{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:18:13Z","timestamp":1787818693907,"version":"build-2784847793"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["contracts 75N92025D00022"],"award-info":[{"award-number":["contracts 75N92025D00022"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92020D00001"],"award-info":[{"award-number":["75N92020D00001"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201500003I"],"award-info":[{"award-number":["HHSN268201500003I"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95159"],"award-info":[{"award-number":["N01-HC-95159"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92025D00026"],"award-info":[{"award-number":["75N92025D00026"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92020D00005"],"award-info":[{"award-number":["75N92020D00005"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95160"],"award-info":[{"award-number":["N01-HC-95160"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92025D00027"],"award-info":[{"award-number":["75N92025D00027"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92020D00002"],"award-info":[{"award-number":["75N92020D00002"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92025D00028"],"award-info":[{"award-number":["75N92025D00028"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92025D00025"],"award-info":[{"award-number":["75N92025D00025"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95161"],"award-info":[{"award-number":["N01-HC-95161"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92020D00003"],"award-info":[{"award-number":["75N92020D00003"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95162"],"award-info":[{"award-number":["N01-HC-95162"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92020D00006"],"award-info":[{"award-number":["75N92020D00006"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95163"],"award-info":[{"award-number":["N01-HC-95163"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92020D00004"],"award-info":[{"award-number":["75N92020D00004"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95164"],"award-info":[{"award-number":["N01-HC-95164"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["75N92020D00007"],"award-info":[{"award-number":["75N92020D00007"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95165"],"award-info":[{"award-number":["N01-HC-95165"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95166"],"award-info":[{"award-number":["N01-HC-95166"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95167"],"award-info":[{"award-number":["N01-HC-95167"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95168"],"award-info":[{"award-number":["N01-HC-95168"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01-HC-95169"],"award-info":[{"award-number":["N01-HC-95169"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01 HL077612\/HL\/NHLBI NIH HHS\/United States"],"award-info":[{"award-number":["R01 HL077612\/HL\/NHLBI NIH HHS\/United States"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1-TR-000040"],"award-info":[{"award-number":["UL1-TR-000040"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1-TR-001079"],"award-info":[{"award-number":["UL1-TR-001079"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1-TR-001420"],"award-info":[{"award-number":["UL1-TR-001420"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000139","name":"U.S. Environmental Protection Agency","doi-asserted-by":"publisher","award":["No. RD831697 (MESA Air)"],"award-info":[{"award-number":["No. RD831697 (MESA Air)"]}],"id":[{"id":"10.13039\/100000139","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000139","name":"U.S. Environmental Protection Agency","doi-asserted-by":"publisher","award":["RD-83830001 (MESA Air Next Stage)"],"award-info":[{"award-number":["RD-83830001 (MESA Air Next Stage)"]}],"id":[{"id":"10.13039\/100000139","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01 AR079620\/AR\/NIAMS NIH HHS\/United States"],"award-info":[{"award-number":["R01 AR079620\/AR\/NIAMS NIH HHS\/United States"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Skeletal Radiol"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1007\/s00256-026-05263-7","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T22:48:22Z","timestamp":1780181302000},"page":"2527-2537","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Deep learning\u2013based CT-derived vertebral bone mineral density and metformin therapy: a longitudinal study in the Multi-Ethnic Study of Atherosclerosis"],"prefix":"10.1007","volume":"55","author":[{"given":"Sara","family":"Momtazmanesh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quincy A.","family":"Hathaway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payam","family":"Jannatdoust","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Ghotbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Bancks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Bluemke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Graham","family":"Barr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin M.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy S.","family":"Post","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Budoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o A. C.","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5991-5924","authenticated-orcid":false,"given":"Shadpour","family":"Demehri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,31]]},"reference":[{"key":"5263_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.107843","volume":"157","author":"P Saeedi","year":"2019","unstructured":"Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes Res Clin Pract. 2019;157:107843.","journal-title":"Diabetes Res Clin Pract"},{"issue":"11","key":"5263_CR2","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.14770","volume":"75","author":"C Bucsa","year":"2021","unstructured":"Bucsa C, Farcas A, Iaru I, Mogosan C, Rusu A. Drug utilisation study of antidiabetic medication during 2012-2019 in Romania. Int J Clin Pract. 2021;75(11):e14770.","journal-title":"Int J Clin Pract"},{"issue":"4","key":"5263_CR3","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1038\/nrendo.2016.153","volume":"13","author":"N Napoli","year":"2017","unstructured":"Napoli N, Chandran M, Pierroz DD, Abrahamsen B, Schwartz AV, Ferrari SL. Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol. 2017;13(4):208\u201319.","journal-title":"Nat Rev Endocrinol"},{"issue":"3","key":"5263_CR4","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/S2213-8587(21)00347-8","volume":"10","author":"LC Hofbauer","year":"2022","unstructured":"Hofbauer LC, Busse B, Eastell R, Ferrari S, Frost M, M\u00fcller R, et al. Bone fragility in diabetes: novel concepts and clinical implications. Lancet Diabetes Endocrinol. 2022;10(3):207\u201320.","journal-title":"Lancet Diabetes Endocrinol"},{"key":"5263_CR5","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvaa046.1684","author":"T Vilaca","year":"2020","unstructured":"Vilaca T, Schini M, Harnan S, Poku E, Cummings SR, Eastell R. SUN-622 the risk of hip and non-vertebral fractures in diabetes: a systematic review and meta-analysis update. J Endocr Soc. 2020. https:\/\/doi.org\/10.1210\/jendso\/bvaa046.1684.","journal-title":"J Endocr Soc"},{"issue":"7-8","key":"5263_CR6","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1111\/ans.15878","volume":"90","author":"ZC Ding","year":"2020","unstructured":"Ding ZC, Zeng WN, Rong X, Liang ZM, Zhou ZK. Do patients with diabetes have an increased risk of impaired fracture healing? A systematic review and meta-analysis. ANZ J Surg. 2020;90(7\u20138):1259\u201364.","journal-title":"ANZ J Surg"},{"key":"5263_CR7","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1038603","author":"Y Wang","year":"2023","unstructured":"Wang Y, Yu L, Ye Z, Lin R, Sun AR, Liu L, et al. Association of metformin use with fracture risk in type 2 diabetes: a systematic review and meta-analysis of observational studies. Front Endocrinol. 2023. https:\/\/doi.org\/10.3389\/fendo.2022.1038603.","journal-title":"Front Endocrinol"},{"issue":"10","key":"5263_CR8","doi-asserted-by":"publisher","first-page":"1494","DOI":"10.1111\/obr.12885","volume":"20","author":"K Hidayat","year":"2019","unstructured":"Hidayat K, Du X, Wu MJ, Shi BM. The use of metformin, insulin, sulphonylureas, and thiazolidinediones and the risk of fracture: systematic review and meta\u2010analysis of observational studies. Obes Rev. 2019;20(10):1494\u2013503.","journal-title":"Obes Rev"},{"issue":"6","key":"5263_CR9","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-072904","volume":"13","author":"J Hu","year":"2023","unstructured":"Hu J, Han J, Jin M, Jin J, Zhu J. Effects of metformin on bone mineral density and bone turnover markers: a systematic review and meta-analysis. BMJ Open. 2023;13(6):e072904.","journal-title":"BMJ Open"},{"key":"5263_CR10","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.952560","author":"Y Song","year":"2022","unstructured":"Song Y, Wu Z, Zhao P. The effects of metformin in the treatment of osteoarthritis: current perspectives. Front Pharmacol. 2022. https:\/\/doi.org\/10.3389\/fphar.2022.952560.","journal-title":"Front Pharmacol"},{"key":"5263_CR11","doi-asserted-by":"publisher","DOI":"10.1177\/20420188251397207","volume":"16","author":"Y Liu","year":"2025","unstructured":"Liu Y, Wang X, Wu J, Wu A, Yu X. Metformin and bone metabolism: unraveling their direct and indirect effects. Ther Adv Endocrinol Metab. 2025;16:20420188251397207.","journal-title":"Ther Adv Endocrinol Metab"},{"issue":"5","key":"5263_CR12","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1080\/09513590.2020.1718092","volume":"36","author":"JE Bl\u00fcmel","year":"2020","unstructured":"Bl\u00fcmel JE, Arteaga E, Aedo S, Arriola-Montenegro J, L\u00f3pez M, Martino M, et al. Metformin use is associated with a lower risk of osteoporosis in adult women independent of type 2 diabetes mellitus and obesity. REDLINC IX study. Gynecol Endocrinol. 2020;36(5):421\u20135.","journal-title":"Gynecol Endocrinol"},{"issue":"3","key":"5263_CR13","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.242133","volume":"314","author":"QA Hathaway","year":"2025","unstructured":"Hathaway QA, Kasaeian A, Pan T, Bluemke DA, Ghotbi E, Klein JG, et al. A deep learning model for three-dimensional determination of whole thoracic vertebral bone mineral density from noncontrast chest CT: the Multi-Ethnic Study of Atherosclerosis. Radiology. 2025;314(3):e242133.","journal-title":"Radiology"},{"issue":"3","key":"5263_CR14","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1148\/radiol.2020192706","volume":"296","author":"J Therkildsen","year":"2020","unstructured":"Therkildsen J, Nissen L, J\u00f8rgensen HS, Thygesen J, Ivarsen P, Frost L, et al. Thoracic bone mineral density derived from cardiac CT is associated with greater fracture rate. Radiology. 2020;296(3):499\u2013508.","journal-title":"Radiology"},{"issue":"6","key":"5263_CR15","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1007\/s00198-024-07040-5","volume":"35","author":"D Li","year":"2024","unstructured":"Li D, Mao SS, Budoff MJ. Trabecular bone mineral density as measured by thoracic vertebrae predicts incident hip and vertebral fractures: the Multi-Ethnic Study of Atherosclerosis. Osteoporos Int. 2024;35(6):1061\u20138.","journal-title":"Osteoporos Int"},{"issue":"6","key":"5263_CR16","doi-asserted-by":"publisher","first-page":"693","DOI":"10.7326\/M23-1874","volume":"177","author":"FS Yen","year":"2024","unstructured":"Yen FS, Hwu CM, Liu JS, Wu YL, Chong K, Hsu CC. Sodium-glucose cotransporter-2 inhibitors and the risk for dialysis and cardiovascular disease in patients with stage 5 chronic kidney disease. Ann Intern Med. 2024;177(6):693\u2013700.","journal-title":"Ann Intern Med"},{"key":"5263_CR17","unstructured":"National Heart L, and Blood Institute,. Multi-Ethnic Study of Atherosclerosis (MESA)."},{"key":"5263_CR18","unstructured":"Uo S. FRAX\u00ae Fracture Risk Assessment Tool."},{"key":"5263_CR19","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2022.116376","volume":"159","author":"JD Allbritton-King","year":"2022","unstructured":"Allbritton-King JD, Elrod JK, Rosenberg PS, Bhattacharyya T. Reverse engineering the FRAX algorithm: clinical insights and systematic analysis of fracture risk. Bone. 2022;159:116376.","journal-title":"Bone"},{"key":"5263_CR20","doi-asserted-by":"crossref","unstructured":"Sieren JP, Newell JD Jr., Barr RG, Bleecker ER, Burnette N, Carretta EE, et al. SPIROMICS protocol for multicenter quantitative computed tomography to phenotype the lungs. Am J Respir Crit Care Med. 2016;194(7):794\u2013806.","DOI":"10.1164\/rccm.201506-1208PP"},{"issue":"5","key":"5263_CR21","doi-asserted-by":"publisher","DOI":"10.1148\/ryai.230024","volume":"5","author":"J Wasserthal","year":"2023","unstructured":"Wasserthal J, Breit HC, Meyer MT, Pradella M, Hinck D, Sauter AW, et al. TotalSegmentator: robust segmentation of 104 anatomic structures in CT images. Radiol Artif Intell. 2023;5(5):e230024.","journal-title":"Radiol Artif Intell"},{"issue":"3","key":"5263_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","volume":"45","author":"S van Buuren","year":"2011","unstructured":"van Buuren S, Groothuis-Oudshoorn K. mice: multivariate imputation by chained equations in R. J Stat Softw. 2011;45(3):1\u201367.","journal-title":"J Stat Softw"},{"issue":"14","key":"5263_CR23","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1056\/NEJMsr1203730","volume":"367","author":"RJ Little","year":"2012","unstructured":"Little RJ, D\u2019Agostino R, Cohen ML, Dickersin K, Emerson SS, Farrar JT, et al. The prevention and treatment of missing data in clinical trials. N Engl J Med. 2012;367(14):1355\u201360.","journal-title":"N Engl J Med"},{"issue":"3","key":"5263_CR24","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1177\/0962280210395740","volume":"22","author":"SR Seaman","year":"2013","unstructured":"Seaman SR, White IR. Review of inverse probability weighting for dealing with missing data. Stat Methods Med Res. 2013;22(3):278\u201395.","journal-title":"Stat Methods Med Res"},{"issue":"6","key":"5263_CR25","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1093\/aje\/kwn164","volume":"168","author":"SR Cole","year":"2008","unstructured":"Cole SR, Hernan MA. Constructing inverse probability weights for marginal structural models. Am J Epidemiol. 2008;168(6):656\u201364.","journal-title":"Am J Epidemiol"},{"issue":"9","key":"5263_CR26","first-page":"1322","volume":"37","author":"PC Austin","year":"2021","unstructured":"Austin PC, White IR, Lee DS, van Buuren S. Missing data in clinical research: a tutorial on multiple imputation. Can J Cardiol. 2021;37(9):1322\u201331.","journal-title":"Can J Cardiol"},{"key":"5263_CR27","first-page":"1","volume":"2019","author":"J L","year":"2019","unstructured":"L J, J B, Z Y. Role of metformin on osteoblast differentiation in type 2 diabetes. BioMed Res Int. 2019;2019:1\u20136.","journal-title":"BioMed Res Int"},{"issue":"6","key":"5263_CR28","doi-asserted-by":"publisher","first-page":"e072904","DOI":"10.1136\/bmjopen-2023-072904","volume":"13","author":"J Hu","year":"2023","unstructured":"Hu J, Han J, Jin M, Jin J, Zhu J. Effects of metformin on bone mineral density and bone turnover markers: a systematic review and meta-analysis. BMJ Open. 2023;13(6):e072904\u2013e072904.","journal-title":"BMJ Open"},{"issue":"11","key":"5263_CR29","doi-asserted-by":"publisher","first-page":"2279","DOI":"10.1007\/s00198-021-05989-1","volume":"32","author":"AV Schwartz","year":"2021","unstructured":"Schwartz AV, Pan Q, Aroda VR, Crandall JP, Kriska A, Piromalli C, et al. Long-term effects of lifestyle and metformin interventions in DPP on bone density. Osteoporos Int. 2021;32(11):2279\u201387.","journal-title":"Osteoporos Int"},{"issue":"11","key":"5263_CR30","doi-asserted-by":"publisher","first-page":"2517","DOI":"10.1007\/s00198-018-4637-z","volume":"29","author":"AK Nordklint","year":"2018","unstructured":"Nordklint AK, Almdal TP, Vestergaard P, Lundby-Christensen L, Boesgaard TW, Breum L, et al. The effect of metformin versus placebo in combination with insulin analogues on bone mineral density and trabecular bone score in patients with type 2 diabetes mellitus: a randomized placebo-controlled trial. Osteoporos Int. 2018;29(11):2517\u201326.","journal-title":"Osteoporos Int"},{"issue":"6","key":"5263_CR31","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1007\/s00198-023-07013-0","volume":"35","author":"Y Cai","year":"2024","unstructured":"Cai Y, G J, X Z. Metformin treatment reduces the incidence of osteoporosis: a two-sample Mendelian randomized study. Osteoporos Int. 2024;35(6):1089\u201398.","journal-title":"Osteoporos Int"},{"issue":"6","key":"5263_CR32","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1007\/s00198-019-04948-1","volume":"30","author":"A Salari-Moghaddam","year":"2019","unstructured":"Salari-Moghaddam A, Sadeghi O, Keshteli AH, Larijani B, Esmaillzadeh A. Metformin use and risk of fracture: a systematic review and meta-analysis of observational studies. Osteoporos Int. 2019;30(6):1167\u201373.","journal-title":"Osteoporos Int"},{"issue":"2","key":"5263_CR33","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1530\/EJE-20-0507","volume":"184","author":"C-H Tseng","year":"2021","unstructured":"Tseng C-H. Metformin use is associated with a lower risk of osteoporosis\/vertebral fracture in Taiwanese patients with type 2 diabetes mellitus. Eur J Endocrinol. 2021;184(2):299\u2013310.","journal-title":"Eur J Endocrinol"},{"key":"5263_CR34","doi-asserted-by":"publisher","first-page":"110082","DOI":"10.1016\/j.diabres.2022.110082","volume":"192","author":"W-H Tsai","year":"2022","unstructured":"Tsai W-H, Kong S-K, Lin C-L, Cheng K-H, Cheng Y-T, Chien M-N, et al. Risk of fracture caused by anti-diabetic drugs in individuals with type 2 diabetes: a network meta-analysis. Diabetes Res Clin Pract. 2022;192:110082\u2013110082.","journal-title":"Diabetes Res Clin Pract"},{"key":"5263_CR35","unstructured":"Wang CP, Lorenzo C, Espinoza SE. Frailty attenuates the impact of metformin on reducing mortality in older adults with type 2 diabetes. J Endocrinol Diabetes Obes. 2014;2(2)."},{"issue":"5","key":"5263_CR36","doi-asserted-by":"publisher","first-page":"101350","DOI":"10.1016\/j.diabet.2022.101350","volume":"48","author":"J Sun","year":"2022","unstructured":"Sun J, Liu Q, He H, Jiang L, Lee KO, Li D, et al. Metformin treatment is associated with an increase in bone mineral density in type 2 diabetes mellitus patients in China: a retrospective single center study. Diabetes Metab. 2022;48(5):101350\u2013101350.","journal-title":"Diabetes Metab"},{"issue":"10","key":"5263_CR37","doi-asserted-by":"publisher","first-page":"2902","DOI":"10.1002\/jcb.23206","volume":"112","author":"Q-G Mai","year":"2011","unstructured":"Mai Q-G, Zhang Z-M, Xu S, Lu M, Zhou R-P, Zhao L, et al. Metformin stimulates osteoprotegerin and reduces RANKL expression in osteoblasts and ovariectomized rats. J Cell Biochem. 2011;112(10):2902\u20139.","journal-title":"J Cell Biochem"},{"issue":"8","key":"5263_CR38","doi-asserted-by":"publisher","first-page":"2624","DOI":"10.1002\/art.34474","volume":"64","author":"P de Pablo","year":"2012","unstructured":"de Pablo P, Cooper MS, Buckley CD. Association between bone mineral density and C-reactive protein in a large population-based sample. Arthritis & Rheumatism. 2012;64(8):2624\u201331.","journal-title":"Arthritis & Rheumatism"},{"issue":"13","key":"5263_CR39","doi-asserted-by":"publisher","first-page":"1805","DOI":"10.1042\/CS20200137","volume":"134","author":"L Cheng","year":"2020","unstructured":"Cheng L, Wang L, Guo M, He J, Deng Y, Liu J, et al. Clinically relevant high levels of human C-reactive protein induces endothelial dysfunction and hypertension by inhibiting the AMPK-eNOS axis. Clin Sci (Lond). 2020;134(13):1805\u201319.","journal-title":"Clin Sci (Lond)"},{"key":"5263_CR40","doi-asserted-by":"publisher","DOI":"10.3390\/genes13050806","author":"W Weng","year":"2022","unstructured":"Weng W, Li H, Zhu S. An overlooked bone metabolic disorder: cigarette smoking-induced osteoporosis. Genes. 2022. https:\/\/doi.org\/10.3390\/genes13050806.","journal-title":"Genes"},{"issue":"24","key":"5263_CR41","doi-asserted-by":"publisher","first-page":"4443","DOI":"10.1007\/s00018-017-2585-y","volume":"74","author":"Z Luo","year":"2017","unstructured":"Luo Z, Liu Y, Liu Y, Chen H, Shi S, Liu Y. Cellular and molecular mechanisms of alcohol-induced osteopenia. Cellular and Molecular Life Sciences. 2017;74(24):4443\u201353.","journal-title":"Cellular and Molecular Life Sciences"},{"issue":"7","key":"5263_CR42","doi-asserted-by":"publisher","first-page":"e245","DOI":"10.1038\/emm.2016.81","volume":"48","author":"S-M Jeon","year":"2016","unstructured":"Jeon S-M. Regulation and function of AMPK in physiology and diseases. Exp Mol Med. 2016;48(7):e245\u2013e245.","journal-title":"Exp Mol Med"},{"issue":"6","key":"5263_CR43","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1111\/dom.14350","volume":"23","author":"JG Timmons","year":"2021","unstructured":"Timmons JG, Greenlaw N, Boyle JG, Chaturvedi N, Ford I, Brouwers MCGJ, et al. Metformin and carotid intima-media thickness in never-smokers with type 1 diabetes: the REMOVAL trial. Diabetes Obes Metab. 2021;23(6):1371\u20138.","journal-title":"Diabetes Obes Metab"},{"issue":"7","key":"5263_CR44","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1093\/qjmed\/hci077","volume":"98","author":"D Hamerman","year":"2005","unstructured":"Hamerman D. Osteoporosis and atherosclerosis: biological linkages and the emergence of dual-purpose therapies. QJM. 2005;98(7):467\u201384.","journal-title":"QJM"},{"issue":"1","key":"5263_CR45","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1002\/jbmr.534","volume":"27","author":"GA Greendale","year":"2012","unstructured":"Greendale GA, Sowers M, Han W, Huang MH, Finkelstein JS, Crandall CJ, et al. Bone mineral density loss in relation to the final menstrual period in a multiethnic cohort: results from the Study of Women\u2019s Health Across the Nation (SWAN). J Bone Miner Res. 2012;27(1):111\u20138.","journal-title":"J Bone Miner Res"}],"container-title":["Skeletal Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00256-026-05263-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00256-026-05263-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00256-026-05263-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:36:51Z","timestamp":1787816211000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00256-026-05263-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,31]]},"references-count":45,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["5263"],"URL":"https:\/\/doi.org\/10.1007\/s00256-026-05263-7","relation":{},"ISSN":["0364-2348","1432-2161"],"issn-type":[{"value":"0364-2348","type":"print"},{"value":"1432-2161","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,31]]},"assertion":[{"value":"19 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 May 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 May 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study is in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments. The Multi-Ethnic Study of Atherosclerosis (MESA) protocol received approval from the Institutional Review Boards at all participating institutions, with all participants providing written informed consent.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"RGB received grant funding from the National Institutes of Health (NIH) and the Chronic Obstructive Pulmonary Disease (COPD) Foundation. Other authors have declared that no competing interests exist.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}