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Update in Osteoporosis and Related Bone Metabolic Disease
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Update in Osteoporosis and Related Bone Metabolic Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (25 November 2023) | Viewed by 12465

Special Issue Editor

Dr. Olivier Malaise

E-Mail Website
Guest Editor
Laboratory of Rheumatology, GIGA-Research, CHULiège, ULiège, 4000 Liège, Belgium
Interests: osteoporosis; metabolic bone disease; osteoarthritis; dual X-ray densitometry; high-resolution peripheral quantitative computed tomography
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Osteoporosis is a common and well-known disease, associated with fractures. These fractures lead to pain, disabilities, and incapacitation but are also associated with a higher mortality rate. However, despite this simple and clear assessment, osteoporosis remains an underdiagnosed and, therefore, undertreated disease. Although medical conditions leading to low bone mineral density and fracture risk are widely known to the medical community, screening these patients for osteoporosis is not effective enough. Moreover, even after fragility fracture, therapeutic prescription is often forgotten. 

This Special Issue aims to reduce this treatment gap and focuses on recognizing and screening for osteoporosis, especially after fracture and among patients with medical chronic diseases. Articles on osteoporosis screening, secondary osteoporosis, treatment gap or fracture detection are welcomed, as are any articles helping to better recognize osteoporosis or describing new or alternative methods of osteoporosis diagnosis.

Dr. Olivier Malaise
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • osteoporosis
  • metabolic bone disease
  • screening
  • fracture
  • dual X-ray densitometry

Published Papers (6 papers)

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Research

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13 pages, 623 KiB  
Article
Trabecular Bone Score Significantly Influences Treatment Decisions in Secondary Osteoporosis
by Leith Al-Hashimi, Jens Klotsche, Sarah Ohrndorf, Timo Gaber and Paula Hoff
J. Clin. Med. 2023, 12(12), 4147; https://doi.org/10.3390/jcm12124147 - 20 Jun 2023
Viewed by 1651
Abstract
The trabecular bone score (TBS) can be determined in addition to the Dual Energy X-ray Absorptiometry (DXA) for bone mineral density (BMD) measurement to diagnose, evaluate, and stratify bone loss and decide on appropriate treatment in patients at risk. Especially in patients with [...] Read more.
The trabecular bone score (TBS) can be determined in addition to the Dual Energy X-ray Absorptiometry (DXA) for bone mineral density (BMD) measurement to diagnose, evaluate, and stratify bone loss and decide on appropriate treatment in patients at risk. Especially in patients with secondary osteoporosis, TBS detects restricted bone quality. To investigate the influence of an additional evaluation of TBS on patients’ treatment strategy decisions, we enrolled 292 patients, with a high proportion of patients with secondary osteoporosis, from one outpatient unit over one year. Patients eligible for BMD measurement had the option to opt-in for TBS measurement. We analyzed demographic data, leading diagnoses, bone metabolism parameters, and results of BMD and TBS measurements. More than 90% of patients consented to TBS measurement. TBS measurement influenced the decision in approximately 40% of patients with a treatment indication for anti-osteoporotic drugs. We demonstrate that depending on the underlying disease/risk spectrum, 21–25.5% of patients had an unremarkable BMD measurement with poor bone quality shown in the TBS measurement. In patients with secondary osteoporosis, the use of TBS supplementary to DXA seems useful to better assess fracture risk and, thus, to initiate therapy for osteoporosis in these patients in time. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease)
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8 pages, 258 KiB  
Article
Lung Function Impairment, Associating Hyperinflation with Impaired Diffusion Capacity and Transfer Coefficient, Is a Risk Factor for Hip Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease
by Olivier Malaise, Cécile André, Caroline Van Durme, Laurence Seidel, Florence Schleich, Renaud Louis, Michel Malaise and Clio Ribbens
J. Clin. Med. 2023, 12(6), 2383; https://doi.org/10.3390/jcm12062383 - 20 Mar 2023
Cited by 1 | Viewed by 1152
Abstract
Chronic obstructive pulmonary disease (COPD) is a risk factor for osteoporosis. Our objective is to determine if functional indices associated with emphysema on pulmonary function tests (DLCO—diffusion capacity of the lung for CO-; DLCO/AV—DLCO corrected for alveolar volume- and TLC—total lung capacity), considered [...] Read more.
Chronic obstructive pulmonary disease (COPD) is a risk factor for osteoporosis. Our objective is to determine if functional indices associated with emphysema on pulmonary function tests (DLCO—diffusion capacity of the lung for CO-; DLCO/AV—DLCO corrected for alveolar volume- and TLC—total lung capacity), considered alone or together, can identify COPD patients with osteoporosis. Methods: 90 COPD patients underwent dual-energy X-ray absorptiometry (DEXA) and pulmonary function tests. Results: 26% of the COPD patients were osteoporotic. In univariate analysis, each functional parameter associated with emphysema, analyzed separately, was not associated with osteoporosis. In contrast, patients with hyperinflation associated with impaired diffusion capacity and transfer coefficient, defined by the association of the three functional indices (DLCO < 70%, DLCO/AV < 80% and CPT > 115%), had significantly more osteoporosis at the total hip (OR: 5.9, CI: 1.5–23.8, p = 0.013). In multivariate analysis, this phenotype was confirmed as an independent factor associated with hip osteoporosis. In contrast, COPD airway obstruction severity, based on FEV1 (%), was not associated with osteoporosis. A lower BMI, female gender and age were also identified as osteoporosis risk factors. Conclusions: COPD patients with hyperinflation associated with impaired diffusion capacity and transfer coefficient are at higher risk for osteoporosis. Pulmonary function tests associated with emphysema detection can help to identify COPD patients with osteoporosis, in addition to the classical risk factors. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease)
13 pages, 1769 KiB  
Article
Osteoporosis Assessment among Adults with Liver Cirrhosis
by Claudiu Marinel Ionele, Adina Turcu-Stiolica, Mihaela Simona Subtirelu, Bogdan Silviu Ungureanu, Teodor Nicusor Sas and Ion Rogoveanu
J. Clin. Med. 2023, 12(1), 153; https://doi.org/10.3390/jcm12010153 - 25 Dec 2022
Cited by 5 | Viewed by 1752
Abstract
Osteopenic bone disease occurs frequently in patients with chronic liver cirrhosis, which most frequently presents with hepatic osteodystrophy. Thus, the relationship between nutritional status and bone mineral density has been poorly measured in liver cirrhosis. This single-center study consisted of a group of [...] Read more.
Osteopenic bone disease occurs frequently in patients with chronic liver cirrhosis, which most frequently presents with hepatic osteodystrophy. Thus, the relationship between nutritional status and bone mineral density has been poorly measured in liver cirrhosis. This single-center study consisted of a group of 70 patients diagnosed with liver cirrhosis. The nutritional status was evaluated with the Controlling Nutritional Status index, and volumetric vertebral bone mineral density was measured with quantitative computed tomography. Among the 70 patients included, osteopenia and osteoporosis were found in 71% and 24.3%, respectively. Malnutrition assessed with the Controlling Nutritional Status index was observed in 56 (80%) patients and was more frequent in alcoholic cirrhosis patients than viral cirrhosis patients (87.24% vs. 65.22%). Significant positive correlation with Controlling Nutritional Status score was found with Model for End-Stage Liver Disease (rho = 0.576, p-value < 0.0001), Child–Pugh score (rho = 0.670, p-value < 0.0001), International Normalized Ratio (rho = 0.517, p-value = 0.001), aspartate aminotransferase (rho = 0.293, p-value = 0.045), and bilirubin (rho =0.395, p-value = 0.02). Among the liver cirrhosis patients, 15 had osteoporosis and 49 had osteopenia at the lumbar spine (L1-L4 vertebrae), as determined by bone mass density via quantitative computed tomography. A non-significant relationship between Controlling Nutritional Status index-assessed nutritional status and bone mass density was documented. Regarding osteoporosis, no differences were found between the viral and alcohol types of liver cirrhosis patients (p-value = 0.870). Age, obesity, grade of varices, Child–Pugh score, and Model for End-Stage Liver Disease score were associated with osteoporosis in patients with liver cirrhosis. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease)
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Review

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22 pages, 1836 KiB  
Review
Trabecular Bone Score (TBS) in Individuals with Type 2 Diabetes Mellitus: An Updated Review
by Alexandra-Ioana Trandafir, Oana-Claudia Sima, Ana-Maria Gheorghe, Adrian Ciuche, Anca-Pati Cucu, Claudiu Nistor and Mara Carsote
J. Clin. Med. 2023, 12(23), 7399; https://doi.org/10.3390/jcm12237399 - 29 Nov 2023
Cited by 2 | Viewed by 1165
Abstract
Bone fragility is a complication of type 2 diabetes mellitus (T2DM) that has been identified in recent decades. Trabecular bone score (TBS) appears to be more accurate than bone mineral density (BMD) in diabetic bone disease, particularly in menopausal women with T2DM, to [...] Read more.
Bone fragility is a complication of type 2 diabetes mellitus (T2DM) that has been identified in recent decades. Trabecular bone score (TBS) appears to be more accurate than bone mineral density (BMD) in diabetic bone disease, particularly in menopausal women with T2DM, to independently capture the fracture risk. Our purpose was to provide the most recent overview on TBS-associated clinical data in T2DM. The core of this narrative review is based on original studies (PubMed-indexed journals, full-length, English articles). The sample-based analysis (n = 11, N = 4653) confirmed the use of TBS in T2DM particularly in females (females/males ratio of 1.9), with ages varying between 35 and 91 (mean 65.34) years. With concern to the study design, apart from the transversal studies, two others were prospective, while another two were case-control. These early-post-pandemic data included studies of various sample sizes, such as: males and females (N of 245, 361, 511, and 2294), only women (N of 80, 96, 104, 243, 493, and 887), and only men (N = 169). Overall, this 21-month study on published data confirmed the prior profile of BMD-TBS in T2DM, while the issue of whether checking the fracture risk is mandatory in adults with uncontrolled T2DM remains to be proven or whether, on the other hand, a reduced TBS might function as a surrogate marker of complicated/uncontrolled T2DM. The interventional approach with bisphosphonates for treating T2DM-associated osteoporosis remains a standard one (n = 2). One control study on 4 mg zoledronic acid showed after 1 year a statistically significant increase of lumbar BMD in both diabetic and non-diabetic groups (+3.6%, p = 0.01 and +6.2%, p = 0.01, respectively). Further studies will pinpoint additive benefits on glucose status of anti-osteoporotic drugs or will confirm if certain glucose-lowering regimes are supplementarily beneficial for fracture risk reduction. The novelty of this literature research: these insights showed once again that the patients with T2DM often have a lower TBS than those without diabetes or with normal glucose levels. Therefore, the decline in TBS may reflect an early stage of bone health impairment in T2DM. The novelty of the TBS as a handy, non-invasive method that proved to be an index of bone microarchitecture confirms its practicality as an easily applicable tool for assessing bone fragility in T2DM. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease)
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17 pages, 1038 KiB  
Review
A Mini Review on Osteoporosis: From Biology to Pharmacological Management of Bone Loss
by Kok-Yong Chin, Ben Nett Ng, Muhd Khairik Imran Rostam, Nur Farah Dhaniyah Muhammad Fadzil, Vaishnavi Raman, Farzana Mohamed Yunus, Syed Alhafiz Syed Hashim and Sophia Ogechi Ekeuku
J. Clin. Med. 2022, 11(21), 6434; https://doi.org/10.3390/jcm11216434 - 30 Oct 2022
Cited by 20 | Viewed by 4667
Abstract
Osteoporosis refers to excessive bone loss as reflected by the deterioration of bone mass and microarchitecture, which compromises bone strength. It is a complex multifactorial endocrine disease. Its pathogenesis relies on the presence of several endogenous and exogenous risk factors, which skew the [...] Read more.
Osteoporosis refers to excessive bone loss as reflected by the deterioration of bone mass and microarchitecture, which compromises bone strength. It is a complex multifactorial endocrine disease. Its pathogenesis relies on the presence of several endogenous and exogenous risk factors, which skew the physiological bone remodelling to a more catabolic process that results in net bone loss. This review aims to provide an overview of osteoporosis from its biology, epidemiology and clinical aspects (detection and pharmacological management). The review will serve as an updated reference for readers to understand the basics of osteoporosis and take action to prevent and manage this disease. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease)
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Other

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11 pages, 2072 KiB  
Case Report
Osteoporosis as the First Sign of Cushing’s Disease in a Thin 16-Year-Old Boy—A Case Report
by Anna Łupińska, Sara Aszkiełowicz, Grzegorz Zieliński, Renata Stawerska and Andrzej Lewiński
J. Clin. Med. 2023, 12(18), 5967; https://doi.org/10.3390/jcm12185967 - 14 Sep 2023
Viewed by 1235
Abstract
Cushing’s disease (CD) is an extremely rare diagnosis in children. In this report, we present the case of an almost 16-year-old, short and thin boy with CD, the first symptoms of which were spinal pain and vertebral fractures as a result of osteoporosis. [...] Read more.
Cushing’s disease (CD) is an extremely rare diagnosis in children. In this report, we present the case of an almost 16-year-old, short and thin boy with CD, the first symptoms of which were spinal pain and vertebral fractures as a result of osteoporosis. In light of his growth retardation and short stature, the boy underwent diagnostics, which excluded growth hormone (GH) deficiency, hypothyroidism and celiac disease. Finally, based on cortisol profile results, dexamethasone suppression tests and bilateral sampling during catheterization of the inferior petrosal sinuses, CD was diagnosed. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease)
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