Osteoporose aus dem Augenfoto? Was neue Risikomarker für die Knochen taugen

Osteoporosis often lacks accessible screening tools, leading to underdiagnosis and increased fracture risk. We explored the potential of a retinal aging biomarker, measured by the RetiAGE algorithm, in stratifying osteoporosis risk. Cross-sectional and prospective cohort study. The retinal biological aging biomarker, RetiAGE, indicates the probability of being older than 65 years, was derived from retinal photographs using a deep learning algorithm. In the cross-sectional PopulatION HEalth and Eye Disease PRofilE in Elderly Singaporeans (PIONEER) study with 1,965 participants with both retinal images and Dual-energy X-ray Absorptiometry (DEXA) measurements, we assessed the association of RetiAGE with bone mineral density (BMD) and BMD's standard deviation (SD) score (T-score), and major osteoporotic and hip fracture risk scores calculated from fracture assessment tool (FRAX) using linear regression models, and its association with osteoporosis using logistic model. In the prospective UK Biobank cohort with 43,938 participants with retinal photographs and without osteoporosis at baseline, we evaluated the association between RetiAGE and the onset of osteoporosis using multivariable Cox proportional hazard models. Subgroup analyses were performed by further adjusting for menopause, hormone replacement therapy and glucocorticoids in women. In the PIONEER study, older RetiAGE was inversely associated with BMD and T-scores in various femoral regions after adjusting for risk factor

<h4>Objectives</h4>This study evaluated the association between Body Roundness Index (BRI) and QUS-defined osteoporosis, its discriminative ability, empirical cutoff, and subgroup heterogeneity in middle-aged and older adults.<h4>Methods</h4>We analyzed cross-sectional data from 1,444 community-dwelling adults aged 35-75 years. Osteoporosis was defined using tibial quantitative ultrasound-derived T-scores. Receiver operating characteristic curves assessed discrimination, restricted cubic splines examined dose-response relationships, logistic and robust regression analyses quantified associations, and subgroup analyses evaluated effect modification.<h4>Results</h4>The Youden index identified an optimal BRI cutoff of 4.5. High BRI (≥ 4.5) was associated with higher odds of osteoporosis in the unadjusted model (OR = 1.606, 95% CI: 1.292-1.996; P < 0.001), the age- and sex-adjusted model (OR = 1.432, 95% CI: 1.141-1.797; P = 0.002), and the fully adjusted model excluding BMI (OR = 1.404, 95% CI: 1.105-1.783; P = 0.005). The association was approximately linear (P for non-linearity = 0.539; P-overall < 0.001). BRI alone showed modest discrimination (AUC = 0.562, 95% CI: 0.529-0.594), which increased after adjustment for age and sex (AUC = 0.680, 95% CI: 0.652-0.710) and after full covariate adjustment (AUC = 0.695, 95% CI: 0.674-0.731). The association was stronger among participants with metabolic syndrome (OR = 2.62, 95% CI: 1.641-4.179) than among those without it (OR = 1.39, 9

<b>Background:</b> Fibroblast growth factor 23 (FGF23) and α-Klotho are key regulators of mineral metabolism and bone homeostasis; however, their combined diagnostic value in postmenopausal osteoporosis remains incompletely understood. This study investigated the associations of serum FGF23, α-Klotho, and the FGF23/α-Klotho ratio with bone mineral density (BMD), bone turnover markers, and their diagnostic performance for postmenopausal osteoporosis. <b>Methods:</b> This cross-sectional study included 165 women divided into three groups: premenopausal healthy controls (n = 55), postmenopausal non-osteoporotic women (n = 55), and postmenopausal women with osteoporosis (n = 55). Serum FGF23 and α-Klotho concentrations were measured by enzyme-linked immunosorbent assay. Bone mineral density was assessed by dual-energy X-ray absorptiometry. Correlation analyses, age- and BMI-adjusted partial correlations, multivariable linear and logistic regression analyses, receiver operating characteristic (ROC) analyses, and incremental diagnostic models were performed. Diagnostic ROC and incremental model analyses were restricted to postmenopausal women (n = 110). <b>Results:</b> Serum FGF23 concentrations and the FGF23/α-Klotho ratio increased progressively across the study groups, whereas α-Klotho levels decreased (all <i>p</i> < 0.001). FGF23 was inversely correlated with lumbar spine, femoral neck, and total hip BMD and T-scores (all <i>p</i> < 0.001), whereas α-Klotho demonstrated positi

Sestrin2 is a stress-inducible protein that plays a significant role in maintaining antioxidant balance and metabolic homeostasis via the AMPK/mTOR pathways. Animal models suggested that Sestrin2 deficiency may be associated with high bone mass; however, how this may translate into humans, especially in aging and stress conditions, is unknown. We performed a cross-sectional analysis of 910 adults recruited from the Qatar Biobank cohort. Participants were stratified into 3 groups: younger than 40 yr, 40-55 yr, and older than 55 yr. We investigated the relationship between plasma Sestrin2 and FN BMD T-score in adults using multiple linear regression, controlling for age, sex, BMI, diabetes, and estimated glomerular filtration rate. We observed a significant interaction between Sestrin2 and age (<i>p</i> < .001). In younger and middle-aged adults, Sestrin2 was not correlated with BMD. However, in adults aged >55 yr, Sestrin2 was strongly and positively correlated with FN T-scores (β = .131, 95% CI: 0.062-0.201, <i>p</i> < .001). This association remained significant after adjustment for all possible confounders, with an effect size reduction of only 7.7%. Further analysis showed that this association is more pronounced in males (β = .155, <i>p</i> < .001) but is not significant in females (β = -.008, <i>p</i> = .935). Our study indicates that Sestrin2 and BMD are significantly correlated but only in aged adults. In contrast to animal models, we showed that Sestrin2 in aged adult