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Polygenic risk score-guided personalized osteoporosis screening : a population-based study

Wang, Dongxue ; Sun, Wen ; Liu, Di ; Yi, Huan ; Wang, Xiao LU ; Li, Xiaodan and Ji, Jianguang (2026) In BMC Medicine 24(1).
Abstract

Background: Despite robust evidence that genetic factors substantially influence both osteoporosis development and fracture risk, current screening guidelines fail to incorporate genetic factors into risk-assessment protocols. This study aims to determine personalized screening ages for osteoporosis based on polygenic risk score (PRS). Methods: This prospective cohort study utilized data from 223,818 women in the UK Biobank, and only participants who were osteoporosis-free at baseline were included in the study. Participants were categorized into three subgroups (low, medium, and high groups) based on their PRS. Ten-year cumulative risk of osteoporosis, risk-adapted starting age of osteoporosis screening, and risk advancement periods... (More)

Background: Despite robust evidence that genetic factors substantially influence both osteoporosis development and fracture risk, current screening guidelines fail to incorporate genetic factors into risk-assessment protocols. This study aims to determine personalized screening ages for osteoporosis based on polygenic risk score (PRS). Methods: This prospective cohort study utilized data from 223,818 women in the UK Biobank, and only participants who were osteoporosis-free at baseline were included in the study. Participants were categorized into three subgroups (low, medium, and high groups) based on their PRS. Ten-year cumulative risk of osteoporosis, risk-adapted starting age of osteoporosis screening, and risk advancement periods (RAP) of women across different stratifications based on PRS were calculated as the main outcomes. Results: In the general female population at age 65 (current US Preventive Services Task Force recommended screening age), the 10-year cumulative osteoporosis risk was 5.95%. Women reached this risk threshold depending on their PRS, which was 60 years for high-risk women and 69 years for low-risk women. Compared to medium-risk participants, high-risk participants developed osteoporosis 4.99 years earlier (RAP, 4.99; 95% CI, 4.94, 6.28), whereas low-risk participants developed it 4.89 years later (RAP, − 4.89; 95% CI, − 6.54, − 4.69). Conclusions: The integration of PRS could revolutionize osteoporosis prevention by enabling early detection in genetically high-risk women, potentially years before the current screening guidelines. Our findings advance the field of precision prevention for osteoporosis and may significantly reduce the population burden of osteoporotic fractures.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Osteoporosis, Polygenic risk score, Screening age, Women health
in
BMC Medicine
volume
24
issue
1
article number
56
publisher
BioMed Central (BMC)
external identifiers
  • pmid:41530839
  • scopus:105028667821
ISSN
1741-7015
DOI
10.1186/s12916-025-04601-1
language
English
LU publication?
yes
id
556c7aec-dc4a-4976-8052-7963d1e3cee9
date added to LUP
2026-02-17 13:50:38
date last changed
2026-02-18 03:00:02
@article{556c7aec-dc4a-4976-8052-7963d1e3cee9,
  abstract     = {{<p>Background: Despite robust evidence that genetic factors substantially influence both osteoporosis development and fracture risk, current screening guidelines fail to incorporate genetic factors into risk-assessment protocols. This study aims to determine personalized screening ages for osteoporosis based on polygenic risk score (PRS). Methods: This prospective cohort study utilized data from 223,818 women in the UK Biobank, and only participants who were osteoporosis-free at baseline were included in the study. Participants were categorized into three subgroups (low, medium, and high groups) based on their PRS. Ten-year cumulative risk of osteoporosis, risk-adapted starting age of osteoporosis screening, and risk advancement periods (RAP) of women across different stratifications based on PRS were calculated as the main outcomes. Results: In the general female population at age 65 (current US Preventive Services Task Force recommended screening age), the 10-year cumulative osteoporosis risk was 5.95%. Women reached this risk threshold depending on their PRS, which was 60 years for high-risk women and 69 years for low-risk women. Compared to medium-risk participants, high-risk participants developed osteoporosis 4.99 years earlier (RAP, 4.99; 95% CI, 4.94, 6.28), whereas low-risk participants developed it 4.89 years later (RAP, − 4.89; 95% CI, − 6.54, − 4.69). Conclusions: The integration of PRS could revolutionize osteoporosis prevention by enabling early detection in genetically high-risk women, potentially years before the current screening guidelines. Our findings advance the field of precision prevention for osteoporosis and may significantly reduce the population burden of osteoporotic fractures.</p>}},
  author       = {{Wang, Dongxue and Sun, Wen and Liu, Di and Yi, Huan and Wang, Xiao and Li, Xiaodan and Ji, Jianguang}},
  issn         = {{1741-7015}},
  keywords     = {{Osteoporosis; Polygenic risk score; Screening age; Women health}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Medicine}},
  title        = {{Polygenic risk score-guided personalized osteoporosis screening : a population-based study}},
  url          = {{http://dx.doi.org/10.1186/s12916-025-04601-1}},
  doi          = {{10.1186/s12916-025-04601-1}},
  volume       = {{24}},
  year         = {{2026}},
}