Advances in Clinical Diagnosis and Monitoring of Postmenopausal Osteoporosis

Lijun Xie; Yuan Wu

doi:10.54097/n1rcxk15

Authors

Lijun Xie
Yuan Wu

DOI:

https://doi.org/10.54097/n1rcxk15

Keywords:

Bone Fragility, Fracture Risk, Bone Mineral Density, Bone Turnover Markers, FRAX, Trabecular Bone Score, Cell-free DNA

Abstract

Postmenopausal osteoporosis is a major cause of fragility fracture, disability, and loss of independence in older women. Although dual-energy X-ray absorptiometry remains the diagnostic cornerstone, bone mineral density alone does not fully reflect bone quality, remodeling activity, treatment response, or short-term fracture probability. This review summarizes evidence published from 2021 to 2025 on major tools used in the diagnosis and monitoring of postmenopausal osteoporosis, including dual-energy X-ray absorptiometry, trabecular bone score, vertebral-fracture assessment, quantitative computed tomography, bone turnover markers, FRAX-based risk assessment, and emerging molecular approaches such as circulating microRNAs, extracellular vesicles, and cell-free DNA. Current evidence favors a multimodal strategy in which imaging remains foundational, biochemical markers are used mainly for biological contextualization and treatment monitoring, and molecular biomarkers are developed as complementary rather than replacement tools.

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