Automated abdominal aortic calcification scoring from vertebral fracture assessment images and fall-associated hospitalisations: the Manitoba Bone Mineral Density Registry.

Abdominal aortic calcification (AAC), a subclinical measure of cardiovascular disease (CVD) that can be assessed on vertebral fracture assessment (VFA) images during osteoporosis screening, is reported to be a falls risk factor. A limitation to incorporating AAC clinically is that its scoring requires trained experts and is time-consuming. We examined if our machine learning (ML) algorithm for AAC (ML-AAC24) is associated with a higher fall-associated hospitalisation risk in the Manitoba Bone Mineral Density (BMD) Registry.

The association of hip bone mineral density (BMD) with incident major osteoporotic and hip fractures varies by body mass index.

Background: Bone mineral density (BMD) measurement is less precise amongst those with body mass index (BMI) > 30 kg/m. We hypothesized that the association of BMD with incident hip and major osteoporotic fractures (MOF; hip, clinical vertebral, forearm, or humerus) becomes weaker with increasing BMI.

Methodology: Our study population was 75,391 individuals age ≥ 50 years who had a bone density test in the province of Manitoba 1998 to 2018.

Development of an Algorithm to Predict Appendicular Lean Mass Index From Regional Spine and Hip Dxa Scans.

Introduction: Sarcopenia is characterized by progressive muscle loss with reduced physical function and/or reduced muscle strength. Operational definitions of sarcopenia include a measurement of muscle mass, most often from dual-energy X-ray absorptiometry (DXA)-derived appendicular lean mass. Appendicular lean mass can be derived from whole-body dual-DXA scans; however, these scans are performed less commonly than hip and spine scans as part of clinical care.

Rheumatoid arthritis and subsequent fracture risk: an individual person meta-analysis to update FRAX.

Unlabelled: The relationship between rheumatoid arthritis (RA) and fracture risk was estimated in an international meta-analysis of individual-level data from 29 prospective cohorts. RA was associated with an increased fracture risk in men and women, and these data will be used to update FRAX®.

Introduction: RA is a well-documented risk factor for subsequent fracture that is incorporated into the FRAX algorithm.

Increase in major osteoporotic fractures after therapy with immune checkpoint inhibitors.

Background: Immune checkpoint inhibitors (ICIs) can cause severe and sometimes long-standing immune-related adverse events (irAEs). Enhanced immune activation from ICI can theoretically result in osteoclast activation, bone loss and fracture. The objective of this study was to evaluate the incidence rates of major osteoporotic fractures (MOFs) in patients with melanoma treated with ICI.

Effects of femoral neck width and hip Axis length on incident hip fracture risk: a registry-based cohort study.

Bone mineral density (BMD) measured with dual-energy X-ray absorptiometry (DXA) is widely used in clinical practice to assess fracture risk and guide management. DXA can also assess hip geometry, including femoral neck width (FNW) and hip axis length (HAL), which have both been associated with increased risk for hip fracture independently from BMD. Our objective was to assess if FNW predicts hip fracture independently from other factors including HAL.

Assessing the Effects of Immune Checkpoint Inhibitors on Bone Utilizing Machine Learning-assisted Opportunistic Quantitative Computed Tomography.

Immune checkpoint inhibitors (ICI) are widely used in cancer treatment, yet their impact on bone health remains unclear. This study aimed to perform a retrospective cohort study utilizing routine computed tomography (CT) scans from patients with melanoma to perform opportunistic quantitative CT (QCT) analysis to investigate the effects of ICI treatment on skeletal health, including volumetric bone mineral density (vBMD) measurements and osteoarthritis (OA) parameters. A previously established machine-learning assisted opportunistic QCT pipeline was used to estimate lumbar spine vBMD from baseline and 12-month follow-up CT scans in patients with melanoma treated with ICI therapy and those not treated with ICI therapy.

A real-world analysis of 1,823 hospitalized osteoporotic fractures in Northeast China.

Context: There are limited real-world data evidence assessing the clinical characteristics of hospitalized osteoporotic fractures in China.

Objective: To investigate the clinical characteristics of hospitalized major osteoporotic fractures in Northeast China.

Methods: We identified hospitalized fracture patients aged 50 and over from the First Affiliated Hospital of Jinzhou Medical University between January 1, 2018, and December 31, 2022.

Fracture Risk Assessment in the 2023 Osteoporosis Canada Guideline.

Radiologists and other diagnostic imaging specialists play a pivotal role in the management of osteoporosis, a highly prevalent condition of reduced bone strength and increased fracture risk. Bone mineral density (BMD) measurement with dual-energy X-ray absorptiometry (DXA) is a critical component of identifying individuals at high risk for fracture. Strategies to prevent fractures are consolidated in the Osteoporosis Canada clinical practice guideline which was updated in 2023.

Automated abdominal aortic calcification and major adverse cardiovascular events in people undergoing osteoporosis screening: the Manitoba Bone Mineral Density Registry.

Vertebral fracture assessment (VFA) images from bone density machines enable the automated machine learning assessment of abdominal aortic calcification (ML-AAC), a marker of cardiovascular disease (CVD) risk. The objective of this study was to describe the risk of a major adverse cardiovascular event (MACE, from linked health records) in patients attending routine bone mineral density (BMD) testing and meeting specific criteria based on age, BMD, height loss, or glucocorticoid use have a VFA in the Manitoba Bone Mineral Density Registry. The cohort included 10 250 individuals (mean 75.

Age at First Fracture and Later Fracture Risk in Older Adults Undergoing Osteoporosis Assessment.

Importance: Fragility fractures are often defined as those that occur after a certain age (eg, 40-50 years). Whether fractures occurring in early adulthood are equally associated with future fractures is unclear.

Objective: To examine whether the age at which a prior fracture occurred is associated with future fracture risk.

The development and validation of the beliefs about Baby Crying at Night (BBCN) scale.

Objective: What are young children trying to express when they cry at night? According to Sadeh, parental beliefs about why their child is crying may play a role in the development and persistence of their child's insomnia. The aim of this study was to create a scale that specifically assesses these parental interpretations in different dimensions.

Methods: Children aged between 6 months and 3 years with either good sleep habits or behavioural insomnia were recruited.

Fracture Risk Prediction Using the Fracture Risk Assessment Tool in Individuals With Cancer.

Importance: The Fracture Risk Assessment Tool (FRAX) is a fracture risk prediction tool for 10-year probability of major osteoporotic fracture (MOF) and hip fracture in the general population. Whether FRAX is useful in individuals with cancer is uncertain.

Objective: To determine the performance of FRAX for predicting incident fractures in individuals with cancer.

Among people on osteoporosis medication, loss of appendicular or total body lean mass is an independent risk factor for hip and major osteoporotic fractures.

Unlabelled: People with prior lean mass loss had a ~ 10% higher risk of MOF and ~ 22-26% higher risk of hip fracture, and the results were similar in people on anti-osteoporosis medications. Loss of lean mass is associated with increased fracture risk. Patients should be encouraged to pursue strategies to prevent loss of lean mass.

Treatment reclassification in Canada from the Osteoporosis Canada 2023 clinical practice guidelines: the Manitoba BMD Registry.

Unlabelled: Osteoporosis Canada 2023 clinical practice guidelines increase the number of individuals recommended or suggested for anti-osteoporosis pharmacotherapy by refining treatment guidance for those who fell within the 2010 guidelines' moderate-risk category.

Purpose: In 2023, Osteoporosis Canada updated its 2010 clinical practice guidelines based upon consideration of fracture history, 10-year major osteoporotic fracture (MOF) risk, and BMD T-score in conjunction with age. The 2023 guidelines eliminated risk categories, including the moderate-risk group that did not provide clear treatment guidance.

Bone Mineral Density Monitoring in Contiguous versus Non-Contiguous Lumbar Vertebrae: The Manitoba BMD Registry.

Introduction: Only change in bone mineral density (BMD) on repeat DXA that exceeds the 95% least significant change (LSC) should be considered clinically meaningful. Frequently lumbar spine DXA must be reported after omitting vertebrae with localized structural artifact, which reduces measurement precision. Previous reports have raised concerns of higher least significant change (LSC) when spine BMD is based on non-contiguous rather than contiguous vertebrae.

The Effect of Smoking Cessation versus Current Smoking on Fracture Risk: The Manitoba BMD Registry.

Current tobacco smoking is included in FRAX calculator for fracture risk assessment. It is unknown whether previous smoking increases the risk of fracture. The current analysis was performed to compare incident fracture risk associated with current smoking, smoking cessation and non-smoking.