometabolic health, and is correlated with several health outcomes. However, research examining the relationship between CMI and bone mineral density (BMD), particularly in adolescent populations, remains limited and warrants further investigation.MethodsThe weighted multiple linear regression analysis was conducted to elucidate the association between CMI and BMD.ResultsOur study ultimately included 1,514 participants. After adjusting for pertinent covariates, we observed that per-unit increases in the CMI corresponded with reductions in BMD by 0.052 g/cm2 for femoral neck (β=-0.052, 95% CI: -0.087 to -0.018) and 0.048 g/cm2 for lumbar spine (L1-L4) (β=-0.048, 95% CI: -0.085 to -0.011). In quartile analyses, individuals in the highest quartile displayed significantly reduced BMD at the femoral neck (β=-0.036, 95% CI: -0.064 to -0.007) and lumbar spine (L1-L4) (β=-0.041, 95% CI: -0.070 to -0.011) compared to those in the lowest quartile (P&amp;lt;0.05). No statistical significance was detected between CMI and BMD at the total femur, trochanter, and intertrochanter sites. Furthermore, stratified analyses indicated no significant interactions involving age, sex, or race in relation to CMI and BMD.ConclusionsIn the adolescent population, CMI is inversely related to BMD. These findings highlight a potential link between cardiometabolic health and bone health. Future longitudinal investigations are warranted to determine causal relationships and underlying mechanisms.

Small Molecules, Big Impact: Exploring Oxidative Stress, Micronutrients, and Bone Health

Small Molecules, Big Impact: Exploring Oxidative Stress, Micronutrients, and Bone Health

Role of Masticatory Force in Modulating Jawbone Immunity and Bone Homeostasis: A Review

Mastication exerts a significant influence on both the structural and immunological environment of the jawbone. The mechanical stress generated during chewing initiates bone remodeling through the coordinated activities of osteoclasts and osteoblasts, with these processes being modulated by immune cell responses. This review summarizes the interaction between masticatory forces and jawbone immunity, focusing on key mechanisms such as mechanotransduction in osteocytes, macrophage polarization, and the activation of T cells. The review also delves into the role of the receptor activator of nuclear factor κ-B ligand (RANKL), receptor activator of nuclear factor κ-B (RANK), and osteoprotegerin (OPG) signaling pathway, highlighting its critical function in bone resorption and immune regulation. Additionally, the review summarizes how masticatory forces modulate the immune response through changes in immune cells, particularly focusing on cytokines, and the involvement of hormonal and molecular pathways. These findings provide valuable insights into the complex interplay between mechanical forces and immune cells, with implications for bone health.