{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:07:17Z","timestamp":1793390837370,"version":"4.5.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T00:00:00Z","timestamp":1729209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["K23 AR054127"],"award-info":[{"award-number":["K23 AR054127"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01 AR049896"],"award-info":[{"award-number":["R01 AR049896"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000038","name":"United States Food and Drug Administration","doi-asserted-by":"publisher","award":["R01 FD003902"],"award-info":[{"award-number":["R01 FD003902"]}],"id":[{"id":"10.13039\/100000038","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000038","name":"United States Food and Drug Administration","doi-asserted-by":"publisher","award":["FDA RO1 FD006007"],"award-info":[{"award-number":["FDA RO1 FD006007"]}],"id":[{"id":"10.13039\/100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Pregnancy and lactation-associated osteoporosis (PLO) is a rare presentation of early-onset osteoporosis characterized by low trauma and spontaneous fractures during late pregnancy\/lactation. Herein, we report areal BMD (aBMD) by DXA and volumetric BMD (vBMD), microarchitecture, and strength at the distal radius and tibia by HR-pQCT in 59 women with PLO\u2014in comparison to both healthy premenopausal controls (n\u00a0=\u200928) and premenopausal women with idiopathic osteoporotic fractures not associated with pregnancy\/lactation (non-PLO IOP; n\u00a0=\u200950). Women with PLO (aged 34\u2009\u00b1\u20096\u00a0yr) had a more severe clinical presentation than non-PLO IOP: 80% had vertebral and 92% had multiple fractures (p&amp;lt;.001). They had lower DXA aBMD at all sites vs Controls (all p&amp;lt;.001) and non-PLO IOP (all p&amp;lt;.05). By HR-pQCT, PLO had deficits in all radial\/tibial density and most microarchitecture parameters and lower bone strength than controls (all p&amp;lt;.001). Compared to non-PLO IOP, PLO had lower total and trabecular density at radius and tibia (all p\u2009\u2264\u2009.01) and significant deficits in trabecular microstructure and cortical thickness at the radius only. We studied PLO subgroups with clinical factors potentially related to bone physiology: Within PLO, women with vertebral fractures had lower spine aBMD and higher tibial cortical porosity but were otherwise structurally similar to the nonvertebral group. Those with prior heparin exposure had larger bone size and trabecular area, and those with renal stones had smaller bone size and lower 1\/3 radius aBMD. We also compared groups based on postpartum timing: Recent PLO (n\u00a0=\u200925) evaluated \u226412\u00a0M postpartum, before expected recovery of pregnancy\/lactation bone loss, had significantly lower aBMD than distant PLO (n\u00a0=\u200934) evaluated &amp;gt;12\u00a0M postpartum. However, radial\/tibial HR-pQCT measures did not differ, suggesting pre-existing and\/or persistent structural deficits. This structural study increases our mechanistic understanding of the severe bone fragility presentation that characterizes PLO and also highlights areas of potential mechanistic heterogeneity that require additional investigation.<\/jats:p>","DOI":"10.1093\/jbmr\/zjae167","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T17:50:00Z","timestamp":1729273800000},"page":"38-49","source":"Crossref","is-referenced-by-count":12,"title":["HR-pQCT reveals marked trabecular and cortical structural deficits in women with pregnancy and lactation-associated osteoporosis (PLO)"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4978-0717","authenticated-orcid":false,"given":"Sanchita","family":"Agarwal","sequence":"first","affiliation":[{"name":"Department of Medicine , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]},{"name":"Columbia University Vagelos College of Physicians and Surgeons , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dany","family":"El-Najjar","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]},{"name":"Columbia University Vagelos College of Physicians and Surgeons , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ananya","family":"Kondapalli","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]},{"name":"Columbia University Vagelos College of Physicians and Surgeons , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayoung","family":"Kil","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]},{"name":"Columbia University Vagelos College of Physicians and Surgeons , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mafo","family":"Kamanda-Kosseh","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]},{"name":"Columbia University Vagelos College of Physicians and Surgeons , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Bucovsky","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]},{"name":"Columbia University Vagelos College of Physicians and Surgeons , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivelisse","family":"Colon","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]},{"name":"Columbia University Vagelos College of Physicians and Surgeons , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan M","family":"Lappe","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 2420 Cuming St, Omaha, NE-68131 ,","place":["United States"]},{"name":"Creighton University Medical Center , , 2420 Cuming St, Omaha, NE-68131 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Stubby","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 2420 Cuming St, Omaha, NE-68131 ,","place":["United States"]},{"name":"Creighton University Medical Center , , 2420 Cuming St, Omaha, NE-68131 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R","family":"Recker","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 2420 Cuming St, Omaha, NE-68131 ,","place":["United States"]},{"name":"Creighton University Medical Center , , 2420 Cuming St, Omaha, NE-68131 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0804-7279","authenticated-orcid":false,"given":"X Edward","family":"Guo","sequence":"additional","affiliation":[{"name":"Bone Bioengineering Laboratory , Department of Biomedical Engineering, , 116th and Broadway, New York, NY-10027 ,","place":["United States"]},{"name":"Columbia University , Department of Biomedical Engineering, , 116th and Broadway, New York, NY-10027 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Shane","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]},{"name":"Columbia University Vagelos College of Physicians and Surgeons , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adi","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Medicine , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]},{"name":"Columbia University Vagelos College of Physicians and Surgeons , , 180 Fort Washington Ave, New York, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,18]]},"reference":[{"issue":"5","key":"2025042707320136200_ref1","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1007\/s00223-021-00815-6","article-title":"Pregnancy and lactation associated osteoporosis","volume":"110","author":"Hardcastle","year":"2022","journal-title":"Calcif Tissue Int"},{"issue":"4","key":"2025042707320136200_ref2","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1111\/j.1365-2265.1993.tb02398.x","article-title":"Pregnancy associated osteoporosis","volume":"39","author":"Dunne","year":"1993","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"11","key":"2025042707320136200_ref3","doi-asserted-by":"publisher","first-page":"3135","DOI":"10.1007\/s00198-017-4165-2","article-title":"Pregnancy-related fractures: a retrospective study of a French cohort of 52 patients and review of the literature","volume":"28","author":"Laroche","year":"2017","journal-title":"Osteoporos Int"},{"issue":"1","key":"2025042707320136200_ref4","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s00198-017-4239-1","article-title":"Subsequent fracture risk of women with pregnancy and lactation-associated osteoporosis after a median of 6 years of follow-up","volume":"29","author":"Kyvernitakis","year":"2018","journal-title":"Osteoporos Int"},{"issue":"1","key":"2025042707320136200_ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12891-021-04776-7","article-title":"Pregnancy-and lactation-associated osteoporosis with vertebral fractures: a systematic review","volume":"22","author":"Qian","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"issue":"8","key":"2025042707320136200_ref6","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1007\/s00198-023-06793-9","article-title":"Clinical characteristics of pregnancy and lactation associated osteoporosis: an online survey study","volume":"34","author":"Kondapalli","year":"2023","journal-title":"Osteoporos Int"},{"issue":"1","key":"2025042707320136200_ref7","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1080\/00016470510030274","article-title":"Maternity and bone mineral density","volume":"76","author":"Karlsson","year":"2005","journal-title":"Acta Orthop"},{"issue":"24","key":"2025042707320136200_ref8","doi-asserted-by":"publisher","first-page":"3130","DOI":"10.1001\/jama.1993.03500240074029","article-title":"Changes in bone density with lactation","volume":"269","author":"Sowers","year":"1993","journal-title":"JAMA"},{"issue":"1","key":"2025042707320136200_ref9","first-page":"52","article-title":"Bone mineral changes during and after lactation","volume":"94","author":"Polatti","year":"1999","journal-title":"Obstet Gynecol"},{"issue":"2","key":"2025042707320136200_ref10","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1152\/physrev.00027.2015","article-title":"Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery","volume":"96","author":"Kovacs","year":"2016","journal-title":"Physiol Rev"},{"issue":"4","key":"2025042707320136200_ref11","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1002\/jbmr.3018","article-title":"Irreversible deterioration of cortical and trabecular microstructure associated with breastfeeding","volume":"32","author":"Bj\u00f8rnerem","year":"2017","journal-title":"J Bone Miner Res"},{"key":"2025042707320136200_ref12","doi-asserted-by":"publisher","volume-title":"American Society for Bone and Mineral Research 34th Annual Meeting 2012. Journal of Bone and Mineral Research","author":"Kepley","DOI":"10.1002\/jbmr.1852"},{"issue":"7","key":"2025042707320136200_ref13","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1002\/jbmr.3998","article-title":"Pregnancy-related bone mineral and microarchitecture changes in women aged 30 to 45 years","volume":"35","author":"\u00d3 Breasail","year":"2020","journal-title":"J Bone Miner Res"},{"issue":"2","key":"2025042707320136200_ref14","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1210\/jc.2014-2825","article-title":"Changes in cortical volumetric bone mineral density and thickness, and trabecular thickness in lactating women postpartum","volume":"100","author":"Brembeck","year":"2015","journal-title":"J Clin Endocrinol Metabol"},{"issue":"3","key":"2025042707320136200_ref15","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1359\/jbmr.2000.15.3.557","article-title":"A detailed assessment of alterations in bone turnover, calcium homeostasis, and bone density in normal pregnancy","volume":"15","author":"Black","year":"2000","journal-title":"J Bone Miner Res"},{"issue":"1","key":"2025042707320136200_ref16","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1359\/jbmr.2000.15.1.129","article-title":"The effect of pregnancy on bone density and bone turnover","volume":"15","author":"Naylor","year":"2000","journal-title":"J Bone Miner Res"},{"issue":"6","key":"2025042707320136200_ref17","first-page":"841","article-title":"A prospective evaluation of bone mineral change in pregnancy","volume":"77","author":"Sowers","year":"1991","journal-title":"Obstet Gynecol"},{"issue":"10","key":"2025042707320136200_ref18","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1007\/s001980170033","article-title":"Pregnancy and lactation confer reversible bone loss in humans","volume":"12","author":"Karlsson","year":"2001","journal-title":"Osteoporos Int"},{"issue":"4","key":"2025042707320136200_ref19","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1042\/cs0940405","article-title":"Bone mineral changes during pregnancy and lactation: a longitudinal cohort study","volume":"94","author":"Kolthoff","year":"1998","journal-title":"Clin Sci"},{"issue":"1","key":"2025042707320136200_ref20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11657-019-0601-6","article-title":"Parity and lactation are not associated with incident fragility fractures or radiographic vertebral fractures over 16 years of follow-up: Canadian Multicentre Osteoporosis Study (CaM os)","volume":"14","author":"Cooke-Hubley","year":"2019","journal-title":"Arch Osteoporos"},{"issue":"1","key":"2025042707320136200_ref21","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1097\/AOG.0000000000002096","article-title":"Associations of parity, breastfeeding, and fractures in the Women\u2019s Health Observational Study","volume":"130","author":"Crandall","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"9","key":"2025042707320136200_ref22","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.1002\/jbmr.3750","article-title":"Women with pregnancy and lactation\u2013associated osteoporosis (PLO) have low bone remodeling rates at the tissue level","volume":"34","author":"Cohen","year":"2019","journal-title":"J Bone Miner Res"},{"key":"2025042707320136200_ref23","doi-asserted-by":"publisher","first-page":"115911","DOI":"10.1016\/j.bone.2021.115911","article-title":"Relevant genetic variants are common in women with pregnancy and lactation-associated osteoporosis (PLO) and predispose to more severe clinical manifestations","volume":"147","author":"Butscheidt","year":"2021","journal-title":"Bone"},{"issue":"5","key":"2025042707320136200_ref24","doi-asserted-by":"publisher","first-page":"bvab031","DOI":"10.1210\/jendso\/bvab031","article-title":"Severe bone microarchitecture impairment in women with pregnancy and lactation-associated osteoporosis","volume":"5","author":"Scioscia","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2025042707320136200_ref25","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1007\/s00198-011-1560-y","article-title":"Premenopausal women with idiopathic low-trauma fractures and\/or low bone mineral density","volume":"23","author":"Cohen","year":"2012","journal-title":"Osteoporos Int"},{"issue":"10","key":"2025042707320136200_ref26","doi-asserted-by":"publisher","first-page":"e3540","DOI":"10.1210\/clinem\/dgaa489","article-title":"Effect of teriparatide on bone remodeling and density in premenopausal idiopathic osteoporosis: a phase II trial","volume":"105","author":"Cohen","year":"2020","journal-title":"J Clin Endocrinol Metabol"},{"issue":"5-6","key":"2025042707320136200_ref27","doi-asserted-by":"publisher","first-page":"329","DOI":"10.3233\/THC-1998-65-606","article-title":"In vivo high resolution 3D-QCT of the human forearm","volume":"6","author":"Laib","year":"1998","journal-title":"Technol Health Care"},{"issue":"7","key":"2025042707320136200_ref28","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1359\/jbmr.1999.14.7.1167","article-title":"Direct three-dimensional morphometric analysis of human cancellous bone: microstructural data from spine, femur, iliac crest, and calcaneus","volume":"14","author":"Hildebrand","year":"1999","journal-title":"J Bone Miner Res"},{"issue":"4","key":"2025042707320136200_ref29","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.bone.2007.07.007","article-title":"Automatic segmentation of cortical and trabecular compartments based on a dual threshold technique for in vivo micro-CT bone analysis","volume":"41","author":"Buie","year":"2007","journal-title":"Bone"},{"issue":"10","key":"2025042707320136200_ref30","doi-asserted-by":"publisher","first-page":"2955","DOI":"10.1007\/s00198-016-3621-8","article-title":"In vivo assessment of bone structure and estimated bone strength by first- and second-generation HR-pQCT","volume":"27","author":"Agarwal","year":"2016","journal-title":"Osteoporos Int"},{"issue":"3","key":"2025042707320136200_ref31","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1007\/s00223-013-9808-5","article-title":"Bone microarchitecture and estimated strength in 499 adult Danish women and men: a cross-sectional, population-based high-resolution peripheral quantitative computed tomographic study on peak bone structure","volume":"94","author":"Hansen","year":"2014","journal-title":"Calcif Tissue Int"},{"issue":"1","key":"2025042707320136200_ref32","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1002\/jbmr.4739","article-title":"Teriparatide followed by denosumab in premenopausal idiopathic osteoporosis: bone microstructure and strength by HR-pQCT","volume":"38","author":"Agarwal","year":"2023","journal-title":"J Bone Miner Res"},{"key":"2025042707320136200_ref33","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.2201","volume-title":"American Society for Bone and Mineral Research Annual Meeting","author":"Nishiyama","year":"2013"},{"issue":"6","key":"2025042707320136200_ref34","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1016\/j.bone.2011.03.755","article-title":"Quantitative characterization of subject motion in HR-pQCT images of the distal radius and tibia","volume":"48","author":"Sode","year":"2011","journal-title":"Bone"},{"issue":"3","key":"2025042707320136200_ref35","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1016\/j.bone.2010.05.034","article-title":"Reproducibility of direct quantitative measures of cortical bone microarchitecture of the distal radius and tibia by HR-pQCT","volume":"47","author":"Burghardt","year":"2010","journal-title":"Bone"},{"issue":"2","key":"2025042707320136200_ref36","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/1350-4533(95)91884-J","article-title":"Three-dimensional finite element modelling of non-invasively assessed trabecular bone structures","volume":"17","author":"M\u00fcller","year":"1995","journal-title":"Med Eng Phys"},{"issue":"6","key":"2025042707320136200_ref37","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1016\/S8756-3282(02)00736-6","article-title":"Estimation of distal radius failure load with micro-finite element analysis models based on three-dimensional peripheral quantitative computed tomography images","volume":"30","author":"Pistoia","year":"2002","journal-title":"Bone"},{"issue":"4","key":"2025042707320136200_ref38","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1002\/jbmr.1503","article-title":"Site-specific changes in bone microarchitecture, mineralization, and stiffness during lactation and after weaning in mice","volume":"27","author":"Liu","year":"2011","journal-title":"J Bone Miner Res"},{"issue":"4","key":"2025042707320136200_ref39","first-page":"608","article-title":"Bone mineral changes during and after lactation","volume":"94","author":"Laskey","year":"1999","journal-title":"Obstet Gynecol"},{"issue":"3","key":"2025042707320136200_ref40","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1016\/j.bone.2003.11.005","article-title":"Recovery of pregnancy mediated bone loss during lactation","volume":"34","author":"Pearson","year":"2004","journal-title":"Bone"},{"issue":"6","key":"2025042707320136200_ref41","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1007\/s11914-019-00555-5","article-title":"Mechanical regulation of the maternal skeleton during reproduction and lactation","volume":"17","author":"Liu","year":"2019","journal-title":"Curr Osteoporos Rep"},{"issue":"7","key":"2025042707320136200_ref42","doi-asserted-by":"publisher","first-page":"1939","DOI":"10.1007\/s00198-011-1790-z","article-title":"Lactation is associated with greater maternal bone size and bone strength later in life","volume":"23","author":"Wiklund","year":"2012","journal-title":"Osteoporos Int"},{"issue":"12","key":"2025042707320136200_ref43","doi-asserted-by":"publisher","first-page":"2165","DOI":"10.1002\/jbmr.3559","article-title":"Structural adaptations in the rat tibia bone induced by pregnancy and lactation confer protective effects against future estrogen deficiency","volume":"33","author":"de Bakker","year":"2018","journal-title":"J Bone Miner Res"},{"issue":"4","key":"2025042707320136200_ref44","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1016\/0002-9378(93)90378-V","article-title":"Osteoporotic fractures and the recurrence of thromboembolism during pregnancy and the puerperium in 184 women undergoing thromboprophylaxis with heparin","volume":"168","author":"Dahlman","year":"1993","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"2025042707320136200_ref45","doi-asserted-by":"publisher","first-page":"1314","DOI":"10.1182\/blood.V88.4.1314.bloodjournal8841314","article-title":"Histomorphometric analysis of the effects of standard heparin on trabecular bone in vivo","volume":"88","author":"Muir","year":"1996","journal-title":"Blood"},{"issue":"10","key":"2025042707320136200_ref46","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1359\/jbmr.2001.16.10.1893","article-title":"Bone mineral density and fracture among prevalent kidney stone cases in the Third National Health and Nutrition Examination Survey","volume":"16","author":"Lauderdale","year":"2001","journal-title":"J Bone Miner Res"},{"issue":"2","key":"2025042707320136200_ref47","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1046\/j.1523-1755.1998.00779.x","article-title":"Fracture risk among patients with urolithiasis: a population-based cohort study","volume":"53","author":"Melton","year":"1998","journal-title":"Kidney Int"},{"issue":"3","key":"2025042707320136200_ref48","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1007\/s11914-020-00574-7","article-title":"Effects of PTH and PTH hypersecretion on bone: a clinical perspective","volume":"18","author":"Rejnmark","year":"2020","journal-title":"Curr Osteoporos Rep"},{"issue":"5","key":"2025042707320136200_ref49","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1007\/s00774-022-01336-4","article-title":"Fractures within 2 years of an obstetric hospitalization: analysis of nationwide administrative data in Japan","volume":"40","author":"Toba","year":"2022","journal-title":"J Bone Miner Metab"},{"issue":"1","key":"2025042707320136200_ref50","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1186\/s12884-024-06520-0","article-title":"Pregnancy and lactation-associated osteoporosis as a major type of premenopausal osteoporosis: a retrospective cohort study based on real-world data","volume":"24","author":"Kasahara","year":"2024","journal-title":"BMC Pregnancy Childbirth"}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jbmr\/advance-article-pdf\/doi\/10.1093\/jbmr\/zjae167\/60338388\/zjae167.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/40\/1\/38\/60338388\/zjae167.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/40\/1\/38\/60338388\/zjae167.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T11:32:09Z","timestamp":1745753529000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/40\/1\/38\/7826673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,18]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,10,18]]},"published-print":{"date-parts":[[2024,12,31]]}},"URL":"https:\/\/doi.org\/10.1093\/jbmr\/zjae167","relation":{},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1]]},"published":{"date-parts":[[2024,10,18]]}}}