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UNLABELLED: Our study examined associations of the CXC motif chemokine ligand 9 (CXCL9), a pro-inflammatory protein implicated in age-related inflammation, with musculoskeletal function in elderly men. We found in certain outcomes both cross-sectional and longitudinal significant associations of CXCL9 with poorer musculoskeletal function and increased mortality in older men. This requires further investigation. PURPOSE: We aim to determine the relationship of (CXCL9), a pro-inflammatory protein implicated in age-related inflammation, with both cross-sectional and longitudinal musculoskeletal outcomes and mortality in older men. METHODS: A random sample from the Osteoporotic Fractures in Men (MrOS) Study cohort (N = 300) was chosen for study subjects that had attended the third and fourth clinic visits, and data was available for major musculoskeletal outcomes (6 m walking speed, chair stands), hip bone mineral density (BMD), major osteoporotic fracture, mortality, and serum inflammatory markers. Serum levels of CXCL9 were measured by ELISA, and the associations with musculoskeletal outcomes were assessed by linear regression and fractures and mortality with Cox proportional hazards models. RESULTS: The mean CXCL9 level of study participants (79.1 ± 5.3 years) was 196.9 ± 135.2 pg/ml. There were significant differences for 6 m walking speed, chair stands, physical activity scores, and history of falls in the past year across the quartiles of CXCL9. However, higher CXCL9 was only significantly associated with changes in chair stands (β =  - 1.098, p

A fracture liaison service is a systems-level multidisciplinary approach designed to reduce subsequent fracture risk in patients who recently sustained fragility fractures. It is estimated that one in three women and one in five men over the age of 50 years old have osteoporosis. Nonetheless, only 9 to 20% of patients who sustain an initial fragility fracture eventually receive any osteoporosis treatment. With the aim of preventing subsequent fractures, a fracture liaison service (FLS) works through identifying patients presenting with fragility fractures to the hospital and providing them with easier access to osteoporosis care through referrals for bone health and fracture risk assessment and recommendation or initiation of osteoporosis treatment. Currently, there are four major types of FLS models ranging from services that only identify at-risk patients and inform and educate the patient but take no further part in communicating their findings to other stakeholders in patients care, to services that identify, investigate, and initiate treatment at the other end of the spectrum. In this article, we review the benefits, challenges, and outcomes of FLS in the American healthcare system with further exploration of the roles each member of the multidisciplinary team can play in improving patients bone health.

UNLABELLED: Long-term physical functioning trajectories following distal forearm fracture are unknown. We found that women with versus those without distal forearm fracture were more likely to experience a 5-year decline in physical functioning, independent of initial physical functioning level. This association was most evident among women 80 years and older. INTRODUCTION: Physical functioning trajectory following lower arm or wrist fracture is not well understood. PURPOSE: This study is to evaluate physical functioning trajectory before vs. after lower arm or wrist fracture, stratified by age. METHODS: We performed a nested case-control study of prospective data from the Womens Health Initiative Study (n = 2097 cases with lower arm or wrist fracture, 20,970 controls). Self-reported fractures and the physical functioning subscale of the RAND 36-item Short-Form Health Survey were assessed annually. We examined three physical functioning trajectory groups: stable, improving, and declining. RESULTS: Mean (SD) number of physical functioning measurements was 5.2 (1.5) for cases and 5.0 (1.4) for controls. Declining physical functioning was observed among 20.4% of cases and 16.0% of controls. Compared to women without lower arm or wrist fracture, women with lower arm or wrist fracture were 33% more likely to experience declining physical functioning (adjusted odds ratio [aOR] 1.33 95% confidence interval [CI] 1.19-1.49, reference group stable or improving physical functioning trajectory). Associations varied by age: age ≥ 80 years aOR 1.56 (95% CI 1.29-1.88); age 70-79 years aOR 1.29 (95% CI 1.09-1.52); age

This study aimed to compare the diagnostic value of dual-energy CT (DECT)-based volumetric material decomposition with that of Hounsfield units (HU)-based values and cortical thickness ratio for predicting the 2-year risk of osteoporosis-associated fractures. The L1 vertebrae of 111 patients (55 men, 56 women; median age, 62 years) who underwent DECT between 01/2015 and 12/2018 were retrospectively analyzed. For phantomless bone mineral density (BMD) assessment, a specialized DECT postprocessing software employing material decomposition was utilized. The digital records of all patients were monitored for two years after the DECT scans to track the incidence of osteoporotic fractures. Diagnostic accuracy parameters were calculated for all metrics using receiver-operating characteristic (ROC) and precision-recall (PR) curves. Logistic regression models were used to determine associations of various predictive metrics with the occurrence of osteoporotic fractures. Patients who sustained one or more osteoporosis-associated fractures in a 2-year interval were significantly older (median age 74.5 years [IQR 57–83 years]) compared those without such fractures (median age 50.5 years [IQR 38.5–69.5 years]). According to logistic regression models, DECT-derived BMD was the sole predictive parameter significantly associated with osteoporotic fracture occurrence across all age groups. ROC and PR curve analyses confirmed the highest diagnostic accuracy for DECT-based BMD, with an area under the curve (AUC) of 0.95 [95% CI: 0.89–0.98] for the ROC curve and an AUC of 0.96 [95% CI: 0.85–0.99] for the PR curve. The diagnostic performance of DECT-based BMD in predicting the 2-year risk of osteoporotic fractures is greater than that of HU-based metrics and the cortical thickness ratio. DECT-based BMD values are highly valuable in identifying patients at risk for osteoporotic fractures. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Many studies have indicated that abnormal bone mineral density (BMD) is related to abnormal liver and kidney function, but the effect of serum albumin level on abnormal BMD and osteoporotic fracture is still controversial. The aim of this retrospective study was to investigate the effects of serum albumin levels on abnormal BMD and osteoporotic fractures. Methods: The study included 538 patients through the electronic medical records of inpatients and outpatients stored at Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology. A multivariate logistic regression model was employed to test the relationship between serum albumin levels and abnormal BMD, and the effect of serum albumin levels on osteoporotic fractures was verified through the U test. Correlation between age, sex, kidney stones, coronary heart disease, hypertension, diabetes, fatty liver disease, haemoglobin (HB), mean corpuscular haemoglobin concentration (MCHC), platelets (PLT), platelet distribution width (PDW), lymphocytes (LYMP), alanine aminotransferase (ALT), total protein (TP), albumin (ALB), uric acid (UA), total bilirubin (TBIL), total cholesterol (TC), high-density lipoprotein (HDL) and abnormal BMD were analysed by logistic regression modelling after excluding confounding factors. Results: The ALB level in osteoporotic patients was 41.70 (36.40–45.00) g/L, which was significantly lower than those in the normal BMD and reduced BMD groups. The odds ratio (OR) (95% confidence interval [CI]) between the osteoporosis and normal BMD groups was 0.445 (0.394–0.502); the OR (95% CI) between the osteoporosis and reduced BMD groups was 0.395 (0.341–0.459). In the subgroup analysis by whether or not a fracture was present, the OR (95% CI) was 0.073 (0.045–0.119). Conclusions: ALB is a protective factor against osteoporosis and osteoporotic fractures, suggesting that it may have the potential to predict osteoporosis onset and fractures. [ABSTRACT FROM AUTHOR]

Background/Objectives: Lumbar degenerative disease is a common age-related condition, with epidural steroid injection (ESI) being a widely employed conservative treatment approach. However, the potential effect of ESI on osteoporosis and fracture risk remains unclear. This study investigated the risk of osteoporotic vertebral compression fractures (OVCFs) in patients with lumbar degenerative disease who underwent ESI treatment. Methods: A cohort of 64 patients who received ESI treatment and a control group of 256 patients were included in this study. Demographic data, clinical characteristics, and follow-up information were collected. Cox proportional hazards models were used to analyze risk factors for OVCF, and subgroup analyses were conducted. Results: OVCF was more common in the ESI group than in the control group (hazard ratio [HR]: 3.49, 95% confidence interval [CI]: 1.06–11.43, p = 0.039). After confounding factors were adjusted for, ESI remained an independent risk factor for OVCF (HR: 4.60, 95% CI: 1.01–20.89, p = 0.048). In a subgroup analysis, lower socioeconomic status was associated with higher OVCF risk (HR: 11.82, 95% CI: 1.06–131.26, p = 0.044). The ESI group had improved short-term pain relief, with nonsignificant long-term effects. Conclusions: Patients with lumbar degenerative disease receiving ESI treatment are at an increased risk of OVCF, particularly those with lower socioeconomic status. These findings underscore the importance of regular bone density monitoring and fracture prevention following ESI treatment. Clinicians should carefully weigh the short-term benefits of ESI against the long-term risks and develop individualized follow-up plans for high-risk patients. [ABSTRACT FROM AUTHOR]

Background: Osteoporotic fractures (OPF) are fractures that occur with low-energy injuries or during daily activities, representing a serious consequence of osteoporosis (OP). With the worsening of population aging, the number of OPF patients continues to expand, causing a significant burden on families and society. Consequently, it is significant to diagnose and analyze OPF at the molecular level. Objective: The aim of this research was to explore the diagnostic value of miR-32-3p in OPF patients and to exploit new biomarkers for clinical applications. Methods: The miR-32-3p expression level of patients was detected by RT-qPCR. Diagnostic accuracy of miR-32-3p analyzed adopting ROC curve. Additionally, the risk factors correlation with the occurrence of OPF were assessed by logistic analysis. The effect of miR-32-3p on BMSCs was verified by in vitro transfection experiments. Results: miR-32-3p expression was lower in OPF patients than in OP patients. ROC curve implied that miR-32-3p exhibits commendable sensitivity (88.9%) and specificity (75.6%) to differentiate between OP and OPF patients (AUC = 0.905, P < 0.001). Furthermore, miR-32-3p was correlated with the development of OPF and was a risk factor for OPF (P < 0.001). Functional assays revealed that transfection with miR-32-3p mimic could promote proliferation and inhibit apoptosis, whereas transfection with miR-32-3p inhibitor had the opposite effect. Conclusion: miR-32-3p demonstrates significant diagnostic potential for OPF patients. It is likely that miR-32-3p probably is a new diagnosis biomarker for OPF, offering promising therapeutic avenues through targeted interventions. [ABSTRACT FROM AUTHOR]

Background: Mastocytosis (MS) is a rare disease that can involve various organs, including the bone. Given the incidence of the disease in the global population, MS poses a challenge for physicians, and early therapeutic intervention in the initial stages could significantly impact the quality of life of affected patients. Objective: The aim of this scoping review was to provide an overview of secondary osteoporosis in systemic mastocytosis (SM), focusing on the heterogeneity of its manifestations, the benefits of early diagnosis, and appropriate pharmacological treatment. Design: A technical expert panel (TEP) consisting of 8 physicians with expertise in metabolic bone diseases conducted the review following the PRISMA-ScR model. A strength of this study is that it provides various therapeutic approaches for patients with bone involvement in SM, although the limited available literature on the topic constituted a limitation. The TEP sought evidence regarding the following diagnostic and therapeutic modalities in the management of SM: "bisphosphonate therapy", "zoledronic acid therapy", "denosumab therapy", "IFN-alpha therapy", and "IFN-alpha therapy in combination with pamidronate". Results: Clinical data showed a correlation between densitometric outcomes, serum tryptase levels, and mast cell infiltration in the bone marrow, between increased bone mineral density and the presence of osteosclerosis in cases of advanced SM, between the severity of osteoporosis and hypertryptasemia, and also provided results on the long-term effects of bisphosphonate therapy, the therapeutic efficacy of zoledronic acid administration, the positive effect of denosumab on the reduction of serum tryptase levels (even if is proved in a limited numbers of cases) and the prevention of new fractures, and the effect of IFN-alpha in more severe cases of SM, either alone or in combination with pamidronate. Conclusions: Studies have demonstrated the effectiveness of various treatments depending on the form of mastocytosis, whether indolent systemic or advanced systemic, in the prognosis of the disease. However, this role should be further investigated in additional clinical studies, considering the limited data on the use of these interventions. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Study Design: Literature review with clinical recommendations. Objective: To highlight important studies about osteoporotic spinal fractures (OF) that may be integrated into clinical practice based on the assessment of the AO Spine KF Trauma and Infection group key opinion leaders. Methods: 4 important studies about OF that may affect current clinical practice of spinal surgeons were selected and reviewed with the aim of providing clinical recommendations to streamline the journey of research into clinical practice. Recommendations were graded as strong or conditional following the GRADE methodology. Results: 4 studies were selected. Article 1: a validation of the Osteoporotic Fracture (OF)-score to treat OF fractures. Conditional recommendation to incorporate the OF score in the management of fractures to improve clinical results. Article 2: a randomized multicenter study comparing romosozumab/alendronate vs alendronate to decrease the incidence of new vertebral fractures. Strong recommendation that the group receiving romosozumab/alendronate had a decreased risk of new OF when compared with the alendronate only group only. Article 3: a systematic literature review of spinal orthoses in the management of. Conditional recommendation to prescribe a spinal orthosis to decrease pain and improve quality of life. Article 4: post-traumatic deformity after OF. A conditional recommendation that middle column injury and pre-injury use of steroids may lead to high risk of post-traumatic deformity after OF. Conclusions: Management of patients with OF is still complex and challenging. This review provides some recommendations that may help surgeons to better manage these patients and improve their clinical practice. [ABSTRACT FROM AUTHOR]

Background: Bones are biological reservoirs for minerals and cells, offering protection to the other organs and contributing to the structural form of the body. Osteoporosis is a prevalent bone condition that significantly impacts people's quality of life. Treatments utilizing natural products and medicinal plants have gained important attention in the management of osteoporosis and its associated implications, such as osteoporotic fractures. Even though thousands of plants grow in the Mediterranean region, the use of medicinal plants as an alternative therapy for osteoporosis is still limited. Methods: This article provides a comprehensive overview of seven Mediterranean medicinal plants that are used in osteoporosis and osteoporotic fractures in in vitro, in vivo, and clinical trials. The mechanism of action of the medicinal plants and their bioactive compounds against diseases are also briefly discussed. Results: The findings clearly indicate the ability of the seven medicinal plants (Ammi majus, Brassica oleracea, Ceratonia siliqua L., Foeniculum vulgare, Glycyrrhiza glabra, Salvia officinalis, and Silybum marianum) as anti-osteoporosis agents. Xanthotoxin, polyphenols, liquiritin, formononetin, silymarin, and silibinin/silybin were the main bioactive compounds that contributed to the action against osteoporosis and osteoporotic fractures. Conclusions: In this review, the Mediterranean medicinal plants prove their ability as an alternative agent for osteoporosis and osteoporotic fractures instead of conventional synthetic therapies. Thus, this can encourage researchers to delve deeper into this field and develop medicinal-plant-based drugs. [ABSTRACT FROM AUTHOR]

Summary: We conducted a retrospective cohort analysis to examine the association between hemoglobin (Hb) levels and refracture risk in elderly patients with osteoporotic fractures (OPFs). Our findings suggest a nonlinear relationship exists in females, and females with Hb levels below 10.7 g/dL may be at a higher risk of refracture. Introduction: Hematopoiesis and bone health have a reciprocal influence on each other. Nevertheless, there is a scarcity of in-depth research on the association between Hb levels and the occurrence of fractures. The present research aimed to investigate the correlation between Hb levels and the rate of refracture within 5 years among individuals with OPFs. Methods: A retrospective cohort analysis was undertaken between 2017 and 2022. The study included 1906 individuals who were inhabitants of Kunshan and were over 60 years old. These individuals had experienced an OPF between January 1, 2017, and July 27, 2022, resulting in their hospitalization. Cox proportional hazard regression models were used to evaluate the risk of refracture within 5 years based on the Hb levels acquired during the admission examination, with consideration for sex differences. A nonlinear relationship was identified using smoothed curve fitting and threshold analysis. Kaplan–Meier curves were used to compare refracture rates between patients with low and high Hb levels. Results: Elderly female patients with OPFs and lower Hb levels exhibited a significantly higher risk of a 5-year refracture. Conversely, no significant associations were observed between the two variables in male patients. A nonlinear correlation was found between Hb levels and the probability of refracture in females, with a turning point identified at 10.7 g/dL of Hb levels. A strong negative association was observed with the five-year refracture rate when Hb levels fell below 10.7 g/dL (hazard ratio (HR) = 0.63; 95% confidence interval (CI) 0.48 to 0.83; P-value = 0.0008). This finding suggests that for every 1 g/dL increase in Hb below 10.7 g/dL, the risk of refracture reduced by 37%. However, no statistically significant association was observed when Hb levels were above 10.7 g/dL. Conclusions: The findings demonstrated a significant negative correlation between Hb levels and the likelihood of refracture in elderly female patients with OPFs and suggested that elderly females with recent OPFs and Hb levels below 10.7 g/dL may be at a higher risk of refracture. Additionally, the Hb levels can serve as an indicator of bone fragility in elderly female patients with OPFs. These findings highlight the importance of monitoring Hb levels as a part of comprehensive management strategies to both assess skeletal health and prevent refractures in this population. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the correlation between the triglyceride-glucose (TyG) index and bone turnover markers (BTMs) in osteoporotic fractures (OPFs) patients hospitalized for surgical intervention. Methods: A retrospective cross-sectional study was conducted on 3558 OPFs patients hospitalized for surgical intervention between January 2017 and July 2022. The study obtained baseline values for various biomarkers and covariates, including fasting blood glucose, b-C-terminal telopeptide of type I collagen (bCTX), procollagen type 1 N-terminal propeptide (P1NP), triglycerides, age, sex, body mass index, smoking, drinking, low-density lipoprotein, high-density lipoprotein, aspartate aminotransferase, uric acid, the score of American society of anesthesiologists, homocysteine, parathyroid hormone, apolipoprotein B, apolipoprotein A, magnesium, phosphorus and calcium. Multiple linear regression, curve fitting, threshold effects, and subgroup analyses were also applied. Results: After adjusting for covariates in the regression analysis, the results revealed a negative correlation between b-CTX and P1NP levels and the baseline TyG index. Specifically, a one-unit increase in the TyG index was associated with a reduction in b-CTX levels of -0.06 (95% CI: -0.10, -0.01; Pvalue = 0.012) and a reduction in P1NP levels of -4.70 (95% CI: -9.30, -0.09; Pvalue = 0.046). Additionally, the inflection points for the nonlinear correlation between the TyG index and b-CTX and P1NP were found to be K = 6.31 and K = 6.63, respectively. Conclusion: The study demonstrated a negative, non-linear relationship among the TyG index, b-CTX and P1NP in OPFs patients hospitalized for surgical intervention. These findings suggest that elevated TyG index levels may adversely affect bone turnover, potentially contributing to the progression of OP. [ABSTRACT FROM AUTHOR]

Osteoporosis is a metabolic bone disease. β-Catenin is associated with fractures. Jian-Pi-Bu-Shen (JPBS) can promote the healing of osteoporotic fractures (OPF). However, the mechanism of β-catenin-mediated skeletal muscle satellite cells (SMSCs) in OPF by the JPBS is unclear. SMSCs were isolated and divided into five groups. The results showed that the survival rate of SMSCs was significantly higher in the low, medium, and high dose JPBS-containing serum groups after 7 days of incubation. The ALP activity and the number of SMSCs mineralized in the JPBS-containing serum intervention group were elevated. Axin, GSK-3β, β-catenin siRNAs were constructed and transfected into cells. Transfection of siRNAs reduced Axin, GSK-3β, and β-catenin expressions, respectively. β-Catenin-siRNA reversed ALP activity, the number of SMSCs mineralized, and the expression of β-catenin, BMP2, Runx2, COL-I, SP7/Ostrix, Osteocalcin, and BMP-7. Transcriptomic results suggested that the TNF signaling pathway associated with OPF was enriched. SD rats were subjected to the construction of OPF model by removing the ovaries. JPBS decreased the levels of PINP, ALP, CTX, and NTX through β-catenin in OPF rats, while increasing Runx2, β-catenin expressions through β-catenin at the broken end of fractures. Moreover, JPBS decreased BMC, BMD, and BV/TV and improved pathological damage through β-catenin in OPF rats. JPBS decreased the expression of Axin, GSK-3β mRNA, and protein, but increased the expressions of β-catenin, Pax7, COL-II, COL-II, BMP2, and Runx2 through β-catenin in OPF rats. In conclusion, JPBS inhibits Axin/GSK-3β expression, activates the β-catenin signaling, and promotes the osteogenic differentiation of SMSCs. [ABSTRACT FROM AUTHOR]

Objective: Periostin, a protein involved in bone remodeling, is linked to osteoporosis. Elevated levels of periostin are associated with an increased risk of fractures due to its role in bone repair and turnover. This meta-analysis aims to investigate the usability of serum periostin levels as a potential biomarker in individuals with osteoporosis and patients at risk of osteoporotic fractures. Methods: This study was conducted in accordance with the PRISMA guideline. We identified studies reporting periostin levels associated with osteoporosis and osteoporotic fractures through a systematic search in PubMed, Cochrane Library, Web of Science, and Scopus databases. From a total of 175 studies, nine studies meeting the inclusion criteria were included for quantitative synthesis (meta-analysis). Meta-analysis was performed using Revman 5.4.1 software, and forest plots were generated using standardized mean differences (SMD). Results: When serum periostin levels (ng/mL) were compared between individuals with osteoporosis and healthy controls, periostin levels were found to be significantly higher in patients with osteoporosis (SMD: 1.29, 95% CI: 0.87-1.71). In addition, in the comparison between individuals with and without osteoporosis, periostin levels were found to be significantly higher in patients with fractures (SMD: 11.23, 95% CI: 5.64-16.82). However, significant heterogeneity was observed across studies (I²: 99% and 72%). Conclusions: This meta-analysis supports the use of serum periostin levels as a potential biomarker of osteoporosis and osteoporotic fracture risk. However, heterogeneity across studies suggests that caution should be exercised in interpreting these findings. In order for periostin to be more widely used in clinical practice, standardized measurement protocols should be developed and confirmatory studies should be conducted in different populations. periostin to be more widely used in clinical practice, standardized measurement protocols should be developed and confirmatory studies should be conducted in different populations. [ABSTRACT FROM AUTHOR]

To investigate the risk factors associated with progressive kyphosis (PK) after percutaneous kyphoplasty (PKP) in osteoporotic vertebral compression fractures (OVCFs).

Abstract Background Many studies have indicated that abnormal bone mineral density (BMD) is related to abnormal liver and kidney function, but the effect of serum albumin level on abnormal BMD and osteoporotic fracture is still controversial. The aim of this retrospective study was to investigate the effects of serum albumin levels on abnormal BMD and osteoporotic fractures. Methods The study included 538 patients through the electronic medical records of inpatients and outpatients stored at Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology. A multivariate logistic regression model was employed to test the relationship between serum albumin levels and abnormal BMD, and the effect of serum albumin levels on osteoporotic fractures was verified through the U test. Correlation between age, sex, kidney stones, coronary heart disease, hypertension, diabetes, fatty liver disease, haemoglobin (HB), mean corpuscular haemoglobin concentration (MCHC), platelets (PLT), platelet distribution width (PDW), lymphocytes (LYMP), alanine aminotransferase (ALT), total protein (TP), albumin (ALB), uric acid (UA), total bilirubin (TBIL), total cholesterol (TC), high-density lipoprotein (HDL) and abnormal BMD were analysed by logistic regression modelling after excluding confounding factors. Results The ALB level in osteoporotic patients was 41.70 (36.40–45.00) g/L, which was significantly lower than those in the normal BMD and reduced BMD groups. The odds ratio (OR) (95% confidence interval [CI]) between the osteoporosis and normal BMD groups was 0.445 (0.394–0.502); the OR (95% CI) between the osteoporosis and reduced BMD groups was 0.395 (0.341–0.459). In the subgroup analysis by whether or not a fracture was present, the OR (95% CI) was 0.073 (0.045–0.119). Conclusions ALB is a protective factor against osteoporosis and osteoporotic fractures, suggesting that it may have the potential to predict osteoporosis onset and fractures.

Abstract Background Osteoporotic fractures (OPF) are fractures that occur with low-energy injuries or during daily activities, representing a serious consequence of osteoporosis (OP). With the worsening of population aging, the number of OPF patients continues to expand, causing a significant burden on families and society. Consequently, it is significant to diagnose and analyze OPF at the molecular level. Objective The aim of this research was to explore the diagnostic value of miR-32-3p in OPF patients and to exploit new biomarkers for clinical applications. Methods The miR-32-3p expression level of patients was detected by RT-qPCR. Diagnostic accuracy of miR-32-3p analyzed adopting ROC curve. Additionally, the risk factors correlation with the occurrence of OPF were assessed by logistic analysis. The effect of miR-32-3p on BMSCs was verified by in vitro transfection experiments. Results miR-32-3p expression was lower in OPF patients than in OP patients. ROC curve implied that miR-32-3p exhibits commendable sensitivity (88.9%) and specificity (75.6%) to differentiate between OP and OPF patients (AUC = 0.905, P

Abstract The association between inflammatory markers (IMs) and bone turnover markers (BTMs) in osteoporotic fracture patients has not been comprehensively studied. Therefore, this study examined the correlation between the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), or Monocyte-to-lymphocyte ratio (MLR) and BTMs in osteoporosis (OP) fracture patients. This retrospective cross-sectional study analyzed 740 OP fracture patients admitted to the hospital from January 2017 to July 2022. MLR, NLR, and PLR were calculated based on each patient’s complete blood count. The relationship between IMs and BTMs was assessed using three models by adjusting variables. Furthermore, the potential curve relationship between IMs and BTMs was also determined via the threshold effect analysis and curve fittings. In addition, stratified analysis was performed on each adjusted variable to confirm the stability of the results. After adjusting the variables, the results showed that NLR was negatively correlated with procollagen type 1 N-terminal propeptide (P1NP) (β = -1.1788, 95% CI: -1.7230 to -0.6345, P-value

BACKGROUND: Growing evidence suggests bidirectional links between gut microbiota and sleep quality as shared contributors to health. Little is known about the relationship between microbiota and sleep among older persons. METHODS: We used 16S rRNA sequencing to characterize stool microbiota among men (n = 606, mean [standard deviation] age = 83.9 [3.8]) enrolled in the Osteoporotic Fractures in Men (MrOS) study from 2014 to 2016. Sleep was assessed concurrently by a questionnaire (Pittsburgh Sleep Quality index [PSQI]), and activity monitor to examine timing (acrophase) and regularity of patterns (F-statistic). Alpha diversity was measured using Faiths phylogenetic diversity (PD). Beta diversity was calculated with robust Aitchison distance with matrix completion (RPCA) and phylogenetic-RPCA (PRPCA). Their association with sleep variables was tested with partial distance-based redundancy analysis (dbRDA). Predictive-ratio biomarkers associated with sleep measurements were identified with CoDaCoRe. RESULTS: In unadjusted analyses, men with poor sleep (PSQI >5) tended to have lower alpha diversity compared to men with normal sleep (Faiths PD, beta = -0.15; 95% confidence interval [CI]: -0.30 to 0.01, p = .06). Sleep regularity was significantly associated with RPCA and PRPCA, even after adjusting for site, batch, age, ethnicity, body mass index, diabetes, antidepressant and sleep medication use, and health behaviors (RPCA/PRPCA dbRDA; p = .033/.002). In taxonomic analysis, ratios of 7:6 bacteria for better regularity (p = .0004) and 4:7 for worse self-reported sleep (p = .005) were differentially abundant: some butyrate-producing bacteria were associated with better sleep characteristics. CONCLUSIONS: Subjective and objective indicators of sleep quality suggest that older men with better sleep patterns are more likely to harbor butyrate-producing bacteria associated with better health.

BACKGROUND: Osteoporotic fracture is the most serious complication of osteoporosis. Previous studies have demonstrated that gut microbiota has a regulatory effect on skeletal tissue and that gut microbiota has an important relationship with osteoporotic fracture, but the causal relationship between the two is unclear. OBJECTIVE: To explore the causal relationship between gut microbiota and osteoporotic fractures using Mendelian randomization method. METHODS: The genome-wide association study (GWAS) datasets of gut microbiota and osteoporotic fracture were obtained from the IEU Open GWAS database and the Finnish database R9, respectively. Using gut microbiota as the exposure factor and osteoporotic fracture as the outcome variable, Mendelian randomization analyses with random-effects inverse variance weighted, MR-Egger regression, weighted median, simple model, and weighted model methods were performed to assess whether there is a causal relationship between gut microbiota and osteoporotic fracture. Sensitivity analyses were performed to test the reliability and robustness of the results. Reverse Mendelian randomization analyses were performed to further validate the causal relationship identified in the forward Mendelian randomization analyses. RESULTS AND CONCLUSION: The results of this Mendelian randomization analysis indicated a causal relationship between gut microbiota and osteoporotic fracture. Elevated abundance of Actinomycetales [odds ratio (OR)=1.562, 95% confidence interval (CI): 1.027-2.375, P=0.037), Actinomycetaceae (OR=1.561, 95% CI: 1.027-2.374, P=0.037), Actinomyces (OR =1.544, 95% CI: 1.130-2.110, P=0.006), Butyricicoccus (OR=1.781, 95% CI: 1.194-2.657, P=0.005), Coprococcus 2 (OR=1.550, 95% CI: 1.068-2.251, P=0.021), Family XIII UCG-001 (OR=1.473, 95% CI: 1.001-2.168, P=0.049), Methanobrevibacter (OR=1.274, 95% CI: 1.001-1.621, P=0.049), and Roseburia (OR=1.429, 95% CI: 1.015-2.013, P=0.041) would increase the risk of osteoporotic fractures in patients. Elevated abundance of Bacteroidia (OR=0.660, 95% CI: 0.455-0.959, P=0.029), Bacteroidales (OR=0.660, 95% CI: 0.455-0.959, P=0.029), Christensenellacea (OR=0.725, 95% CI: 0.529-0.995, P=0.047), Ruminococcaceae (OR=0.643, 95% CI: 0.443-0.933, P=0.020), Enterorhabdus (OR=0.558, 95% CI: 0.395-0.788, P=0.001), Eubacterium rectale group (OR=0.631, 95% CI: 0.435-0.916, P=0.016), Lachnospiraceae UCG008 (OR=0.738, 95% CI: 0.546-0.998, P=0.048), and Ruminiclostridium 9 (OR=0.492, 95% CI: 0.324-0.746, P=0.001) would reduce the risk of osteoporotic fractures in patients. We identified 16 gut microbiota associated with osteoporotic fracture by the Mendelian randomization method. That is, using gut microbiota as the exposure factor and osteoporotic fracture as the outcome variable, eight gut microbiota showed positive causal associations with osteoporotic fracture and another eight gut microbiota showed negative causal associations with osteoporotic fracture. The results of this study not only identify new biomarkers for the early prediction of osteoporotic fracture and potential therapeutic targets in clinical practice, but also provide an experimental basis and theoretical basis for the study of improving the occurrence and prognosis of osteoporotic fracture through gut microbiota in bone tissue engineering. [ABSTRACT FROM AUTHOR]

Objective To investigate the ability of radiological parameter canal bone ratio (CBR) to assess bone mineral density and to differentiate between patients with primary and multiple osteoporotic vertebral compression fracture (OVCF). Methods A retrospective analysis was conducted on OVCF patients treated at our hospital. CBR was measured through full-spine x-rays. Patients were categorized into primary and multiple fracture groups. Receiver operating characteristic curve analysis and area under the curve (AUC) calculation were used to assess the ability of parameters to predict osteoporosis and multiple fractures. Predictors of T values were analyzed by multiple linear regression, and independent risk factors for multiple fractures were determined by multiple logistic regression analysis. Results CBR showed a moderate negative correlation with dual-energy x-ray absorptiometry T values (r = -0.642, p < 0.01). Higher CBR (odds ratio [OR], -6.483; 95% confidence interval [CI], -8.234 to -4.732; p < 0.01) and lower body mass index (OR, 0.054; 95% CI, 0.023–0.086; p < 0.01) were independent risk factors for osteoporosis. Patients with multiple fractures had lower T values (mean ±standard deviation [SD]: -3.76 ±0.73 vs. -2.83 ±0.75, p < 0.01) and higher CBR (mean ±SD: 0.54 ±0.07 vs. 0.46 ±0.06, p < 0.01). CBR had an AUC of 0.819 in predicting multiple fractures with a threshold of 0.53. T values prediction had an AUC of 0.816 with a threshold of -3.45. CBR > 0.53 was an independent risk factor for multiple fractures (OR, 14.66; 95% CI, 4.97–43.22; p < 0.01). Conclusion CBR is negatively correlated with bone mineral density (BMD) and can be a novel opportunistic BMD assessment method. It is a simple and effective measurement index for predicting multiple fractures, with predictive performance not inferior to T values.

Abstract We conducted this cross-sectional study to investigate the independent associations between lipid metabolites and osteoporotic fractures among participants aged 40–69 years from the UK Biobank. Serum lipid, lipoprotein levels and nuclear magnetic resonance (NMR) based metabolic biomarkers were measured at the baseline. We conducted multivariable logistic analyses to investigate potential independent associations between concentrations of lipid metabolites and osteoporotic fractures in both men and women. The odds ratios (ORs) for lipid metabolites were calculated based on their lowest tertile. Over a median follow-up period of 15 years, a total of 978 men and 4515 women were diagnosed with osteoporosis, whereas 138 men and 327 women encountered incident fractures. Statistically significant disparities were identified in NMR-based metabolic biomarkers among men and women with incident fractures compared to those without. Out of the 144 distinct lipid metabolites known, 35 exhibited significant associations with incident fractures in patients diagnosed with osteoporosis. Following the adjustment for confounding factors, degree of unsaturation (p = 0.0066) and docosahexaenoic acids (p = 0.0011) in male patients increased the risk of incident fractures. And high level of different metabolites of HDL (p = 0.0153), 3-Hydroxybutyrate (p = 0.0012) and Sphingomyelins (p = 0.0036) decreased the risk of incident fractures in female patients. This outcome indicates that these identified lipid metabolites may potentially have unique roles in independently contributing to the occurrence of osteoporotic fractures.

Summary: What are the fractures associated with osteoporosis in Colombian persons over 50 years of age? Through the analysis of the Ministry of Health databases, Colombians over 50 years of age with osteoporosis fracture the forearm the most, followed by the thoracolumbar vertebrae and then the hip. We describe the differences between men and women. Purpose: The aim of this study was to determine the frequency of all bone fractures among adults aged 50 and above, both with and without osteoporosis, using data from SISPRO (Integrated Information System for Social Protection), the administrative database of the Colombian Ministry of Health. Methods: Information was collected for the years 2017 to 2021 for all bone fractures (except cranial or face fractures), and how many of them occurred in patients who had the diagnosis of osteoporosis. Prevalence ratios (PR) were estimated separately for males and females by dividing the prevalence in those with by the prevalence of those without osteoporosis. Results: For the period from 2017 to 2021, 303,037 adults over 50 years of age (females 279,057, 92.1%) were diagnosed with osteoporosis in Colombia, for a prevalence of 39.4 per thousand women and 4.14 in men; 40,823 of these women (14.6%) presented a fracture in the period, as well as 4020 of men (16.7%). Osteoporosis was present in 7.5% of the 596.618 (females 369.795; 62.0%) who suffered any fracture (1.8% of males and 11.0% of females). Overall PR was 3.4 (males 4.3; females 3.3). In men with osteoporosis, the most frequent fractures were hip (902), followed by lumbar vertebrae (842), ribs (648), and forearm (538), while in women, forearm (11,001), followed by hip (6885), lumbar vertebra (4813), and thoracic vertebra (2701) were the most common. PR in men was 21.9 for dorsal vertebrae fracture, 21.3 for lumbar vertebrae, 11.8 for ribs, and 7.7 for hip fracture. In women, PR was 15.7 for thoracic vertebrae, 13.3 for lumbar vertebrae, 3.3 for hip fracture, and 2.2 for forearm fracture. Conclusion: Osteoporosis is a highly prevalent disease in Colombia where women are more affected. Although fractures were more common in women, men with osteoporosis have a higher PR of associated fractures. [ABSTRACT FROM AUTHOR]

Objective: To investigate the ability of radiological parameter canal bone ratio (CBR) to assess bone mineral density and to differentiate between patients with primary and multiple osteoporotic vertebral compression fracture (OVCF). Methods: A retrospective analysis was conducted on OVCF patients treated at our hospital. CBR was measured through full-spine x-rays. Patients were categorized into primary and multiple fracture groups. Receiver operating characteristic curve analysis and area under the curve (AUC) calculation were used to assess the ability of parameters to predict osteoporosis and multiple fractures. Predictors of T values were analyzed by multiple linear regression, and independent risk factors for multiple fractures were determined by multiple logistic regression analysis. Results: CBR showed a moderate negative correlation with dual-energy x-ray absorptiometry T values (r = -0.642, p < 0.01). Higher CBR (odds ratio [OR], -6.483; 95% confidence interval [CI], -8.234 to -4.732; p < 0.01) and lower body mass index (OR, 0.054; 95% CI, 0.023–0.086; p < 0.01) were independent risk factors for osteoporosis. Patients with multiple fractures had lower T values (mean ±standard deviation [SD]: -3.76 ±0.73 vs. -2.83 ±0.75, p < 0.01) and higher CBR (mean ±SD: 0.54 ±0.07 vs. 0.46 ±0.06, p < 0.01). CBR had an AUC of 0.819 in predicting multiple fractures with a threshold of 0.53. T values prediction had an AUC of 0.816 with a threshold of -3.45. CBR > 0.53 was an independent risk factor for multiple fractures (OR, 14.66; 95% CI, 4.97–43.22; p < 0.01). Conclusion: CBR is negatively correlated with bone mineral density (BMD) and can be a novel opportunistic BMD assessment method. It is a simple and effective measurement index for predicting multiple fractures, with predictive performance not inferior to T values. [ABSTRACT FROM AUTHOR]

Low-back pain is frequent, especially in the active adult population after an osteoporotic vertebral fracture. Several orthopaedic conditions can cause low back pain, significantly worsening the quality of life. The treatments vary from drugs, physical therapy, kinesiology, and local infiltration. TECARs have a crucial role in treating the inflammatory causes of pain, with several studies demonstrating the efficacy of 0.5 Mh radio frequency longwave therapy in treating low-back pain. We treat twenty consecutive patients with low back pain after a vertebral amielic spinal fracture with or without leg pain, using a combination of painkillers, orthosis, and half of them tecar therapy. The patients were treated three times a week, every other day, for 20 sessions. We evaluated clinical outcomes using the visual analogic scale for individual pain. Tests started before the beginning of therapies and eight weeks after the end of the treatment. Visual analogic scale (VAS) score significantly improved from an average value pretreatment to a 50% reduction average value eight weeks posttreatment. Patients denoted a more significant improvement in VAS and empiric patient satisfaction in the group with low back pain also treated with TECAR. Acute back pain is a relatively common clinical situation. The treatments for this condition are different, and they can give 2 a crucial role in diathermia, shortwave, microwave, and tecar therapy. This study concludes that the association between painkillers, orthosis, exercises, and tecar therapy in treating low-back Pain after an amyelic vertebral spine fracture type genant, with or without leg pain, can significantly reduce pain and improve the quality of life. ''Highlights'' Diathermy Tecar is an almost new and updated physical therapy that uses electromagnetic waves to treat muscle and joint pain through capacitive and resistive pads. It provides good pain relief for several sharp pains. The physiotherapist should be trained to use them appropriately in acute settings. Clin Ter 2024; 175 (5):291-295 doi: 10.7417/CT.2024.5133 [ABSTRACT FROM AUTHOR]

Objectives: To examine patient, surgical and hospital factors associated with Day‐1 postoperative mobility after hip fracture surgery in older adults. Methods: A cohort study using Australia and New Zealand Hip Fracture Registry was conducted. Participants were aged older than 50 years and underwent hip fracture surgery between 1 January 2020 and 31 December 2020 inclusive. The outcome was standing and step transferring out of bed onto a chair and/or walking Day‐1 after hip fracture surgery. Results: Mean age was 82 years and 68% were women. Of 12,318 patients with hip fracture, 5981 (49%) actually mobilised Day‐1. Odds of actual first‐day mobilisation were lower for individuals usually walking with either stick or crutch (OR = 0.71, 95% CI 0.62–0.82) or two aids or frame (OR = 0.57, 95% CI 0.52–0.64) or wheelchair/bed bound (OR = 0.24, 95% CI 0.17–0.33); who had impaired cognition preadmission (OR = 0.57, 95% CI 0.51–0.64); from aged care facilities (OR = 0.59, 95% CI 0.52–0.67); had an American Society of Anaesthesiologists grade 2 (OR = 0.63, 95% CI 0.41–0.97), 3 (OR = 0.31, 95% CI 0.20–0.47) or 4 or 5 (OR = 0.21, 95% CI 0.14–0.32); surgery delay >48 h (OR = 0.81, 95% CI 0.71–0.91); and restricted/non‐weight‐bearing status immediately postoperatively (OR = 0.53, 95% CI 0.42–0.67). Conclusions: Both non‐modifiable and modifiable patient and surgical factors influence first‐day mobilisation after hip fracture surgery. Reducing time to surgery might assist future quality improvement efforts to increase Day‐1 postoperative mobility. [ABSTRACT FROM AUTHOR]

Summary: This study aimed to describe the incidence of hospitalizations for osteoporotic fractures in patients aged 50 years and over in Belgium between 2010 and 2021. A declining trend in crude and age-adjusted hospitalization incidence was observed, however, the absolute number of hospitalisations for osteoporotic fractures increased due to demographic changes. Purpose: The secular trends of hospitalizations for hip and other osteoporotic fractures between 2010 and 2021 in patients aged 50 years and over in Belgium are unknown. This study aimed to describe the incidence of hospitalizations for osteoporotic fractures in patients aged 50 years and over in Belgium between 2010 and 2021. Methods: Population-based, retrospective study based on hospitalization data extracted by the national database NIHDI and demographical data retrieved from the Belgian Federal Bureau for Statistics. Data were combined to determine the crude and age-standardized hospitalization incidence of fractures of the hip, distal femur, pelvis, humerus, wrist, and spine (2010 as the reference year). Results: A total of 445,234 hospitalizations for osteoporotic fractures were reported between 2010 and 2021 (excluding 2015). Hospitalizations increased by 5.8% between 2010 and 2021 (p = 0.013) with a higher increase in men (12.1%; p = 0.001) compared to women (4.1%; p = 0.041). The crude incidence of hospitalizations for all fractures per 100,000 persons per year decreased from 990 to 910 between 2010 and 2021 (p = 0.572). The age-standardized incidence for hospitalizations of any osteoporotic fracture in men declined from 5.30/1,000 to 4.42/1,000 (p = 0.010). In women, a similar decrease was observed (13.84/1,000 to 11.62/1,000; p = 0.003). Both age-standardized hospitalizations for hip and non-hip fractures showed a decrease in both sexes. Conclusion: Although a declining trend in the crude incidence per 100,000 and in the age-adjusted incidence of hospitalizations for osteoporotic fractures was observed, the absolute number of hospitalizations for osteoporotic fractures increased due to the demographic change of an ageing population. [ABSTRACT FROM AUTHOR]

Accelerometers are used to objectively measure physical activity; however, the relationship between accelerometer-based activity parameters and bone health is not well understood. This study examines the association between accelerometer-estimated daily activity impact intensities and future risk estimates of major osteoporotic fractures in a large population-based cohort. Participants were 3165 adults 46 years of age from the Northern Finland Birth Cohort 1966 who agreed to wear a hip-worn accelerometer during all waking hours for 14 consecutive days. Raw accelerometer data were converted to resultant acceleration. Impact magnitude peaks were extracted and divided into 32 intensity bands, and the osteogenic index (OI) was calculated to assess the osteogenic effectiveness of various activities. Additionally, the impact peaks were categorized into three separate impact intensity categories (low, medium, and high). The 10-year probabilities of hip and all major osteoporotic fractures were estimated with FRAX-tool using clinical and questionnaire data in combination with body mass index collected at the age of 46 years. The associations of daily activity impact intensities with 10-year fracture probabilities were examined using three statistical approaches: multiple linear regression, partial correlation, and partial least squares (PLS) regression. On average, participants' various levels of impact were 8331 (SD = 3478) low; 2032 (1248) medium; and 1295 (1468) high impacts per day. All three statistical approaches found a significant positive association between the daily number of low-intensity impacts and 10-year probability of hip and all major osteoporotic fractures. In contrast, increased number of moderate to very high daily activity impacts was associated with a lower probability of future osteoporotic fractures. A higher OI was also associated with a lower probability of future major osteoporotic fractures. Low-intensity impacts might not be sufficient for reducing fracture risk in middle-aged adults, while high-intensity impacts could be beneficial for preventing major osteoporotic fractures. • Free-living daily activity impacts were calculated from hip-worn accelerometry. • Associations of daily activity impact intensities with fracture risk was examined. • Three statistical methods were used to assess the associations with fracture risk. • Low-intensity impacts might not be sufficient for reducing fracture risk in adults. • High-intensity impacts could be beneficial for reducing osteoporotic fracture risk. [ABSTRACT FROM AUTHOR]

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We examined if an interaction exists between bone and muscle in predicting fractures in older men. Prospective data from the Osteoporotic Fractures in Men study was used to build Cox proportional hazards models. Predictors included HR-pQCT total volumetric BMD (Tt.BMD), trabecular BMD (Tb.BMD), cortical BMD (Ct.BMD) and cortical area (Ct.Ar) at distal radius/tibia, HR-pQCT muscle volume and density (diaphyseal tibia), D3 -creatine dilution (D3 Cr) muscle mass, and grip strength and leg force, analyzed as continuous variables and as quartiles. Incident fractures were self-reported every 4 months via questionnaires and centrally adjudicated by physician review of radiology reports. Potential confounders (demographics, comorbidities, lifestyle factors, etc.) were considered. A total of 1353 men (mean age 84.2 ± 4.0 years, 92.7% white) were followed for 6.03 ± 2.11 years. In the unadjusted (continuous) model, there were no interactions (p > 0.05) between any muscle variable (D3 Cr muscle mass, muscle volume, muscle density, grip strength or leg force) and Tt.BMD at distal radius/tibia for fractures (all: n = 182-302; nonvertebral: n = 149-254; vertebral: n = 27-45). No consistent interactions were observed when interchanging Tt.BMD for Tb.BMD/Ct.BMD or for Ct.Ar (bone structure) at the distal radius/tibia in the unadjusted (continuous) models. Compared with men in quartiles (Q) 2-4 of D3 Cr muscle mass and Q2-4 of distal tibia Tt.BMD, men in Q1 of both had increased risk for all fractures (hazard ratio (HR) = 2.00; 95% confidence interval [CI] 1.24-3.23, p = 0.005) and nonvertebral fractures (HR = 2.10; 95% CI 1.25-3.52, p  0.05) when visually inspecting other quartile groups in the multivariable-adjusted model. In this prospective cohort study of older men, there was no consistent interactions between bone and muscle variables on fracture risk. Larger sample sizes and longer follow-up may be needed to clarify if there is an interaction between bone and muscle on fracture risk in men. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).