ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020
Higher fracture prevalence and smaller bone size in patients with hEDS/HSD-a prospective cohort study.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 19 citations in OpenAlex.
- Kinesiophobia, global health, pain, and bone mineral density in women with hypermobile Ehlers-Danlos syndrome: a prospective cohort study.Rheumatology international · 2026Article
- Clinical application of radiofrequency echographic multi-spectrometry (REMS) for diagnosis and follow-up in several rare bone disorders: a case series.BMC medical imaging · 2025Article
- Bone Densitometry Parameters in Females with Ehlers-Danlos Syndrome-Does the Hypermobile Subtype Increase the Risk of Low Bone Mass in Patients with Ehlers-Danlos Syndrome?Journal of clinical medicine · 2025Article
- Genetic Evaluation for Monogenic Disorders of Low Bone Mass and Increased Bone Fragility: What Clinicians Need to Know.Current osteoporosis reports · 2024Review
- Child Abuse, Misdiagnosed by an Expertise Center-Part II-Misuse of Bayes' Theorem.Children (Basel, Switzerland) · 2023Article
- Review
- Rationale and Feasibility of Resistance Training in hEDS/HSD: A Narrative Review.Journal of functional morphology and kinesiology · 2022Review
- Correlation of muscle and bone parameters, daily function and participation in women with generalized joint hypermobility: a descriptive evaluation.Journal of musculoskeletal & neuronal interactions · 2022Article
- Are patients with hypermobile Ehlers-Danlos syndrome or hypermobility spectrum disorder so different?Rheumatology international · 2021Observational
- Ehlers-Danlos Syndromes, Joint Hypermobility and Hypermobility Spectrum Disorders.Advances in experimental medicine and biology · 2021Article
- Bone Disease in Patients with Ehlers-Danlos Syndromes.Current osteoporosis reports · 2020Review
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
Increased fracture risk in patients with Ehlers-Danlos syndromes has been reported, but the reasons for it are incompletely understood. We aimed to investigate possible determinants of this increased risk and found that hEDS/HSD patients present with a cortical bone size deficit compared with control subjects, possibly related to lower mechanical loading.
introductionThe Ehlers-Danlos syndromes (EDS) comprise a group of heritable connective tissue disorders caused by defects in the biosynthesis, secretion, and/or organization of fibrillar collagens which might impair bone strength. Our aim was to compare fracture prevalence, volumetric and areal bone mineral density (BMD), bone geometry, muscle size and the muscle-bone interaction, body composition and longitudinal changes therein between patients with hypermobile EDS (hEDS) or hypermobility spectrum disorder (HSD), and healthy control subjects.
methodsCross-sectional data comprised 39 female hEDS/HSD patients (age 41 ± 11 years) and 43 age-matched controls. After 8 years, 27 hEDS/HSD and 17 control subjects were re-evaluated. Tibial trabecular and cortical volumetric BMD, bone mineral content (BMC), cortical bone geometry, and lower leg muscle cross-sectional area (CSA) were measured using pQCT. Body composition, areal BMD, and BMC were determined by DXA.
resultsAt baseline, patients with hEDS/HSD presented with a smaller cortical bone area, smaller cortical thickness and muscle CSA, and a higher fracture prevalence than control subjects (all p < 0.05). No differences in areal or volumetric BMD were found. Longitudinally, muscle CSA decreased in both groups and muscle density decreased in the hEDS/HSD group (p < 0.001) whereas all bone parameters remained unchanged.
conclusionhEDS/HSD patients have a cortical bone size deficit compared with controls, possibly contributing to their increased fracture risk. They presented with decreased muscle CSA but normal bone/muscle area ratio, suggesting that this bone size deficit is likely secondary to decreased mechanical loading. Further, there were no arguments for accelerated bone loss in hEDS/HSD subjects.
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