Evidence mapPaperPMID 41599874Full record

ReviewNutrients2026

Underlying Mechanisms of Osteoporosis in the Context of Multimorbidity: Clinical Challenges and Management Strategies.

Alberto Castagna, Carmelo Pujia, Elisa Mazza, Samantha Maurotti, Yvelise Ferro, Valeria Rizzo, Martina Formica, Rosy Conforto, Caterina Mercuri, Angela Sciacqua and 3 more

Abstract readReview
In one paragraph

Review in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Alberto CastagnaDepartment of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.ORCID 0000-0001-9136-2055
Carmelo PujiaO.U. Clinical Nutrition, Renato Dulbecco Hospital, 88100 Catanzaro, Italy.ORCID 0009-0000-8854-5854
Elisa MazzaDepartment of Clinical and Experimental Medicine, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.ORCID 0000-0003-3198-7090
Samantha MaurottiDepartment of Clinical and Experimental Medicine, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.ORCID 0000-0001-7644-1337
Yvelise FerroDepartment of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.ORCID 0000-0001-7503-6188
Valeria RizzoO.U. Clinical Nutrition, Renato Dulbecco Hospital, 88100 Catanzaro, Italy.
Martina FormicaDepartment of Clinical and Experimental Medicine, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.
Rosy ConfortoO.U. Clinical Nutrition, Renato Dulbecco Hospital, 88100 Catanzaro, Italy.
Caterina MercuriDepartment of Clinical and Experimental Medicine, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.ORCID 0009-0002-0949-4900
Angela SciacquaDepartment of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.ORCID 0000-0003-1674-5317
Carmine GazzarusoDiabetes and Endocrine and Metabolic Diseases Unit, Centre for Applied Clinical Research (Ce.R.C.A.), Clinical Institute "Beato Matteo" (Hospital Group San Donato), 27029 Vigevano, Italy.ORCID 0000-0001-9974-0735
Arturo PujiaDepartment of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.
Tiziana MontalciniDepartment of Clinical and Experimental Medicine, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.ORCID 0000-0001-7048-5830

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Osteoporosis and chronic conditions such as type 2 diabetes mellitus, cardiovascular disease, heart failure, and chronic kidney disease share several common biological mechanisms, including chronic inflammation, oxidative stress, hormonal dysregulation, and metabolic alterations. In this context, multimorbidity presents an increasing clinical challenge, particularly in older populations, where osteoporosis remains frequently underdiagnosed and undertreated. This review aims to explore the complex interplay between skeletal fragility and cardiometabolic diseases, emphasizing the role of nutritional deficiencies (such as iron and vitamin C), shared molecular pathways (advanced glycation end-products, Renin-Angiotensin-Aldosterone System, RANK Ligand, RANK), and the systemic impact of chronic inflammation and tissue hypoperfusion. The review also addresses the effects of various drug classes-antidiabetics, antihypertensives, anticoagulants, and anti-osteoporotic agents-on bone metabolism and cardiovascular risk. Special focus is given to the implementation of integrated and personalized care models, particularly multidisciplinary team-based approaches, which have demonstrated significant reductions in mortality and refracture rates, despite their still limited adoption in clinical practice. In conclusion, this review highlights the shared mechanisms between osteoporosis and cardiometabolic conditions in the context of multimorbidity, underscoring persistent clinical challenges related to diagnosis, drug interactions, and care fragmentation that warrant further research into integrated care models.

Indexed as

MultimorbidityOsteoporosisCardiovascular DiseasesHumanscomorbiditymetabolic alterationsmultidisciplinary approachosteoporosis

Identifiers

PMID41599874
PMCPMC12845196

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.