ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2022
Bone Microarchitecture Phenotypes Identified in Older Adults Are Associated With Different Levels of Osteoporotic Fracture Risk.
Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Artificial intelligence in osteoporosis screening and fracture risk prediction among aging populations: a bibliometric evidence map.Frontiers in endocrinology · 2026Pooled it
- Distinct Cortical Microstructure in Postmenopausal Women with Distal Radius and Proximal Humerus Fractures.Calcified tissue international · 2026Article
- Demystifying machine learning approaches in digital bone imaging using microCT and HRpQCT.Bone reports · 2026Review
- HR-pQCT skeletal phenotype clustering associated with muscle function in older men and women: The Study of Muscle, Mobility and Aging (SOMMA).Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Bone mineral density assessment by DXA in disease-associated osteoporosis: the limitations.Frontiers in endocrinology · 2026Review
- Knowledge mapping of osteoporotic fractures: a bibliometric analysis from 2014 to 2024.Archives of osteoporosis · 2025Review
- Screening for Osteoporosis in Nonagenarians: A Scoping Review.Journal of the American Geriatrics Society · 2025Article
- Artificial Intelligence in Postmenopausal Health: From Risk Prediction to Holistic Care.Journal of clinical medicine · 2025Review
- Emerging applications of feature selection in osteoporosis research: from biomarker discovery to clinical decision support.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Review
- The association between physical activity during growth and bone microarchitecture at peak bone mass.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Article
- Femoral neck width is associated with unique trajectories of age-related hip structural changes and fracture risk within populations of adult women and men.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Article
- Choose your mother wisely: the familial resemblance of bone adaptation.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Burden of falls in China, 1992-2021 and projections to 2030: a systematic analysis for the global burden of disease study 2021.Frontiers in public health · 2025Article
- Role and mechanism of Integrin α5β1 in bone formation and disease.Frontiers in cell and developmental biology · 2025Review
- Age-related Differences in Volumetric Bone Mineral Density, Structure, and Bone Strength of Surgical Neck of Humerus in Postmenopausal Women.Orthopaedic surgery · 2024Article
- Transferability of bone phenotyping and fracture risk assessment by μFRAC from first-generation high-resolution peripheral quantitative computed tomography to second-generation scan data.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Article
- Development of a semi-anthropomorphic photoacoustic calcaneus phantom based on nano computed tomography and stereolithography 3D printing.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2024Article
- Article
- Quantitative ultrasound imaging reveals distinct fracture-associated differences in tibial intracortical pore morphology and viscoelastic properties in aged individuals with and without diabetes mellitus - an exploratory study.Frontiers in endocrinology · 2024Article
- AI algorithms for accurate prediction of osteoporotic fractures in patients with diabetes: an up-to-date review.Journal of orthopaedic surgery and research · 2023Review
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
Prevalence of osteoporosis is more than 50% in older adults, yet current clinical methods for diagnosis that rely on areal bone mineral density (aBMD) fail to detect most individuals who have a fragility fracture. Bone fragility can manifest in different forms, and a "one-size-fits-all" approach to diagnosis and management of osteoporosis may not be suitable. High-resolution peripheral quantitative computed tomography (HR-pQCT) provides additive information by capturing information about volumetric density and microarchitecture, but interpretation is challenging because of the complex interactions between the numerous properties measured. In this study, we propose that there are common combinations of bone properties, referred to as phenotypes, that are predisposed to different levels of fracture risk. Using HR-pQCT data from a multinational cohort (n = 5873, 71% female) between 40 and 96 years of age, we employed fuzzy c-means clustering, an unsupervised machine-learning method, to identify phenotypes of bone microarchitecture. Three clusters were identified, and using partial correlation analysis of HR-pQCT parameters, we characterized the clusters as low density, low volume, and healthy bone phenotypes. Most males were associated with the healthy bone phenotype, whereas females were more often associated with the low volume or low density bone phenotypes. Each phenotype had a significantly different cumulative hazard of major osteoporotic fracture (MOF) and of any incident osteoporotic fracture (p < 0.05). After adjustment for covariates (cohort, sex, and age), the low density followed by the low volume phenotype had the highest association with MOF (hazard ratio = 2.96 and 2.35, respectively), and significant associations were maintained when additionally adjusted for femoral neck aBMD (hazard ratio = 1.69 and 1.90, respectively). Further, within each phenotype, different imaging biomarkers of fracture were identified. These findings suggest that osteoporotic fracture risk is associated with bone phenotypes that capture key features of bone deterioration that are not distinguishable by aBMD. © 2021 American Society for Bone and Mineral Research (ASBMR).
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