Clinical Osteology, 2025 (vol. 30), issue 4

Editorial

Kostní metabolismus u chorob gastrointestinálního traktu – váhový úbytek a střevní mikrobiom v centru pozornosti

doc. MUDr. Ludmila Brunerová, Ph.D.

Clin Osteol 2025; 30(4): 187

Několik slov úvodem

Vladimír Palička

Clin Osteol 2025; 30(4): 190

Main theme

Bone changes after significant weight loss

Ludmila Brunerová

Clin Osteol 2025; 30(4): 191-194

The impact of obesity on bone mineral density (BMD) is complex. While chronically increased skeletal loading leads to elevated BMD, especially in the axial skeleton, the presence of low-grade inflammation and frequent vitamin D deficiency can negatively affect both the quantity and quality of bone. The risk of fractures in obese patients may be increased not only due to reduced bone quality but also due to impaired balance and a higher risk of falls. The technique used to measure BMD also plays a role. The gold standard - dual-energy X-ray absorptiometry (DXA) - may overestimate BMD in obese patients due to the higher volume of adipose tissue (known...

Gut microbiome and bone: a review of current knowledge

Ivana Cibulková

Clin Osteol 2025; 30(4): 196-201

Bone metabolism is a dynamic and complex process involving a continuous cycle of bone resorption and formation. An imbalance between these processes leads to the development of osteoporosis - the most common metabolic bone disease - characterized by decreased bone mass and an increased risk of fractures, as well as other pathological conditions. While bone metabolism has traditionally been associated primarily with hormonal regulation and mechanical loading, growing evidence points to a key role of the gut microbiota in the regulation of mineralization and the maintenance of bone integrity. The microbiome influences not only intestinal homeostasis...

Review articles

Management of osteoporosis in children

Ľubica Tichá, Ľudmila Podracká

Clin Osteol 2025; 30(4): 203-208

Osteoporosis in childhood is a rare but serious condition characterized by reduced bone density and increased susceptibility to fractures. Primary (genetically determined) disorders account for only a small proportion of cases, while up to 98% develop secondarily in association with another underlying disease. Diagnosis is based on clinical presentation, fracture history, and measurement of bone mineral density using Dual Energy X-ray Absorptiometry (DXA). In children, it is essential to adjust the Z-score for current height to ensure accurate interpretation of the results. Treatment requires a multidisciplinary approach focused on managing the underlying...

Pain management in patients with osteoporosis

Jana Hrubešová, Pavel Ryška

Clin Osteol 2025; 30(4): 210-215

Osteoporosis is characterized by the loss of bone mass, increased bone fragility, and a higher risk of fractures. It can remain asymptomatic for a long time, but once musculoskeletal changes develop, pain often occurs. Pain is one of the most distressing symptoms of osteoporosis and, if not properly managed, can significantly reduce a patient's quality of life and limit their functional abilities. Effective pain management should be an essential part of a comprehensive treatment plan for patients with this condition. When standard analgesic treatments are insufficient, minimally invasive techniques may be considered, offering rapid and effective pain...

Bone in the gynecology clinic

Tomáš Fait, Vlasta Dvořáková

Clin Osteol 2025; 30(4): 216-220

The logical reason for linking gynecology with bone health care is the importance of estrogen for achieving optimal bone density and its dominant role in the prevention of postmenopausal osteoporosis. Bone health can thus be influenced by the choice of contraception, proper care for women with premature ovarian failure, rational choice of hormone replacement therapy during menopause, and early calcium and vitamin D supplementation in women at risk of osteoporosis. The role of gynecologists in bone health care has been confirmed by their current involvement in the screening and treatment of osteoporosis as primary care physicians.

Case reports

An unusual cause of hypercalcemia from an endocrinologist's perspective

Lucie Lysková, Daniela Číhalíková, David Karásek, Jaroslav Michálek

Clin Osteol 2025; 30(4): 221-224

Calcium is an essential element that plays a crucial role in bone mineralization, neuromuscular transmission, and is involved in many cellular signaling processes. Its serum concentration (total albumin-corrected concentration) should range between 2.15 and 2.55 mmol/L and is strictly regulated by several mechanisms. Hypercalcemia is defined as an elevated level of serum calcium above 2.55 mmol/L. It has various causes, ranging from parathyroid gland dysfunction, most commonly in the form of primary hyperparathyroidism, through granulomatous diseases, to serious malignancies with skeletal invasion or paraneoplastic syndromes, such as ectopic production...

Said at the congress

Biosimilar denosumab - a new chapter in the treatment of bone diseases

doc. MUDr. Karel Urbánek, Ph.D., prof. MUDr. Vladimír Palička, CSc., dr.h.c., prof. MUDr. Karel Pavelka, DrSc.

Clin Osteol 2025; 30(4): 226-231

Biosimilar medicines, which are biologically similar to the reference product, although not identical copies, reduce the cost of biological treatment and make it possible to expand the number of patients who can receive it. There is sufficient evidence that the efficacy of biosimilar medicines does not differ from that of the original biological products and that switching from the original medicine to a biosimilar, as well as between biosimilars, is not only feasible but also safe.