Bone is a complex tissue that fulfills the role of a resistance structure. This quality is most commonly assessed by bone densitometry, but bone strength may not only be related to bone mineral density but also to the preservation of bone cytoarchitectonics. The study included two groups of rats, ovariectomized and non-ovariectomized. Each group was divided into three batches: control, simvastatin-treated, and fenofibrate-treated. In the ovariectomized group, hypolipidemic treatment was instituted at 12 weeks post ovariectomy. One rat from each of the 6 batches was sacrificed 8 weeks after the start of treatment in the group. The experimental study was performed using a Bruker Minispec mq 20 spectrometer operating at a frequency of 20 MHz, subsequently also performed by 1H T2-T2 molecular exchange maps. The results were represented by T2-T2 molecular exchange maps that showed, comparatively, both pore size and their interconnectivity at the level of the femoral epiphysis, being able to evaluate both the effect of estrogen on bone tissue biology and the effect of the lipid-lowering medication, simvastatin, and fenofibrate, in both the presence and absence of estrogen. T2-T2 molecular exchange maps showed that the absence of estrogen results in an increase in bone tissue pore size and interconnectivity. In the presence of estrogen, lipid-lowering medication, both simvastatin and fenofibrate alter bone tissue cytoarchitectonics by reducing pore interconnectivity. In the absence of estrogen, fenofibrate improves bone tissue cytoarchitectonics, the T2-T2 molecular exchange map being similar to that of non-osteoporotic bone tissue.

Exogenous polyamines, including putrescine (PUT), spermidine (SPD), and spermine (SPM), and the irreversible inhibitor of the rate-limiting enzyme ornithine decarboxylase (ODC) of polyamine biosynthesis, α-difluoromethylornithine (DFMO), are implicated as stimulants for bone formation. We demonstrate in this study the osteogenic potential of exogenous polyamines and DFMO in human osteoblasts (hOBs), murine monocyte cell line RAW 264.7, and an ovariectomized rat model. The effect of polyamines and DFMO on hOBs and RAW 264.7 cells was studied by analyzing gene expression, alkaline phosphatase (ALP) activity, tartrate-resistant acid phosphatase (TRAP) activity, and matrix mineralization. Ovariectomized rats were treated with polyamines and DFMO and analyzed by micro computed tomography (micro CT). The mRNA level of the early onset genes of osteogenic differentiation, Runt-related transcription factor 2 (Runx2) and ALP, was significantly elevated in hOBs under osteogenic conditions, while both ALP activity and matrix mineralization were enhanced by exogenous polyamines and DFMO. Under osteoclastogenic conditions, the gene expression of both receptor activator of nuclear factor-κB (RANK) and nuclear factor of activated T-cells, cytoplasmic 1 (NFATc1) was reduced, and TRAP activity was suppressed by exogenous polyamines and DFMO in RAW 264.7 cells. In an osteoporotic animal model of ovariectomized rats, SPM and DFMO were found to improve bone volume in rat femurs, while trabecular thickness was increased in all treatment groups. Results from this study provide in vitro and in vivo evidence indicating that polyamines and DFMO act as stimulants for bone formation, and their osteogenic effect may be associated with the suppression of osteoclastogenesis.

A balanced and healthy diet during the menopausal transition and after menopause is crucial for women to reduce the risk for morbidities and chronic diseases due to deficiency of essential nutrients.
OBJECTIVE: The objective of this study was to conduct a systematic review of studies that analyzed the impact of vitamin and nutrient deficiencies in postmenopausal women in relation to increased morbidities and chronic conditions.
METHODS: Observational studies were searched in the databases PubMed, UpToDate, and Google Scholar.
RESULTS: We searched 122 studies, of which 90 were included in our analysis. The meta-analysis of the data could not be performed because of the heterogeneity of the statistical methods in the included studies. In our study, we focused on the aspects of vitamin B6, vitamin B12, vitamin D, iron, omega-3-fatty acids, and lycopene, belonging to the family of carotenoids. Postmenopausal women with deficiencies of these nutrients are more vulnerable to comorbidities such as cardiovascular and cerebrovascular events, metabolic diseases, osteoporosis, obesity, cancer and neurodegenerative diseases such as Parkinson\'s disease, Alzheimer\'s disease, depression, cognitive decline, dementia, and stroke. We concluded that women after menopause tend to have a greater probability of suffering from deficiencies in various vitamins and nutrients, and consequently have an increased risk of developing morbidities and chronic diseases.
CONCLUSIONS: In conclusion, maintaining optimum serum levels of nutrients and vitamins, either through a balanced and healthy diet consuming fresh fruits, vegetables, and fats or by taking appropriate supplementation, is essential in maintaining optimal health-related quality of life and reducing the risk for women during the menopausal transition and after menopause. Nevertheless, more recent studies need to be assessed to formulate adequate recommendations to achieve positive clinical outcomes.

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UNASSIGNED: Despite the fact that China amounts to one-fifth of the world\'s population, has a higher proportion of the elderly, and has a higher prevalence of osteoporosis and fracture, limited studies have investigated the association between dietary patterns and bone mineral density (BMD) as well as fracture risk among the elderly Chinese population. We aimed to investigate the association between different dietary patterns and BMD as well as the risk of fractures, and this association may vary between elderly women and men.
UNASSIGNED: Building upon the China Osteoporosis Prevalence Study, we included 17,489 subjects aged ≥40 years old randomly sampled across 44 counties/districts of 11 provinces or municipalities in China who completed a food frequency questionnaire. BMD was measured by dual x-ray absorptiometry. Vertebral fracture was defined based on lateral spine radiographs using the semi-quantitative technique of Genant.
UNASSIGNED: A diet rich in \"carnivorous\", \"vegetarian\", \"dairy, fruit, and egg\" was significantly associated with higher BMD at total hip (TH), femoral neck (FN), and lumbar spine 1-4 (L1-4). Yet, a diet rich in \"beverage and fried food\" was associated with a lower BMD at the FN and L1-4. High quartiles of the carnivorous diet were associated with 34%-39% reduced risk of clinical fracture in the past 5 years and vertebral fracture. Stronger associations were observed among women. Sensitivity analysis among postmenopausal women presented even stronger positive associations between carnivorous and vegetarian diets and high BMD, as well as between carnivorous diet and reduced risk of fractures.
UNASSIGNED: Our study suggested that a diet rich in meat, vegetables, and dairy, fruit, and eggs might be associated with greater BMD and a lower fracture risk, while beverage and fried foods may be associated with a lower BMD at L1-4, especially among elderly women. These findings are relevant to provide recommendations on dietary nutrition regarding the elderly population at high risk of osteoporosis and fractures, especially postmenopausal women.

Teriparatide, an osteoanabolic agent, is a biosynthetic analogue of the 1-34 amino acids of human parathyroid hormone (PTH) used for the treatment of osteoporosis. It is typically well-tolerated; common side effects include headaches, arthralgias, nausea, and dizziness. In this report, we present a case of gynecomastia occurring shortly after initiating teriparatide therapy, associated with nipple sensitivity and breast tenderness. Secondary workup for various causes of gynecomastia was unremarkable. Finally, a decision was made to discontinue teriparatide due to the patient\'s concerns. The nipple sensitivity started improving shortly afterward, with complete resolution of gynecomastia 4 months later. Although this unusual side effect has been reported as a possibility in postmarketing studies, a chronological report on the occurrence of teriparatide-induced gynecomastia and its complete resolution after discontinuing teriparatide has not yet been published in the literature.

BACKGROUND: We conducted analyses of the association between smoking and osteoporosis and osteoporotic fractures using a secondary dataset analysis of the National Health and Nutrition Examination Survey (NHANES) database and the two-sample Mendelian randomization (MR) method.
METHODS: The associations between smoking and osteoporosis or osteoporotic fractures were analyzed using weighted logistic regression models for both univariate and multivariable analyses using pooled 1999-2018 NHANES data. The summary-level data of genome-wide association studies (GWAS) of smoking and osteoporosis were extracted from the IEU Open GWAS project. The inverse variance weighted method was used as the main method for the two-sample MR analysis.
RESULTS: We obtained the following main findings based on the NHANES data: smoking was associated with osteoporosis according to the analyses of 30856 participants (OR=1.21; 95% CI: 1.06-1.39, p=0.004); smoking was associated with hip osteoporotic fracture according to the analyses of 30928 participants (OR=1.47; 95% CI: 1.14-1.90, p=0.004); smoking was associated with wrist osteoporotic fracture according to the analyses of 30923 participants (OR=1.33; 95% CI: 1.18-1.49, p<0.001); and smoking was associated with spine osteoporotic fracture according to the analyses of 30910 participants (OR=1.43, 95% CI: 1.18-1.73, p<0.001). In addition, we confirmed the potential causal effect of smoking on the risk of osteoporotic fracture (OR=24.5; 95% CI: 1.11-539, p=0.043) by conducting two-sample MR analyses.
CONCLUSIONS: Smoking was associated with increased risks of both osteoporosis and osteoporotic fracture. Smoking showed a potential causal effect on the risk of osteoporotic fracture.

UNASSIGNED: Trabecular bone score (TBS), as a texture indicator of bone microarchitecture, predicts the risk of fracture. This study aims to explore the knowledge map of TBS.
UNASSIGNED: We searched Scopus for \"trabecular bone score\" or \"trabecular score\" from the beginning to 2021. Our inclusion criteria were original articles and reviews that were related to TBS and our exclusion criteria were non-English articles, non-related to TBS, and document type other than original articles and reviews. and related documents were included for bibliometric analysis. Excel, VOS viewer, and Science of Science (Sci2) software were used for data synthesis.
UNASSIGNED: From 749 retrieved articles, 652 articles were included for analysis. These documents were cited 12,153 times and had an H-index of 56. The most productivity belonged to the USA (n = 130 documents), Switzerland (n = 101), and Italy (n = 67). \"Osteoporosis International\" (n = 80) had the highest participation in publishing. The research topics of interest were mainly related to the applicability of TBS for fracture risk assessment in chronic endocrine disorders such as osteoporosis and diabetes mellitus. Bursting analysis of the title and abstract revealed the initial focus of the discriminative power of TBS for osteoporotic fracture and the more recent focus on comparing bone mineral density (BMD) and TBS in a variety of chronic diseases.
UNASSIGNED: The number of annual publications on TBS has increased, especially after 2016. These publications highlight the importance of in-depth knowledge of TBS in predicting fracture risk and also its strengths and limitations of treatment monitoring in different health conditions.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s40200-023-01338-7.

UNASSIGNED: The prevalence of osteoporosis increases as the population ages. The aim of this study was to conduct a systematic review and meta-analysis to estimate the prevalence of osteoporosis among the general population ≥ 50 years old in Iran.
UNASSIGNED: Multiple databases including Scopus, WOS, Medline, Embase, and Persian databases (SID and Magiran) were systematically searched to identify relevant research papers. All population-based studies estimating the prevalence of osteoporosis in the Iranian population were included and imported into Endnote software. Two authors independently reviewed the articles. The Newcastle-Ottawa Scale was used to assess the risk of bias. Statistical analysis was performed using Stata software, and a significance level of 0.05 was applied to the analyses.
UNASSIGNED: Totally 2117 documents were retrieved from the databases up until October 11, 2022. After reading the full texts, 10 documents were included in the study. Our results indicated that the pooled prevalence of osteoporosis in the femoral neck region was 0.19 (95%CI: 0.12-0.26) and 0.19 (95%CI: 0.13-0.25) for women and men, respectively. Pooled prevalence of spinal osteoporosis was 0.29 (95%CI: 0.21-0.38) among women and 0.16 (95%CI: 0.12-0.19) among men. The total pooled prevalence of osteoporosis was 0.38 (95%CI: 0.29-0.48) for women and 0.25 (95%CI: 0.22-0.29) for men.
UNASSIGNED: Our study highlights the elevated prevalence of osteoporosis among individuals aged 50 years and older, with females exhibiting higher rates. Notably, osteoporosis in the femoral neck region demonstrated the lowest prevalence in both sexes. The implementation of comprehensive strategies is imperative to address osteoporosis problems effectively.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s40200-023-01352-9.

UNASSIGNED: The association between osteoporosis and cardiovascular disease, two major health problems, has been reported in some studies. In this study was aimed to investigate the relationship between osteoporosis and the CVD risk score based on Framingham and American College of Cardiology and the American Heart Association (ACC/AHA) prediction models in the population over 60 years old.
UNASSIGNED: A cross-sectional analysis was conducted on data from 2389 men and women participating in the Bushehr Elderly Health (BEH) program. Osteoporosis was defended as T-score ≤  - 2.5 at any site (total hip, femoral neck and lumbar spine (L1-L4). Based on Framingham and ACC/AHA risk scores, participants were categorized as non-high risk (< 20%) or high-risk (≥ 20%). Logistic regression model, was applied to investigate the relationship between osteoporosis and cardiovascular disease risk scores. All comparisons were stratified by sex.
UNASSIGNED: Considering the cut point of ≥ 20% for CVD risk, 36.7% of women and 66.2% of men were categorized as having high risk of CVD in ACC/AHA model. These values in women and men based on the Framingham model were 30% and 35.7%, respectively. In general, there was a negative significant correlation between BMD in the femoral neck, total hip and TBS except for the spine with the CVD risk score in both models. After adjusting for confounding variables, a significant positive association was observed between osteoporosis only at femoral neck with CVD risk score ≥ 20% based on ACC/AHA in both genders.
UNASSIGNED: The ACC/AHA model is effective in identifying the CVD risk difference between individuals with and without osteoporosis.