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It is not known whether muscle mass and strength could impact the osteoporosis pharmacological response.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Aim<\/jats:title>\n            <jats:p>The aim of this study was to analyze the association between muscle mass and strength with the response to denosumab in osteoporosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Postmenopausal women at high fracture risk receiving denosumab (60\u00a0mg subcutaneously administered every 6\u00a0months) were considered. The likelihood of sarcopenia was estimated by administering the SARC-F questionnaire, muscle mass and performance were assessed by measuring calf circumference (CC) and hand grip strength, respectively. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>130 women (age 70.2\u2009\u00b1\u20099.4 years) were recruited. Baseline BMD T-score values were \u2212\u00a02.6\u2009\u00b1\u20091.1 SD and \u2212\u00a02.3\u2009\u00b1\u20090.7 SD at lumbar spine and femoral neck, respectively; while CC and grip strength were 31.9\u2009\u00b1\u20092.9\u00a0cm and 22.7\u2009\u00b1\u20096.7\u00a0kg, respectively. The SARC-F score was associated with the 10-year probability of major osteoporotic fracture (r\u2009=\u20090.21, p\u2009&lt;\u20090.05). The CC was positively associated with the T-score values of both lumbar spine (r\u2009=\u20090.262, p\u2009=\u20090.034) and femoral neck (r\u2009=\u20090.359, p\u2009=\u20090.004). Denosumab administration (treatment duration 43\u00a0months), lead to BMD improvement by\u2009+\u20099.6% at the lumbar spine and\u2009+\u20097.3% at the femoral neck (p<jats:sup>all<\/jats:sup>\u2009&lt;\u20090.05). After adjustment for comorbidities, fracture risk and treatment duration, the CC (\u03b2\u2009=\u20091.76, SE\u2009=\u20090.82, p\u2009=\u20090.03) and the baseline femoral BMD (\u03b2\u2009=\u2009\u2212\u00a094.19, SE\u2009=\u200926.09, p\u2009=\u20090.0009) were independently associated with femoral BMD gain over time.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In postmenopausal osteoporotic women, the CC was positively and independently associated with denosumab treatment response.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40520-025-02989-7","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T10:52:27Z","timestamp":1746442347000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Calf circumference predicts changes of bone mineral density in postmenopausal osteoporotic women receiving denosumab"],"prefix":"10.1007","volume":"37","author":[{"given":"Cecilia","family":"Oliveri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Xourafa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nunziata","family":"Morabito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Di Giovanni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Lupo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Basile","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agostino","family":"Gaudio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Catalano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,5]]},"reference":[{"key":"2989_CR1","doi-asserted-by":"publisher","unstructured":"Hernlund E, Svedbom A, Iverg\u00e5rd M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. 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