ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025
Modified criteria for identifying elevated bone mass.
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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
This study used modified criteria to exclude osteoporosis and osteopenia from elevated bone mass (EBM) to avoid a diagnostic paradox and demonstrated that diffuse idiopathic skeletal hyperostosis (DISH), severe lumbar degenerative disease (LDD), elevated body mass index (BMI), and diabetes are key risk factors for super EBM (SEBM). PURPOSE: The current criteria classify individuals with both EBM and osteopenia/osteoporosis. To avoid this contradiction, we used a modified criterion to exclude osteoporosis or osteopenia from EBM and to examine the clinical impact and risk factors of EBM.
methodsIn this retrospective study, bone mineral density (BMD) data from participants aged 18 years or older collected at a tertiary hospital between 2021 and 2023 were analyzed. Inclusion criteria were complete Z-scores and T-scores for the lumbar spine, femoral neck, and total hip. Participants with a history of lumbar spine surgery or hip arthroplasty prior to BMD measurement were excluded. Normal bone mass (NBM) was defined as T-scores ≥ -1.0 at all sites and Z-scores < 2.5 at any site. EBM was defined as NBM plus Z-scores ≥ 2.5 at any site. EBM was further subdivided into moderate EBM (MEBM) with Z-scores between 2.5 and 4.0, and SEBM with Z-scores ≥ 4.0. Demographic data, medical history, and comorbidities were collected and analyzed.
resultsOf the 33,479 eligible participants, 1,472 (4.4%) were identified with EBM. The EBM group was divided into 1,267 (3.8%) with MEBM and 205 (0.6%) with SEBM. SEBM group had a significantly higher proportion of men and a higher BMI than the MEBM group (p < 0.001). In addition, SEBM group had a higher prevalence of conditions such as DISH, ankylosing spondylitis (AS), LDD, and diabetes (p < 0.001). Different correlation trends between BMI, T-scores, and Z-scores were observed in the SEBM and MEBM groups. Chi-squared Automatic Interaction Detection (CHAID) analysis identified DISH as the strongest predictor of SEBM, while severe LDD, increased BMI, and diabetes were contributing factors for SEBM.
conclusionsUsing the modified criteria for EBM, which exclude cases of osteoporosis and osteopenia, SEBM has a higher rate of comorbidities compared to MEBM. The presence of DISH, higher severity of LDD, increased BMI, and diabetes were identified as strong risk factor of SEBM.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.