{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:33:15Z","timestamp":1791261195603,"version":"4.1.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["178098"],"award-info":[{"award-number":["178098"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bob and Nola Rintoul Chair in Bone and Joint Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Monitoring bone health for osteoporosis is typically based on measuring areal BMD. However, widely used fracture risk prediction tools are primarily driven by clinical risk factors and show limited sensitivity to underlying bone changes over time. This study evaluated the ability of the new Microarchitecture Fracture Risk Assessment Calculator ($\\mu $FRAC) to detect longitudinal changes in fracture risk in relation to bone quality. Our study cohort included 601 participants (70.2% female) from a longitudinal population study. HR-pQCT scans of the distal radius and tibia were acquired at 2 visits, 3\u201310 years apart. The $\\mu $FRAC 5-year risk of major osteoporotic fracture was calculated at both time points. Participants were divided into quartiles based on the absolute change in tibia bone strength between study visits to assess the model\u2019s sensitivity to changes in bone fragility. Differences between quartiles were assessed using a Mann-Whitney U test and the standardized response mean (SRM). Additionally, changes in fracture risk by decade, were analyzed to investigate age- and sex-specific trends in fracture risk. The average age of participants was 53.8 $\\pm $ 15.4 years, with an average follow-up of 6.8 $\\pm $ 1.8 years. The greatest absolute annualized changes in $\\mu $FRAC risk occurred in individuals with the largest differences in bone strength (SRM = 0.73-0.78), while the least change was observed in individuals with minimal changes (SRM = 0.07-0.21). Age- and sex-specific trends aligned with previously established patterns of bone aging, showing the greatest annualized changes in fracture risk in menopausal females (40-60 years) and older adults (70+ years). We demonstrated $\\mu $FRAC is sensitive to changes in fracture risk driven by declines in bone quality in aging adults. These results suggest $\\mu $FRAC is well suited for tracking fracture prediction longitudinally and has potential to monitor osteoporosis disease progression and treatment response.<\/jats:p>","DOI":"10.1093\/jbmr\/zjaf111","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T11:53:36Z","timestamp":1755172416000},"page":"112-119","source":"Crossref","is-referenced-by-count":1,"title":["Longitudinal associations between changes in bone mechanical strength and fracture risk estimated by\n                    <b>\u03bc<\/b>\n                    FRAC"],"prefix":"10.1093","volume":"41","author":[{"given":"Annabel R","family":"Bugbird","sequence":"first","affiliation":[{"name":"McCaig Institute for Bone and Joint Health , Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6,","place":["Canada"]},{"name":"Department of Biomedical Engineering , Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle E","family":"Whittier","sequence":"additional","affiliation":[{"name":"McCaig Institute for Bone and Joint Health , Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6,","place":["Canada"]},{"name":"Department of Cell Biology and Anatomy , Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren A","family":"Burt","sequence":"additional","affiliation":[{"name":"McCaig Institute for Bone and Joint Health , Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6,","place":["Canada"]},{"name":"Department of Radiology , Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2T9,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven K","family":"Boyd","sequence":"additional","affiliation":[{"name":"McCaig Institute for Bone and Joint Health , Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6,","place":["Canada"]},{"name":"Department of Biomedical Engineering , Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4,","place":["Canada"]},{"name":"Department of Radiology , Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2T9,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"issue":"5","key":"2026020308315879500_ref1","doi-asserted-by":"crossref","first-page":"150","DOI":"10.18773\/austprescr.2022.054","article-title":"Treating osteoporosis: risks and management","volume":"45","author":"Zhu","year":"2022","journal-title":"Aust Prescr"},{"key":"2026020308315879500_ref2","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s00198-011-1822-8","article-title":"Relationship of femoral neck areal bone mineral density to volumetric bone mineral density, bone size, and femoral strength in men and women","volume":"23","author":"Srinivasan","year":"2012","journal-title":"Osteoporos Int"},{"issue":"2","key":"2026020308315879500_ref3","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1359\/jbmr.081004","article-title":"Association between change in bmd and fragility fracture in women and men","volume":"24","author":"Berger","year":"2009","journal-title":"J Bone Miner Res"},{"issue":"9","key":"2026020308315879500_ref4","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1001\/jamainternmed.2020.2986","article-title":"Serial bone density measurement and incident fracture risk discrimination in postmenopausal women","volume":"180","author":"Crandall","year":"2020","journal-title":"JAMA Intern Med"},{"key":"2026020308315879500_ref5","doi-asserted-by":"crossref","DOI":"10.1007\/s00198-021-06252-3","article-title":"Predictive performance of the garvan fracture risk calculator: a registry-based cohort study","volume":"33","author":"Agarwal","year":"2022","journal-title":"Osteoporos Int"},{"issue":"5","key":"2026020308315879500_ref6","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.bone.2009.01.373","article-title":"Frax and its applications to clinical practice","volume":"44","author":"Kanis","year":"2009","journal-title":"Bone"},{"issue":"5","key":"2026020308315879500_ref7","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1002\/jbmr.2151","article-title":"Can change in frax score be used to \u201dtreat to target\u201d? A population-based cohort study","volume":"29","author":"Leslie","year":"2014","journal-title":"J Bone Miner Res"},{"issue":"6","key":"2026020308315879500_ref8","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1002\/jbmr.1582","article-title":"Does osteoporosis therapy invalidate frax for fracture prediction?","volume":"27","author":"Leslie","year":"2012","journal-title":"J Bone Miner Res"},{"issue":"3","key":"2026020308315879500_ref9","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/jbmr.1472","article-title":"Relationship between bone mineral density changes with denosumab treatment and risk reduction for vertebral and nonvertebral fractures","volume":"27","author":"Austin","year":"2012","journal-title":"J Bone Miner Res"},{"issue":"8","key":"2026020308315879500_ref10","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/S2213-8587(20)30159-5","article-title":"Treatment-related changes in bone mineral density as a surrogate biomarker for fracture 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