{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T11:26:37Z","timestamp":1793877997830,"version":"4.7.0"},"reference-count":58,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kaohsiung Medical University Research Center Grant","award":["KMU-TC108A01"],"award-info":[{"award-number":["KMU-TC108A01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Osteoporosis is defined as a systemic skeletal disease characterized by a reduction in bone mass and microarchitectural deterioration of bone tissue. Previous studies have reported associations between air pollution and lower bone mineral density; however, few studies have investigated the association between air pollution and osteoporosis. In this study, we combined two databases, the first including 5000 individuals registered in the Taiwan Biobank, and the second containing detailed daily data on air pollution. After multivariable adjustments, ozone (O3) (unstandardized coefficient \u03b2, 0.015; p = 0.008) was significantly positively associated with T-score, whereas carbon monoxide (CO) (unstandardized coefficient \u03b2, \u22120.809; p &lt; 0.001), sulfur dioxide (SO2) (unstandardized coefficient \u03b2, \u22120.050; p = 0.005), nitric oxide (NO) (unstandardized coefficient \u03b2, \u22120.040; p &lt; 0.001), nitrogen dioxide (NO2) (unstandardized coefficient \u03b2, \u22120.023; p &lt; 0.001), and nitrogen oxide (NOx) (unstandardized coefficient \u03b2, \u22120.017; p &lt; 0.001) were significantly negatively associated with T-score. The interactions between CO and NOx (p = 0.001) and SO2 and NO2 (p = 0.004) on T-score were statistically significant. An increase in exposure to CO, NO and NOx was associated with a faster decline in T-score in the female participants compared to the male participants. In addition, an increase in O3 was associated with a faster increase in T-score in the female participants compared to the male participants. In conclusion, the air pollutants CO, SO2, NO, NO2, and NOx were associated with osteoporosis. In addition, there were interaction and synergetic effects between CO and NOx and SO2 and NO2 on T-score. We also observed differences in the associations between air pollutants and T-score between the female and male participants.<\/jats:p>","DOI":"10.3390\/ijerph17249165","type":"journal-article","created":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T09:17:04Z","timestamp":1607419024000},"page":"9165","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Air Pollutants Interaction and Gender Difference on Bone Mineral Density T-Score in Taiwanese Adults"],"prefix":"10.3390","volume":"17","author":[{"given":"Yu-Hsuan","family":"Lin","sequence":"first","affiliation":[{"name":"Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Electronics, National Chiao Tung University, Hsinchu 300, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsuan","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo-Cheng","family":"Lai","sequence":"additional","affiliation":[{"name":"Institute of Electronics, National Chiao Tung University, Hsinchu 300, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1044-2673","authenticated-orcid":false,"given":"Hung-Pin","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Yu","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5897-2860","authenticated-orcid":false,"given":"Jiun-Chi","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan"},{"name":"Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1610-4184","authenticated-orcid":false,"given":"Szu-Chia","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan"},{"name":"Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1007\/BF01622200","article-title":"Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report","volume":"4","author":"Kanis","year":"1994","journal-title":"Osteoporos. Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"itc17","DOI":"10.7326\/AITC201708010","article-title":"Osteoporosis","volume":"167","author":"Ensrud","year":"2017","journal-title":"Ann. Intern. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1007\/s00198-014-2794-2","article-title":"Clinician\u2019s Guide to Prevention and Treatment of Osteoporosis","volume":"25","author":"Cosman","year":"2014","journal-title":"Osteoporos. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/0002-9343(93)90218-E","article-title":"Consensus development conference: Diagnosis, prophylaxis, and treatment of osteoporosis","volume":"94","author":"Rapado","year":"1993","journal-title":"Am. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1007\/s00198-007-0424-y","article-title":"Outdoor air pollution and bone mineral density in elderly men\u2014The Oslo Health Study","volume":"18","author":"Alvaer","year":"2007","journal-title":"Osteoporos. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e337","DOI":"10.1016\/S2542-5196(17)30136-5","article-title":"Association of air particulate pollution with bone loss over time and bone fracture risk: Analysis of data from two independent studies","volume":"1","author":"Prada","year":"2017","journal-title":"Lancet Planet. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1016\/S0140-6736(17)30505-6","article-title":"Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: An analysis of data from the Global Burden of Diseases Study 2015","volume":"389","author":"Cohen","year":"2017","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1016\/j.chemosphere.2007.04.002","article-title":"Characterization and inventory of PCDD\/F emissions from coal-fired power plants and other sources in Taiwan","volume":"68","author":"Lin","year":"2007","journal-title":"Chemosphere"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1002\/ana.21403","article-title":"Ambient air pollution and risk for ischemic stroke and transient ischemic attack","volume":"64","author":"Lisabeth","year":"2008","journal-title":"Ann. Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/EDE.0b013e31815c0827","article-title":"Residential outdoor air pollution and lung function in schoolchildren","volume":"19","author":"Oftedal","year":"2008","journal-title":"Epidemiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1159\/000339680","article-title":"Ambient air pollutants and acute case-fatality of cerebro-cardiovascular events: Takashima Stroke and AMI Registry, Japan (1988\u20132004)","volume":"34","author":"Turin","year":"2012","journal-title":"Cerebrovasc. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"113121","DOI":"10.1016\/j.envpol.2019.113121","article-title":"Short-term associations between daily mortality and ambient particulate matter, nitrogen dioxide, and the air quality index in a Middle Eastern megacity","volume":"254","author":"Amini","year":"2019","journal-title":"Environ. Pollut."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"113036","DOI":"10.1016\/j.envpol.2019.113036","article-title":"Ambient air pollution and lipid profile: Systematic review and meta-analysis","volume":"254","author":"Gaio","year":"2019","journal-title":"Environ. Pollut."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"114077","DOI":"10.1016\/j.envpol.2020.114077","article-title":"Association between long-term exposure to ambient air pollution and obesity in a Chinese rural population: The Henan Rural Cohort Study","volume":"260","author":"Liu","year":"2020","journal-title":"Environ. Pollut."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.tins.2009.05.009","article-title":"Air pollution: Mechanisms of neuroinflammation and CNS disease","volume":"32","author":"Block","year":"2009","journal-title":"Trends Neurosci."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"K\u00fcnzli, N., Jerrett, M., Garcia-Esteban, R., Basaga\u00f1a, X., Beckermann, B., Gilliland, F., Medina, M., Peters, J., Hodis, H.N., and Mack, W.J. (2010). Ambient air pollution and the progression of atherosclerosis in adults. PLoS ONE, 5.","DOI":"10.1371\/annotation\/21f6b02b-e533-46ca-9356-86a0eef8434e"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"114707","DOI":"10.1016\/j.envpol.2020.114707","article-title":"Genome-wide DNA methylation analysis reveals significant impact of long-term ambient air pollution exposure on biological functions related to mitochondria and immune response","volume":"264","author":"Wang","year":"2020","journal-title":"Environ. Pollut."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.envpol.2019.07.054","article-title":"Arthritis diagnosis and early-life exposure to air pollution","volume":"253","author":"Shepherd","year":"2019","journal-title":"Environ. Pollut."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e733","DOI":"10.1097\/MD.0000000000000733","article-title":"Exposure to air pollution increases the risk of osteoporosis: A nationwide longitudinal study","volume":"94","author":"Chang","year":"2015","journal-title":"Medicine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1007\/s00198-009-1130-8","article-title":"Outdoor air pollution, bone density and self-reported forearm fracture: The Oslo Health Study","volume":"21","author":"Alver","year":"2010","journal-title":"Osteoporos. Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1007\/s00198-018-4605-7","article-title":"Short-term association between outdoor air pollution and osteoporotic hip fracture","volume":"29","author":"Mazzucchelli","year":"2018","journal-title":"Osteoporos. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1289\/ehp.0901725","article-title":"Oxidative damage to DNA and lipids as biomarkers of exposure to air pollution","volume":"118","author":"Loft","year":"2010","journal-title":"Environ. Health Perspect."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1002\/jat.3275","article-title":"Changes in RANKL and osteoprotegerin expression after chronic exposure to indoor air pollution as a result of cooking with biomass fuel","volume":"36","author":"Saha","year":"2016","journal-title":"J. Appl. Toxicol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1097\/EDE.0b013e31824523f0","article-title":"Air pollution and markers of coagulation, inflammation, and endothelial function: Associations and epigene-environment interactions in an elderly cohort","volume":"23","author":"Bind","year":"2012","journal-title":"Epidemiology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"109465","DOI":"10.1016\/j.envres.2020.109465","article-title":"Molecular and cellular mechanisms linking air pollution and bone damage","volume":"185","author":"Prada","year":"2020","journal-title":"Environ. Res."},{"key":"ref_26","first-page":"5321","article-title":"Population structure of Han Chinese in the modern Taiwanese population based on 10,000 participants in the Taiwan Biobank project","volume":"25","author":"Chen","year":"2016","journal-title":"Hum. Mol. Genet."},{"key":"ref_27","first-page":"816","article-title":"Taiwan Regulation of Biobanks","volume":"43","author":"Fan","year":"2015","journal-title":"J. Law Med. Ethics A J. Am. Soc. Law Med. Ethics"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"461","DOI":"10.7326\/0003-4819-130-6-199903160-00002","article-title":"A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Modification of Diet in Renal Disease Study Group","volume":"130","author":"Levey","year":"1999","journal-title":"Ann. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"347","DOI":"10.3109\/10715769209049150","article-title":"Oxidative damage to human plasma proteins by ozone","volume":"15","author":"Cross","year":"1992","journal-title":"Free Radic. Res. Commun."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1097\/scs.0b013e31857261f","article-title":"Ozone therapy in the treatment of avascular bisphosphonate-related jaw osteonecrosis","volume":"18","author":"Agrillo","year":"2007","journal-title":"J. Craniofacial Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jbo.2012.08.001","article-title":"Efficacy and tolerability of medical ozone gas insufflations in patients with osteonecrosis of the jaw treated with bisphosphonates-Preliminary data: Medical ozone gas insufflation in treating ONJ lesions","volume":"1","author":"Ripamonti","year":"2012","journal-title":"J. Bone Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1097\/SCS.0b013e3182a244ae","article-title":"Effects of laser and ozone therapies on bone healing in the calvarial defects","volume":"24","author":"Kazancioglu","year":"2013","journal-title":"J. Craniofacial Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1093\/ejo\/cjv045","article-title":"The effect of different concentrations of topical ozone administration on bone formation in orthopedically expanded suture in rats","volume":"38","author":"Buyuk","year":"2016","journal-title":"Eur. J. Orthod."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1136\/tc.2003.003673","article-title":"Determination of tar, nicotine, and carbon monoxide yields in the mainstream smoke of selected international cigarettes","volume":"13","author":"Calafat","year":"2004","journal-title":"Tob. Control."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1007\/s11356-016-7896-2","article-title":"Global estimates of carbon monoxide emissions from 1960 to 2013","volume":"24","author":"Zhong","year":"2017","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1164\/rccm.201606-1275CI","article-title":"Carbon Monoxide Poisoning: Pathogenesis, Management, and Future Directions of Therapy","volume":"195","author":"Rose","year":"2017","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2441","DOI":"10.1210\/jc.2014-1718","article-title":"Apnea and risk of osteoporosis: A population-based cohort study in Taiwan","volume":"99","author":"Chen","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1159\/000430294","article-title":"Carbon Monoxide Inhibits Receptor Activator of NF-\u03baB (RANKL)-Induced Osteoclastogenesis","volume":"36","author":"Tseng","year":"2015","journal-title":"Cell Physiol. Biochem."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.lfs.2013.12.027","article-title":"Sulfur dioxide, a double-faced molecule in mammals","volume":"98","author":"Wang","year":"2014","journal-title":"Life Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/01.shk.0000105501.75189.85","article-title":"Increased levels of serum sulfite in patients with acute pneumonia","volume":"21","author":"Mitsuhashi","year":"2004","journal-title":"Shock"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.niox.2008.12.003","article-title":"The role of sulfur dioxide as an endogenous gaseous vasoactive factor in synergy with nitric oxide","volume":"20","author":"Li","year":"2009","journal-title":"Nitric Oxide"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1080\/08958370590922625","article-title":"Effect of sulfur dioxide inhalation on cytokine levels in lungs and serum of mice","volume":"17","author":"Meng","year":"2005","journal-title":"Inhal. Toxicol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3551","DOI":"10.1002\/art.22175","article-title":"Impaired skeletal development in interleukin-6-transgenic mice: A model for the impact of chronic inflammation on the growing skeletal system","volume":"54","author":"Rucci","year":"2006","journal-title":"Arthritis Rheum."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1002\/jbmr.5650110303","article-title":"Nitric oxide and bone","volume":"11","author":"Evans","year":"1996","journal-title":"J. Bone Miner. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/j.1749-6632.2009.05230.x","article-title":"Nitric oxide and bone","volume":"1192","author":"Wimalawansa","year":"2010","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"109264","DOI":"10.1016\/j.envres.2020.109264","article-title":"Long-term exposure to air pollution might increase prevalence of osteoporosis in Chinese rural population","volume":"183","author":"Qiao","year":"2020","journal-title":"Environ. Res."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Perret, J.L., Bowatte, G., Lodge, C.J., Knibbs, L.D., Gurrin, L.C., Kandane-Rathnayake, R., Johns, D.P., Lowe, A.J., Burgess, J.A., and Thompson, B.R. (2017). The Dose-Response Association between Nitrogen Dioxide Exposure and Serum Interleukin-6 Concentrations. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18051015"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.bone.2005.09.008","article-title":"Systemic bone loss and induction of coronary vessel disease in a rat model of chronic inflammation","volume":"38","author":"Smith","year":"2006","journal-title":"Bone"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/0014-5793(95)00763-Y","article-title":"Nitric oxide regulates mitochondrial respiration and cell functions by inhibiting cytochrome oxidase","volume":"369","author":"Brown","year":"1995","journal-title":"FEBS Lett."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.niox.2019.04.005","article-title":"The effect of nitric oxide on mitochondrial respiration","volume":"88","author":"Poderoso","year":"2019","journal-title":"Nitric Oxide"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1039\/C1CP22217A","article-title":"Synergistic reaction between SO2 and NO2 on mineral oxides: A potential formation pathway of sulfate aerosol","volume":"14","author":"Liu","year":"2012","journal-title":"Phys. Chem. Chem. Phys."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1172\/JCI200317215","article-title":"Role of rank ligand in mediating increased bone resorption in early postmenopausal women","volume":"111","author":"Khosla","year":"2003","journal-title":"J. Clin. Investig."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.ejrad.2009.05.046","article-title":"Assess the discrimination of Achilles InSight calcaneus quantitative ultrasound device for osteoporosis in Chinese women: Compared with dual energy X-ray absorptiometry measurements","volume":"76","author":"Jin","year":"2010","journal-title":"Eur. J. Radiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.ejrad.2008.11.024","article-title":"High correlation between quantitative ultrasound and DXA during 7 years of follow-up","volume":"73","author":"Trimpou","year":"2010","journal-title":"Eur. J. Radiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.ejrad.2007.03.023","article-title":"Hip fracture discrimination by the Achilles Insight QUS imaging device","volume":"63","author":"Damilakis","year":"2007","journal-title":"Eur. J. Radiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1359\/JBMR.051205","article-title":"Long-term fracture prediction by DXA and QUS: A 10-year prospective study","volume":"21","author":"Stewart","year":"2006","journal-title":"J. Bone Miner. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1359\/jbmr.090212","article-title":"Is QUS or DXA better for predicting the 10-year absolute risk of fracture?","volume":"24","author":"Moayyeri","year":"2009","journal-title":"J. Bone Miner. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.jocd.2017.06.018","article-title":"Quantitative Ultrasound (QUS) in the Management of Osteoporosis and Assessment of Fracture Risk","volume":"20","author":"Hans","year":"2017","journal-title":"J. Clin. Densitom."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/24\/9165\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:42:23Z","timestamp":1760179343000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/24\/9165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,8]]},"references-count":58,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["ijerph17249165"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17249165","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,8]]}}}