Evidence map›Paper›PMID 36342539›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2023

Risk factors associated with prevalent vertebral fractures in Duchenne muscular dystrophy.

Kim Phung, Laura McAdam, Jinhui Ma, Hugh J McMillan, Stefan Jackowski, Maya Scharke, Mary-Ann Matzinger, Nazih Shenouda, Khaldoun Koujok, Jacob L Jaremko and 20 more

Abstract read
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In one paragraph

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, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Exploring the natural history of bone mineral density in Duchenne muscular dystrophy: a systematic literature review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Pooled it
  2. Article
  3. Prevalence and risk factors of bone fragility in duchenne muscular dystrophy: A systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Review
  4. Article
  5. Vertebral fractures and muscle function in glucocorticoid-treated individuals with Duchenne muscular dystrophy: a cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
  6. The burden of bone disease in Duchenne muscular dystrophy: age-specific prevalence of osteoporosis and low bone density.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
  7. Article
  8. Targeting cellular senescence in dystrophinPharmacological research · 2025
    Article
  9. Article
  10. Automated bone age calculation is an independent predictor of vertebral fracture burden in Duchenne muscular dystrophy.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Article
  11. Circulating CD34-positive cells are associated with prolonged time to fracture in people with Duchenne muscular dystrophy on chronic glucocorticoids.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025
    Article
  12. Review
  13. Article
  14. Approach to the Pediatric Patient With Glucocorticoid-Induced Osteoporosis.The Journal of clinical endocrinology and metabolism · 2025
    Article
  15. Article
  16. Article
  17. Article
  18. Growth hormone and testosterone delay vertebral fractures in boys with muscular dystrophy on chronic glucocorticoids.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors at 13 institutions in 1 country.

Kim PhungChildren's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
Laura McAdamHolland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
Jinhui MaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Hugh J McMillanMontreal Children's Hospital, McGill University, Montreal, QC, Canada.
Stefan JackowskiThe Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
Maya ScharkeThe Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
Mary-Ann MatzingerDepartment of Medical Imaging, University of Ottawa, Ottawa, ON, Canada.
Nazih ShenoudaDepartment of Medical Imaging, University of Ottawa, Ottawa, ON, Canada.
Khaldoun KoujokDepartment of Medical Imaging, University of Ottawa, Ottawa, ON, Canada.
Jacob L JaremkoDepartment of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada.
Kevin SmitChildren's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
Scott WalkerChildren's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
Colleen HartiganChildren's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
Nasrin KhanThe Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
Victor N KonjiThe Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
Lynn MacLeayThe Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
Marika PageChildren's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
Elizabeth SykesThe Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
Marie-Eve RobinsonChildren's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
Nathalie AlosCHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.
Elizabeth A CummingsIWK Health Centre, Dalhousie University, Halifax, NS, Canada.
Josephine HoAlberta Children's Hospital, University of Calgary, Calgary, AB, Canada.
Anne Marie SbrocchiMontreal Children's Hospital, McGill University, Montreal, QC, Canada.
Robert SteinLondon Health Sciences Centre, Western University, London, ON, Canada.
David SalehKingston Health Sciences Centre, Queen's University, Kingston, ON, Canada.
B Catharine CravenDepartment of Medicine, Temerty Faculty of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada.
Utkarsh J DangDepartment of Health Sciences, Carleton University, Ottawa, ON, Canada.
Kerry SiminoskiDepartment of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada.
Frank RauchShriners Hospital for Children, McGill University, Montreal, QC, Canada.
Leanne M WardChildren's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada. Lward@cheo.on.ca.ORCID http://orcid.org/0000-0003-1557-9185
University of Ottawa · CAChildren's Hospital of Eastern Ontario · CAMontreal Children's Hospital · CAUniversity of Alberta · CACarleton University · CACentre Hospitalier Universitaire Sainte-Justine · CADalhousie University · CAHolland Bloorview Kids Rehabilitation Hospital · CAImpact · CAQueen's University · CAUniversity Health Network · CAUniversity of Calgary · CAWestern University · CA

Funding

CIHR CIHR FRN 64285Physicians' Services Incorporated Foundation 14-03
6 · The paper itself

Abstract

Patients with Duchenne muscular dystrophy (DMD) have a high fracture burden due to progressive myopathy and steroid-induced osteoporosis. This study in males with DMD showed that markers of systemic glucocorticoid exposure including shorter stature, greater bone age delay, and lower lumbar spine bone mineral density were associated with spine fragility.

introductionFragility  fractures are frequent in DMD. The purpose of this study was to identify clinical factors associated with prevalent vertebral fractures (VF) in boys, teens/young adults with Duchenne muscular dystrophy (DMD).

methodsThis was a cross-sectional study of males aged 4-25 years with DMD. VF were evaluated using the modified Genant semi-quantitative method on T4-L4 lateral spine radiographs. Areal bone mineral density (aBMD) was measured at the lumbar spine (LS) and used to estimate volumetric BMD (vBMD). Clinical factors were analyzed for their association with the Spinal Deformity Index (SDI, the sum of the Genant grades).

resultsSixty participants were enrolled (mean age 11.5 years, range 5.4-19.5). Nineteen participants (32%) had a total of 67 VF; 23/67 VF (34%) were moderate or severe. Participants with VF were shorter (mean height Z-score ± standard deviation: - 3.1 ± 1.4 vs. - 1.8 ± 1.4, p = 0.001), had longer glucocorticoid exposure (mean duration 6.0 ± 3.3 vs. 3.9 ± 3.3 years, p = 0.027), greater bone age (BA) delay (mean BA to chronological age difference - 3.2 ± 3.4 vs. - 1.3 ± 1.2 years, p = 0.035), and lower LSaBMD Z-scores (mean - 3.0 ± 1.0 vs. - 2.2 ± 1.2, p = 0.023). There was no difference in LSvBMD Z-scores. Multivariable Poisson regression showed that every 0.1 mg/kg/day increment in average glucocorticoid daily dose was associated with a 1.4-fold SDI increase (95% confidence interval: 1.1-1.7, p = 0.013). Greater BA delay (p < 0.001), higher weight Z-score (p = 0.004), decreased height Z-score (p = 0.025), and lower LSvBMD Z-score (p = 0.025) were also associated with SDI increase.

conclusionReadily measurable clinical variables were associated with prevalent VF in males with glucocorticoid-treated DMD. These variables may be useful to identify candidates for primary osteoporosis prevention after glucocorticoid initiation.

Indexed as

Fractures, BoneMuscular Dystrophy, DuchenneOsteoporosisSpinal FracturesAdolescentAdultBone DensityChildChild, PreschoolCross-Sectional StudiesGlucocorticoidsHumansLumbar VertebraeMaleRisk FactorsYoung AdultGlucocorticoidsBone fragilityDuchenne muscular dystrophyOsteoporosisVertebral fractures

Identifiers

PMID36342539
OpenAlexW4308365286

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.