{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:04:28Z","timestamp":1791612268284,"version":"4.3.4"},"reference-count":58,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:00:00Z","timestamp":1721952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: For years, bone mineral density (BMD) has played a key role in assessing bone health, but the trabecular bone score (TBS) is emerging as an equivalent measure. However, BMD alone may not fully measure bone quality or predict osteoporosis risk. To evaluate the usefulness of TBS and BMD in estimating the risk of bone fracture in young women with FHA, this study examined the association between metabolic parameters and bone quality, which was measured using TBS and BMD. Methods: We analyzed the association of metabolic factors with tests assessing bone quality\u2014TBS and BMD. Patients were checked for BMI, measured body fat, and determined serum glucose levels and insulin levels in a 75g glucose load test. Spearman correlation analysis was used. Results: Significant positive correlations were found between BMD and age (p &lt; 0.001) and body fat (p &lt; 0.001), as well as between TBS values and BMI (p &lt; 0.001) and TBS and percent body fat (p &lt; 0.001). Of the variables analyzed in the multivariate analysis, the only independent predictor of higher bone mineral density in the lumbar spine was found to be higher values of the trabecular bone index in the same segment (p &lt; 0.001). Conclusions: The use of TBS provides a simple tool for estimating the risk of bone damage. Ultimately, early screening, diagnosis and treatment of patients with FHA may help prevent osteoporosis and fragility fractures in the long term.<\/jats:p>","DOI":"10.3390\/jcm13154388","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T14:39:08Z","timestamp":1722004748000},"page":"4388","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Role of Glucose, Insulin and Body Fat in Assessment of Bone Mineral Density and Trabecular Bone Score in Women with Functional Hypothalamic Amenorrhea"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6693-9465","authenticated-orcid":false,"given":"El\u017cbieta","family":"Sowi\u0144ska-Przepiera","sequence":"first","affiliation":[{"name":"Pediatric, Adolescent Gynecology Clinic, Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland"},{"name":"Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4027-7122","authenticated-orcid":false,"given":"Mariola","family":"Krzy\u015bcin","sequence":"additional","affiliation":[{"name":"Pediatric, Adolescent Gynecology Clinic, Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3607-2892","authenticated-orcid":false,"given":"Igor","family":"Syrenicz","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6194-0992","authenticated-orcid":false,"given":"Adrianna","family":"Orli\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powsta\u0144c\u00f3w Wielkopolskich 72, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6963-9329","authenticated-orcid":false,"given":"Adrianna","family":"\u0106wiertnia","sequence":"additional","affiliation":[{"name":"Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powsta\u0144c\u00f3w Wielkopolskich 72, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4019-4615","authenticated-orcid":false,"given":"Adam","family":"Przepiera","sequence":"additional","affiliation":[{"name":"Department of Urology and Urologic Oncology, Pomeranian Medical University in Szczecin, Al. Powsta\u0144c\u00f3w Wielkopolskich 72, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9513-3900","authenticated-orcid":false,"given":"Karolina","family":"Jezierska","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Pomeranian Medical University, ul. Ku S\u0142o\u0144cu 13, 71-073 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aneta","family":"Cymbaluk-P\u0142oska","sequence":"additional","affiliation":[{"name":"Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powsta\u0144c\u00f3w Wielkopolskich 72, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u017dana","family":"Bumbulien\u0117","sequence":"additional","affiliation":[{"name":"Clinics of Obstetrics and Gynecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-08661 Vilnius, Lithuania"},{"name":"Centre of Obstetrics and Gynecology, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anheli","family":"Syrenicz","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1053\/j.semnuclmed.2010.12.002","article-title":"Bone Densitometry","volume":"41","author":"Chun","year":"2011","journal-title":"Semin. Nucl. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s12020-021-02806-x","article-title":"DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis","volume":"74","author":"Shevroja","year":"2021","journal-title":"Endocrine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.bone.2017.06.010","article-title":"Body composition by DXA","volume":"104","author":"Shepherd","year":"2017","journal-title":"Bone"},{"key":"ref_4","unstructured":"Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis (2023, December 18). Report of a WHO Study Group\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/7941614\/."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2222","DOI":"10.1359\/jbmr.2002.17.12.2222","article-title":"Prediction of Fracture Risk in Postmenopausal White Women with Peripheral Bone Densitometry: Evidence From the National Osteoporosis Risk Assessment","volume":"17","author":"Miller","year":"2002","journal-title":"J. Bone Miner. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1007\/s00774-020-01130-0","article-title":"Protective role of osteocalcin in diabetes pathogenesis","volume":"38","year":"2020","journal-title":"J. Bone Miner. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/joim.12725","article-title":"Type 2 diabetes mellitus and bone","volume":"283","author":"Compston","year":"2018","journal-title":"J. Intern. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1002\/jbmr.2176","article-title":"Trabecular Bone Score: A Noninvasive Analytical Method Based Upon the DXA Image","volume":"29","author":"Silva","year":"2014","journal-title":"J. Bone Miner. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.jocd.2012.01.007","article-title":"Identification of Rheumatoid Arthritis Patients with Vertebral Fractures Using Bone Mineral Density and Trabecular Bone Score","volume":"15","author":"Briot","year":"2012","journal-title":"J. Clin. Densitom."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.bone.2012.11.041","article-title":"\u201cTrabecular Bone Score\u201d (TBS): An indirect measure of bone micro-architecture in postmenopausal patients with primary hyperparathyroidism","volume":"53","author":"Romagnoli","year":"2013","journal-title":"Bone"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1210\/jc.2012-3118","article-title":"TBS (Trabecular Bone Score) and Diabetes-Related Fracture Risk","volume":"98","author":"Leslie","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1210\/jc.2012-4255","article-title":"Trabecular Bone Score (TBS)\u2014A Novel Method to Evaluate Bone Microarchitectural Texture in Patients with Primary Hyperparathyroidism","volume":"98","author":"Silva","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"694","DOI":"10.20945\/2359-3997000000559","article-title":"Update on trabecular bone score","volume":"66","author":"Palomo","year":"2022","journal-title":"Arch. Endocrinol. Metab."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e24684","DOI":"10.1097\/MD.0000000000024684","article-title":"The relationship between healthy lifestyles and bone health","volume":"100","author":"Sheng","year":"2021","journal-title":"Medicine"},{"key":"ref_15","first-page":"4184190","article-title":"The Effect of Tobacco Smoking on Musculoskeletal Health: A Systematic Review","volume":"2018","author":"Haddad","year":"2018","journal-title":"J. Environ. Public Health"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Falbov\u00e1, D., Koval\u010d\u00edkov\u00e1, V., Be\u0148u\u0161, R., Sulis, S., and Vorobe\u013eov\u00e1, L. (2023). Effect of COVID-19 pandemic on lifestyle and bone mineral density in young adults. Am. J. Hum. Biol., 36.","DOI":"10.1002\/ajhb.24009"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s00198-012-2188-2","article-title":"Trabecular bone score improves fracture risk prediction in non-osteoporotic women: The OFELY study","volume":"24","author":"Boutroy","year":"2013","journal-title":"Osteoporos. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.bone.2009.06.032","article-title":"A multicentre, retrospective case\u2013control study assessing the role of trabecular bone score (TBS) in menopausal Caucasian women with low areal bone mineral density (BMDa): Analysing the odds of vertebral fracture","volume":"46","author":"Rabier","year":"2009","journal-title":"Bone"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2762","DOI":"10.1002\/jbmr.499","article-title":"Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: The manitoba study","volume":"26","author":"Hans","year":"2011","journal-title":"J. Bone Miner. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1210\/jc.2017-00131","article-title":"Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline","volume":"102","author":"Gordon","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4274\/jcrpe.galenos.2019.2019.S0178","article-title":"Where Have the Periods Gone? The Evaluation and Management of Functional Hypothalamic Amenorrhea","volume":"12","author":"Gibson","year":"2020","journal-title":"J. Clin. Res. Pediatr. Endocrinol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1007\/s11914-020-00634-y","article-title":"Exercise and Diet: Uncovering Prospective Mediators of Skeletal Fragility in Bone and Marrow Adipose Tissue","volume":"18","author":"Pagnotti","year":"2020","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1467-789X.2004.00144.x","article-title":"Obesity as a disease: No lightweight matter","volume":"5","author":"Conway","year":"2004","journal-title":"Obes. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1007\/s00198-004-1640-3","article-title":"Body mass index as a predictor of fracture risk: A meta-analysis","volume":"16","author":"Kanis","year":"2005","journal-title":"Osteoporos. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1007\/s001980200095","article-title":"Mechanical Strain and Bone Cell Function: A Review","volume":"13","author":"Ehrlich","year":"2002","journal-title":"Osteoporos. Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/j.bone.2007.12.224","article-title":"Osteocytes, mechanosensing and Wnt signaling","volume":"42","author":"Bonewald","year":"2008","journal-title":"Bone"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"23698","DOI":"10.1074\/jbc.M601000200","article-title":"The Wnt Co-receptor LRP5 Is Essential for Skeletal Mechanotransduction but Not for the Anabolic Bone Response to Parathyroid Hormone Treatment","volume":"281","author":"Sawakami","year":"2006","journal-title":"J. Biol. Chem."},{"key":"ref_28","first-page":"779","article-title":"Fat mass is an important determinant of whole body bone density in premenopausal women but not in men","volume":"75","author":"Reid","year":"1992","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1002\/jbmr.5650080507","article-title":"Effects of weight and body mass index on bone mineral density in men and women: The framingham study","volume":"8","author":"Felson","year":"1993","journal-title":"J. Bone Miner. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1046\/j.1365-2265.2002.01534.x","article-title":"Prospective 10-year study of the determinants of bone density and bone loss in normal postmenopausal women, including the effect of hormone replacement therapy","volume":"56","author":"Wu","year":"2002","journal-title":"Clin. Endocrinol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"753","DOI":"10.5603\/GP.a2021.0041","article-title":"Relationships between hormonal parameters, body fat distribution and bone mineral density in women with functional menstrual disorders","volume":"92","author":"Syrenicz","year":"2021","journal-title":"Ginekol. Polska"},{"key":"ref_32","first-page":"9","article-title":"Obesity and fracture risk","volume":"11","author":"Gonnelli","year":"2014","journal-title":"Bone Abstr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e10780","DOI":"10.1002\/jbm4.10780","article-title":"Associations of Type 2 Diabetes, Body Composition, and Insulin Resistance with Bone Parameters: The Dubbo Osteoporosis Epidemiology Study","volume":"7","author":"Sheu","year":"2023","journal-title":"JBMR Plus"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2585","DOI":"10.7150\/ijms.49030","article-title":"Positive association between metabolic syndrome and bone mineral density among Malaysians","volume":"17","author":"Chin","year":"2020","journal-title":"Int. J. Med. Sci."},{"key":"ref_35","first-page":"372","article-title":"Obesity, osteoporosis and bone metabolism","volume":"20","author":"Gkastaris","year":"2020","journal-title":"J. Musculoskelet. Neuronal Interact."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Sultan, I., Taha, I., El Tarhouny, S., Mohammed, R.A., Allah, A.M.A., Al Nozha, O., Desouky, M., Ghonimy, A., Elmehallawy, Y., and Aldeeb, N. (2023). Determinants of Z-Score of Bone Mineral Density among Premenopausal Saudi Females in Different Age Groups: A Cross Sectional Study. Nutrients, 15.","DOI":"10.3390\/nu15194280"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Indirli, R., Lanzi, V., Mantovani, G., Arosio, M., and Ferrante, E. (2022). Bone health in functional hypothalamic amenorrhea: What the endocrinologist needs to know. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.946695"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.bone.2012.07.019","article-title":"Cortical microstructure and estimated bone strength in young amenorrheic athletes, eumenorrheic athletes and non-athletes","volume":"51","author":"Ackerman","year":"2012","journal-title":"Bone"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S0020-7292(98)00044-7","article-title":"Oral glucose challenge effects on growth and sex steroid hormones in normal women and women with hypothalamic amenorrhea","volume":"61","author":"Takeuchi","year":"1998","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.bone.2015.04.005","article-title":"Regional fat depots and their relationship to bone density and microarchitecture in young oligo-amenorrheic athletes","volume":"77","author":"Singhal","year":"2015","journal-title":"Bone"},{"key":"ref_41","first-page":"190","article-title":"Factors determining bone mineral density and trabecular bone score in young women with hyperandrogenism","volume":"7","author":"Syrenicz","year":"2017","journal-title":"J. Educ. Health Sport"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1007\/s00774-008-0861-5","article-title":"The influence of ghrelin, adiponectin, and leptin on bone mineral density in healthy postmenopausal women","volume":"26","author":"Leppik","year":"2008","journal-title":"J. Bone Miner. Metab."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/ncprheum0070","article-title":"Mechanisms of Disease: Is osteoporosis the obesity of bone?","volume":"2","author":"Rosen","year":"2006","journal-title":"Nat. Clin. Pract. Rheumatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1210\/jc.2007-2191","article-title":"Visceral Obesity and Plasma Glucose-Insulin Homeostasis: Contributions of Interleukin-6 and Tumor Necrosis Factor-\u03b1 in Men","volume":"93","author":"Cartier","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1161\/CIRCULATIONAHA.107.710509","article-title":"Visceral and Subcutaneous Adipose Tissue Volumes Are Cross-Sectionally Related to Markers of Inflammation and Oxidative Stress","volume":"116","author":"Pou","year":"2007","journal-title":"Circulation"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.mce.2008.05.001","article-title":"The endocrine profile of subcutaneous and visceral adipose tissue of obese patients","volume":"291","year":"2008","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"932","DOI":"10.2337\/dc08-1856","article-title":"Relation of Abdominal Fat Depots to Systemic Markers of Inflammation in Type 2 Diabetes","volume":"32","author":"Sam","year":"2009","journal-title":"Diabetes Care"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e12826","DOI":"10.1111\/ijpo.12826","article-title":"Does the severity of obesity influence bone density, geometry and strength in adolescents?","volume":"16","author":"Julian","year":"2021","journal-title":"Pediatr. Obes."},{"key":"ref_49","first-page":"1166","article-title":"Low trabecular bone score in adolescent female inpatients with anorexia nervosa","volume":"38","author":"David","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"3436","DOI":"10.1210\/jc.2015-2002","article-title":"Spinal Bone Texture Assessed by Trabecular Bone Score in Adolescent Girls with Anorexia Nervosa","volume":"100","author":"Donaldson","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_51","unstructured":"(2023, December 20). Bone Mineral Density and Trabecular Bone Score in Postmenopausal Women with Knee Osteoarthritis and Obesity\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/32285828\/."},{"key":"ref_52","first-page":"889","article-title":"The influence of Visfatin, RBP-4 and insulin resistance on bone mineral density in women with treated primary osteoporosis. Aging Clin","volume":"31","author":"Mihai","year":"2019","journal-title":"Exp. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.2337\/db13-0887","article-title":"Osteocalcin Promotes \u03b2-Cell Proliferation During Development and Adulthood Through Gprc6a","volume":"63","author":"Wei","year":"2014","journal-title":"Diabetes"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1007\/s00198-017-4353-0","article-title":"Trabecular bone quality is lower in adults with type 1 diabetes and is negatively associated with insulin resistance","volume":"29","author":"Shah","year":"2018","journal-title":"Osteoporos. Int."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"137","DOI":"10.2337\/dc19-0925","article-title":"Vertebral Fractures in Individuals with Type 2 Diabetes: More Than Skeletal Complications Alone","volume":"43","author":"Koromani","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1210\/jc.2014-2047","article-title":"Trabecular Bone Score as an Indicator for Skeletal Deterioration in Diabetes","volume":"100","author":"Kim","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s00198-023-06722-w","article-title":"Bone density and trabecular bone score to predict fractures in adults aged 20\u201339 years: A registry-based study","volume":"34","author":"Goel","year":"2023","journal-title":"Osteoporos. Int."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Jose, A., Cherian, K.E., Nandyal, M.B., Jiwanmall, S.A., Kattula, D., Paul, T.V., and Kapoor, N. (2021). Trabecular Bone Score and Bone Mineral Density in Postmenopausal Women with Morbid Obesity\u2014A Clinical Paradox. Med. Sci., 9.","DOI":"10.3390\/medsci9040069"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/15\/4388\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:24:41Z","timestamp":1760109881000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/15\/4388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,26]]},"references-count":58,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["jcm13154388"],"URL":"https:\/\/doi.org\/10.3390\/jcm13154388","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,26]]}}}