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Diagnostics
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Diagnosis and Management of Osteoporosis
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Diagnosis and Management of Osteoporosis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 5481

Special Issue Editor

Dr. Danijela Budimir Mršić

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Guest Editor
Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, Split, Croatia
Interests: CT; ultrasound; cardiothoracic imaging; abdominal imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Bone density loss is a change in bone homeostasis resulting in the micro-architectural deterioration of bone tissue. It occurs with aging and in various medical conditions, and it increases the risks of the incidence of osteopenia and osteoporosis. Osteoporosis is a global and serious public health concern since it is the main non-communicable disease and the most common bone disease. The clinical importance of osteoporosis is the tendency to develop fragility fractures, which affect many sections of society, incurring high medical costs, decreasing life quality, and increasing overall mortality. Osteoporosis remains highly prevalent and underdiagnosed despite enormous efforts in prevention, diagnosis, and management. With the longer life expectancy and longevity of the world’s population and changes in lifestyle habits, the incidence of osteoporosis and related fractures is increasing and will continue to increase in the future. Understanding bone remodeling resulting in bone mineral loss is critical to improve the prevention, diagnosis, and therapy of osteoporosis. It is therefore important to continue research on bone mineral density. The proposed Special Issue aims to offer new improvements and proposes future directions in the understanding of the development of osteopenia and osteoporosis, their prevention, current diagnostic possibilities, and management.

I welcome you to submit your research involving bone mineral density, including the cellular and molecular mechanisms underlying osteoporosis, risk factors, improvements in prevention strategies, diagnostic tools, and treatment options.

Dr. Danijela Budimir Mršić
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. Diagnostics 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

  • bone mineral density
  • osteoporosis
  • fractures
  • cellular mechanisms
  • bone homeostasis
  • pathophysiology
  • prevention
  • DXA
  • MSCT
  • ultrasound
  • MRI
  • osteoporosis therapy

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Published Papers (4 papers)

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Research

13 pages, 1736 KiB  
Article
Automated Opportunistic Osteoporosis Screening Using Low-Dose Chest CT among Individuals Undergoing Lung Cancer Screening in a Korean Population
by Woo Young Kang, Zepa Yang, Heejun Park, Jemyoung Lee, Suk-Joo Hong, Euddeum Shim and Ok Hee Woo
Diagnostics 2024, 14(16), 1789; https://doi.org/10.3390/diagnostics14161789 - 16 Aug 2024
Viewed by 887
Abstract
Opportunistic osteoporosis screening using deep learning (DL) analysis of low-dose chest CT (LDCT) scans is a potentially promising approach for the early diagnosis of this condition. We explored bone mineral density (BMD) profiles across all adult ages and prevalence of osteoporosis using LDCT [...] Read more.
Opportunistic osteoporosis screening using deep learning (DL) analysis of low-dose chest CT (LDCT) scans is a potentially promising approach for the early diagnosis of this condition. We explored bone mineral density (BMD) profiles across all adult ages and prevalence of osteoporosis using LDCT with DL in a Korean population. This retrospective study included 1915 participants from two hospitals who underwent LDCT during general health checkups between 2018 and 2021. Trabecular volumetric BMD of L1-2 was automatically calculated using DL and categorized according to the American College of Radiology quantitative computed tomography diagnostic criteria. BMD decreased with age in both men and women. Women had a higher peak BMD in their twenties, but lower BMD than men after 50. Among adults aged 50 and older, the prevalence of osteoporosis and osteopenia was 26.3% and 42.0%, respectively. Osteoporosis prevalence was 18.0% in men and 34.9% in women, increasing with age. Compared to previous data obtained using dual-energy X-ray absorptiometry, the prevalence of osteoporosis, particularly in men, was more than double. The automated opportunistic BMD measurements using LDCT can effectively predict osteoporosis for opportunistic screening and identify high-risk patients. Patients undergoing lung cancer screening may especially profit from this procedure requiring no additional imaging or radiation exposure. Full article
(This article belongs to the Special Issue Diagnosis and Management of Osteoporosis)
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12 pages, 1907 KiB  
Article
Generation and Validation of Normative, Age-Specific Reference Curves for Bone Strain Index in Women
by Luca Rinaudo, Sofia Cuttone, Carmelo Messina, Veronica Magni, Davide Capra, Luca Maria Sconfienza, Francesco Sardanelli and Fabio Massimo Ulivieri
Diagnostics 2024, 14(10), 1046; https://doi.org/10.3390/diagnostics14101046 - 18 May 2024
Viewed by 909
Abstract
Bone Strain Index (BSI), based on dual-energy X-ray absorptiometry (DXA), is a densitometric index of bone strength of the femur and lumbar spine. Higher BSI values indicate a higher strain applied to bone, predisposing to higher fracture risk. This retrospective, multicentric study on [...] Read more.
Bone Strain Index (BSI), based on dual-energy X-ray absorptiometry (DXA), is a densitometric index of bone strength of the femur and lumbar spine. Higher BSI values indicate a higher strain applied to bone, predisposing to higher fracture risk. This retrospective, multicentric study on Italian women reports the BSI normative age-specific reference curves. A cohort of Caucasian Italian women aged 20 to 90 years was selected from three different clinical centres. Bone mineral density (BMD) and BSI measurements were obtained for the lumbar spine vertebrae (L1–L4) and for the femur (neck, trochanter and intertrochanter) using Hologic densitometers scans. The data were compared with BMD normative values provided by the densitometer manufacturer. Then, the age-specific BSI curve for the femur and lumbar spine was generated. No significant difference was found between the BMD of the subjects in this study and BMD reference data provided by Hologic (p = 0.68 for femur and p = 0.90 for lumbar spine). Spine BSI values (L1–L4) increase by 84% between 20 and 90 years of age. The mean BSI of the total femur increases about 38% in the same age range. The BSI age-specific reference curve could help clinicians improve osteoporosis patient management, allowing an appropriate patient classification according to the bone resistance to the applied loads and fragility fracture risk assessment. Full article
(This article belongs to the Special Issue Diagnosis and Management of Osteoporosis)
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13 pages, 1723 KiB  
Article
Clinical Indicators of Bone Deterioration in Alcoholic Liver Cirrhosis and Chronic Alcohol Abuse: Looking beyond Bone Fracture Occurrence
by Milos Stulic, Jelena Jadzic, Natasa Dostanic, Milica Zivkovic, Tihomir Stojkovic, Jelena Aleksic, Stefan Stojkovic, Milica Stojkovic Lalosevic, Marko Vojnovic, Zeljko Vlaisavljevic, Jelena Martinov Nestorov, Tatjana Nikolić, Violeta Culafic Vojinovic, Djordje Culafic and Danijela Djonic
Diagnostics 2024, 14(5), 510; https://doi.org/10.3390/diagnostics14050510 - 28 Feb 2024
Viewed by 1327
Abstract
Although previous studies indicated that chronic alcohol abuse (CAA) and alcoholic liver cirrhosis (ALC) are associated with increased bone fragility, understanding bone fragility determinants is still modest in these individuals. We used a comprehensive individualized clinical fracture risk assessment approach (vertebral osteodensitometry, femoral [...] Read more.
Although previous studies indicated that chronic alcohol abuse (CAA) and alcoholic liver cirrhosis (ALC) are associated with increased bone fragility, understanding bone fragility determinants is still modest in these individuals. We used a comprehensive individualized clinical fracture risk assessment approach (vertebral osteodensitometry, femoral osteodensitometry and geometry, and serum bone turnover biomarkers) to compare adult male patients with ALC who have not previously had femoral or vertebral fractures (n = 39), patients with CAA (without liver cirrhosis, n = 78) who have not previously had femoral or vertebral fractures and healthy age- and sex-matched controls (n = 43). Our data suggested that intertrochanteric bone mineral density was significantly lower in ALC and CAA patients than in controls. Also, the trabecular bone score was considerably lower in ALC patients compared with CAA and control individuals. The most significant inter-group differences in femoral geometry were noted on the femoral shaft. Patients with ALC and CAA have a higher 10-year risk of major osteoporotic fractures compared to the controls. Analysis of bone turnover biomarkers showed increased osteoprotegerin and beta-C-terminal telopeptide serum concentrations and decreased insulin growth factor-1 concentrations in patients with ALC compared to CAA and control groups. Our data revealed that bone alterations are present in patients with ALC and CAA even if they did not sustain a nontraumatic bone fracture, but it is also indicative that current bone-assessing clinical methods are not entirely reliable. Thus, future studies should focus on developing a reliable integrative clinical tool that can be used to accurately predict and prevent bone fracture occurrences in patients with ALC and CAA. Full article
(This article belongs to the Special Issue Diagnosis and Management of Osteoporosis)
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14 pages, 1174 KiB  
Article
Development and Comparison of Treatment Decision Tools for Glucocorticoid-Induced Osteoporosis
by Jia-Feng Chen, Shan-Fu Yu, Wen-Chan Chiu, Chi-Hua Ko, Chung-Yuan Hsu, Han-Ming Lai, Ying-Chou Chen, Yu-Jih Su, Hong-Yo Kang and Tien-Tsai Cheng
Diagnostics 2024, 14(4), 452; https://doi.org/10.3390/diagnostics14040452 - 19 Feb 2024
Cited by 1 | Viewed by 1814
Abstract
Long-term Glucocorticoid (GC) use results in compromised bone strength and fractures, and several treatment recommendations have been developed to prevent fractures, but none have been validated in a real-world setting. This study aims to create a treatment decision tool and compares this tool [...] Read more.
Long-term Glucocorticoid (GC) use results in compromised bone strength and fractures, and several treatment recommendations have been developed to prevent fractures, but none have been validated in a real-world setting. This study aims to create a treatment decision tool and compares this tool to the treatment suggestions from the American College of Rheumatology (ACR), International Osteoporosis Foundation and European Calcified Tissue Society (IOF-ECTS), and GC-adjusted Fracture Risk Assessment Tool (GC-FRAX), above the intervention threshold. We utilized registry data gathered at Chang Gung Memorial Hospital at Kaohsiung, Taiwan, between September 2014 and April 2021. This research is a single-center, observational, and case-controlled study. We recruited participants using prednisone for at least 2.5 mg/day or the equivalent dose for over 3 months, excluding those younger than 40, those with malignancies, or those currently undergoing anti-osteoporosis therapy. The primary endpoint was new fragility fractures within 3 years, including morphometric vertebral fractures detected at baseline and with a follow-up thoracic–lumbar spine X-ray. Participants were randomly allocated into derivation and validation sets. We developed the Steroid-Associated Fracture Evaluation (SAFE) tool in the derivation cohort by assessing the weights of exploratory variables via logistic regression. Prediction performance was compared in the validation set by the receiver operating characteristic (ROC) curve, the area under the curve (AUC), and sensitivity and specificity. A total of 424 treatment-naïve subjects were enrolled, and 83 (19.6%) experienced new fractures within 3 years. The final formula of the SAFE tool includes osteoporosis (1 point), an accumulated GC dose ≥ 750 mg within 6 months (or equivalent prednisolone of ≥4.5 mg/day for 6 months) (1 point), a BMI ≥ 23.5 (1 point), previous fractures (1 point), and elderliness of ≥70 years (2 points). In the validation set, a treatment decision based on the SAFE ≥ 2 points demonstrated an AUC of 0.65, with a sensitivity/specificity/accuracy of 75.9/54.0/58.9, with an ACR of 0.56 (100.0/11.0/31.0), IOF-ECTS 0.61 (75.9/46.0/52.7), and GC-FRAX 0.62 (82.8/42.0/51.2). Among current GIOP recommendations, the SAFE score serves as an appropriate treatment decision tool with increased accuracy and specificity. Full article
(This article belongs to the Special Issue Diagnosis and Management of Osteoporosis)
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