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Update in Osteoporosis and Related Bone Metabolic Disease—2nd Edition
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Update in Osteoporosis and Related Bone Metabolic Disease—2nd Edition

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

Deadline for manuscript submissions: 30 April 2025 | Viewed by 6377

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,

It is my pleasure to invite you to contribute to the Special Issue entitled “Update in Osteoporosis and Related Bone Metabolic Disease—2nd Edition”. This is a new volume, we published six papers in the first volume. For more details, please visit:
https://www.mdpi.com/journal/jcm/special_issues/Osteoporosis_Bone_Metabolic.

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 a 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

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Published Papers (6 papers)

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Research

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15 pages, 946 KiB  
Article
Clinical Characteristics of Persistent Hypophosphatasemia Uncovered in Adult Patients: A Retrospective Study at a Japanese Tertiary Hospital
by Shintaro Fujiwara, Yuki Otsuka, Masanori Furukawa, Akihito Higashikage and Fumio Otsuka
J. Clin. Med. 2024, 13(23), 7078; https://doi.org/10.3390/jcm13237078 (registering DOI) - 23 Nov 2024
Viewed by 174
Abstract
Background: Hypophosphatasemia is often overlooked despite its potential to indicate underlying pathologies. The aim of this study was to determine the prevalence of persistent hypophosphatasemia in a large, urban, multi-specialty hospital population and characterize the clinical and laboratory findings in adult patients with [...] Read more.
Background: Hypophosphatasemia is often overlooked despite its potential to indicate underlying pathologies. The aim of this study was to determine the prevalence of persistent hypophosphatasemia in a large, urban, multi-specialty hospital population and characterize the clinical and laboratory findings in adult patients with this condition. Methods: In this retrospective observational study, the results of 424,434 alkaline phosphatase (ALP) tests in 50,136 patients aged ≥18 years that were performed at Okayama University Hospital between July 2020 and October 2023 were analyzed. Persistent hypophosphatasemia was defined as consistently low ALP levels (≤40 IU/L) for 28 days with a minimum recorded level of ≤35 IU/L. Results: Persistent hypophosphatasemia was detected in 273 patients (0.54% of the tested patients), and the patients with persistent hypophosphatasemia included a higher proportion of females (72.5% vs. 52.9% in the people without persistent hypophosphatasemia; chi-squared test, p < 0.01) and had a younger median age (51 years vs. 63 years; Mann–Whitney U test, p < 0.01) than those in the overall tested population. The common causes of persistent hypophosphatasemia were cancer (30%), glucocorticoid use (21%), and immunosuppressants (16%). Notably, 38 patients (14%) had no apparent cause for low ALP values. These patients were categorized on the basis of their clinical characteristics, with some patients presenting symptoms potentially related to adult hypophosphatasia. Conclusions: This study provides prevalence and insights into the causes and characteristics of persistent hypophosphatasemia in a Japanese tertiary care setting. While most cases were associated with known causes, patients with unexplained hypophosphatasemia and symptoms such as chronic pain, muscle weakness, and general fatigue could have adult hypophosphatasia. In such cases, comprehensive evaluation and further investigation for hypophosphatasia should be considered. Persistent hypophosphatasemia of undetermined etiology could be a crucial initial step in diagnostic algorithms for this condition. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease—2nd Edition)
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14 pages, 2284 KiB  
Article
The Effect of Lacticaseibacillus paracasei LPC100 and Lactiplantibacillus plantarum LP140 on Bone Mineral Density in Postmenopausal Women: A Multicenter, Randomized, Placebo-Controlled Study
by Joanna Głogowska-Szeląg, Ilona Palka-Kisielowska, Wiesława Porawska, Joanna B. Bierła, Agnieszka K. Szczepankowska, Tamara Aleksandrzak-Piekarczyk and Bożena Cukrowska
J. Clin. Med. 2024, 13(19), 5977; https://doi.org/10.3390/jcm13195977 - 8 Oct 2024
Viewed by 807
Abstract
Objectives: modulation of gut microbiota by probiotics has been proposed as a target for intervention to reduce bone mineral density (BMD) loss in the postmenopausal period. This study aims to evaluate the effect of Lacticaseibacillus (L.) paracasei LPC100 and Lactiplantibacillus (L.) plantarum LP140 [...] Read more.
Objectives: modulation of gut microbiota by probiotics has been proposed as a target for intervention to reduce bone mineral density (BMD) loss in the postmenopausal period. This study aims to evaluate the effect of Lacticaseibacillus (L.) paracasei LPC100 and Lactiplantibacillus (L.) plantarum LP140 on BMD in postmenopausal women in a multicenter, randomized, double-blind, placebo-controlled trial. Methods: the primary outcome was the change in T-score of the lumbar spine measured by dual-energy X-ray absorptiometry assessed after twelve-month probiotic supplementation. Secondary outcomes included changes in serological markers of inflammation and calcium–phosphate metabolism, body mass index, gastrointestinal symptoms, and satisfaction with the intervention. Results: a decrease in T-score indicating the progressive bone demineralization reached a statistically significant difference in the placebo group (from mean values of 0.06 ± 1.04 to −0.28 ± 1.12, p = 0.041) but not in the probiotic group (0.19 ± 0.99 and −0.08 ± 1.05, respectively, p = 0.125) with a p-value = 0.089 between the groups. No significant differences were found in secondary outcomes with the exception of vitamin D concentration and a significant reduction in some gastrointestinal symptoms in the probiotic group. A significant decrease in vitamin D level was observed only in the placebo group (p = 0.014). Probiotics were safe and well tolerated. Conclusions: this study suggests that the oral administration of L. paracasei LPC100 and L. plantarum LP140 may be a viable strategy to prevent BMD loss and vitamin D deficiency in postmenopausal women, but further research is necessary to confirm clinical benefits and to know the mechanism of action [ClinicalTrial.gov NCT06375668]. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease—2nd Edition)
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16 pages, 3226 KiB  
Article
The Role of Glucose, Insulin and Body Fat in Assessment of Bone Mineral Density and Trabecular Bone Score in Women with Functional Hypothalamic Amenorrhea
by Elżbieta Sowińska-Przepiera, Mariola Krzyścin, Igor Syrenicz, Adrianna Orlińska, Adrianna Ćwiertnia, Adam Przepiera, Karolina Jezierska, Aneta Cymbaluk-Płoska, Žana Bumbulienė and Anheli Syrenicz
J. Clin. Med. 2024, 13(15), 4388; https://doi.org/10.3390/jcm13154388 - 26 Jul 2024
Viewed by 895
Abstract
Background: For years, bone mineral density (BMD) has played a key role in assessing bone health, but the trabecular bone score (TBS) is emerging as an equivalent measure. However, BMD alone may not fully measure bone quality or predict osteoporosis risk. To evaluate [...] Read more.
Background: For years, bone mineral density (BMD) has played a key role in assessing bone health, but the trabecular bone score (TBS) is emerging as an equivalent measure. However, BMD alone may not fully measure bone quality or predict osteoporosis risk. To evaluate the usefulness of TBS and BMD in estimating the risk of bone fracture in young women with FHA, this study examined the association between metabolic parameters and bone quality, which was measured using TBS and BMD. Methods: We analyzed the association of metabolic factors with tests assessing bone quality—TBS and BMD. Patients were checked for BMI, measured body fat, and determined serum glucose levels and insulin levels in a 75g glucose load test. Spearman correlation analysis was used. Results: Significant positive correlations were found between BMD and age (p < 0.001) and body fat (p < 0.001), as well as between TBS values and BMI (p < 0.001) and TBS and percent body fat (p < 0.001). Of the variables analyzed in the multivariate analysis, the only independent predictor of higher bone mineral density in the lumbar spine was found to be higher values of the trabecular bone index in the same segment (p < 0.001). Conclusions: The use of TBS provides a simple tool for estimating the risk of bone damage. Ultimately, early screening, diagnosis and treatment of patients with FHA may help prevent osteoporosis and fragility fractures in the long term. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease—2nd Edition)
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Review

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17 pages, 768 KiB  
Review
Osteoporosis and Bone Fragility in Children: Diagnostic and Treatment Strategies
by Giuseppe Cannalire, Giacomo Biasucci, Lorenzo Bertolini, Viviana Patianna, Maddalena Petraroli, Simone Pilloni, Susanna Esposito and Maria Elisabeth Street
J. Clin. Med. 2024, 13(16), 4951; https://doi.org/10.3390/jcm13164951 - 22 Aug 2024
Viewed by 1197
Abstract
The incidence of osteoporosis in children is increasing because of the increased survival rate of children with chronic diseases and the increased use of bone-damaging drugs. As childhood bone fragility has several etiologies, its management requires a thorough evaluation of all potentially contributing [...] Read more.
The incidence of osteoporosis in children is increasing because of the increased survival rate of children with chronic diseases and the increased use of bone-damaging drugs. As childhood bone fragility has several etiologies, its management requires a thorough evaluation of all potentially contributing pathogenetic mechanisms. This review focuses on the main causes of primary and secondary osteoporosis and on the benefits and limits of the different radiological methods currently used in clinical practice for the study of bone quality. The therapeutic and preventive strategies currently available and the most novel diagnostic and treatment strategies are also presented. Optimal management of underlying systemic conditions is key for the treatment of bone fragility in childhood. DXA still represents the gold standard for the radiologic evaluation of bone health in children, although other imaging techniques such as computed tomography and ultrasound evaluations, as well as REMS, are increasingly studied and used. Bisphosphonate therapy is the gold standard for pharmacological treatment in both primary and secondary pediatric osteoporosis. Evidence and experience are building up relative to the use of monoclonal antibodies such as denosumab in cases of poor response to bisphosphonates in specific conditions such as osteogenesis imperfecta, juvenile Paget’s disease and in some cases of secondary osteoporosis. Lifestyle interventions including adequate nutrition with adequate calcium and vitamin D intake, as well as physical activity, are recommended for prevention. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease—2nd Edition)
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20 pages, 3114 KiB  
Review
The Manganese–Bone Connection: Investigating the Role of Manganese in Bone Health
by Gulaim Taskozhina, Gulnara Batyrova, Gulmira Umarova, Zhamilya Issanguzhina and Nurgul Kereyeva
J. Clin. Med. 2024, 13(16), 4679; https://doi.org/10.3390/jcm13164679 - 9 Aug 2024
Viewed by 1779
Abstract
The complex relationship between trace elements and skeletal health has received increasing attention in the scientific community. Among these minerals, manganese (Mn) has emerged as a key element affecting bone metabolism and integrity. This review examines the multifaceted role of Mn in bone [...] Read more.
The complex relationship between trace elements and skeletal health has received increasing attention in the scientific community. Among these minerals, manganese (Mn) has emerged as a key element affecting bone metabolism and integrity. This review examines the multifaceted role of Mn in bone health, including its effects on bone regeneration, mineralization, and overall skeletal strength. This review article is based on a synthesis of experimental models, epidemiologic studies, and clinical trials of the mechanisms of the effect of Mn on bone metabolism. Current research data show that Mn is actively involved in the processes of bone remodeling by modulating the activity of osteoblasts and osteoclasts, as well as the main cells that regulate bone formation and resorption. Mn ions have a profound effect on bone mineralization and density by intricately regulating signaling pathways and enzymatic reactions in these cells. Additionally, Mn superoxide dismutase (MnSOD), located in bone mitochondria, plays a crucial role in osteoclast differentiation and function, protecting osteoclasts from oxidative damage. Understanding the nuances of Mn’s interaction with bone is essential for optimizing bone strategies, potentially preventing and managing skeletal diseases. Key findings include the stimulation of osteoblast proliferation and differentiation, the inhibition of osteoclastogenesis, and the preservation of bone mass through the RANK/RANKL/OPG pathway. These results underscore the importance of Mn in maintaining bone health and highlight the need for further research into its therapeutic potential. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease—2nd Edition)
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7 pages, 472 KiB  
Review
Hypophosphatasia Presenting as a Chronic Diffuse Pain Syndrome with Extra-Articular Calcifications
by Florence Lehane, Olivier Malaise, Christian Von Frenckell, Bernard Otto, Elisa Docampo and Clio Ribbens
J. Clin. Med. 2024, 13(8), 2263; https://doi.org/10.3390/jcm13082263 - 13 Apr 2024
Viewed by 1351
Abstract
Hypophosphatasia is a rare genetic disease characterized by abnormal alkaline phosphatase activity and deficiency of bone and teeth mineralization. Hypophosphatasia is well known in pediatrics with typical presentations in children, but mild forms can also be present in adults and are difficult to [...] Read more.
Hypophosphatasia is a rare genetic disease characterized by abnormal alkaline phosphatase activity and deficiency of bone and teeth mineralization. Hypophosphatasia is well known in pediatrics with typical presentations in children, but mild forms can also be present in adults and are difficult to detect. We present the case of a 50-year-old woman referred for pain management, with a previous diagnosis of fibromyalgia. The association of clinical features (diffuse pain syndrome, early dental loosening, personal history of two fractures with osteoporosis, and family history of osteoporosis) with radiographic (heterotopic calcifications of the yellow and interspinous lumbar ligaments) and biological (low levels of total alkaline phosphatase) indices was suggestive of hypophosphatasia, which was confirmed by genetic analysis. We review and discuss the association between hypophosphatasia, musculoskeletal pain, and calcium pyrophosphate deposition and the importance of raising the diagnosis of adult-onset hypophosphatasia when facing these two rheumatologic entities. Full article
(This article belongs to the Special Issue Update in Osteoporosis and Related Bone Metabolic Disease—2nd Edition)
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