<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">problendo</journal-id><journal-title-group><journal-title xml:lang="ru">Проблемы Эндокринологии</journal-title><trans-title-group xml:lang="en"><trans-title>Problems of Endocrinology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0375-9660</issn><issn pub-type="epub">2308-1430</issn><publisher><publisher-name>Endocrinology Research Centre</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14341/probl13421</article-id><article-id custom-type="elpub" pub-id-type="custom">problendo-13421</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Болезни костной и жировой ткани</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Bones &amp; Adipose tissues diseases</subject></subj-group></article-categories><title-group><article-title>Разработка прогностических клинико-генетических моделей риска развития первичного остеопороза с использованием нейросетевого обучения</article-title><trans-title-group xml:lang="en"><trans-title>Development of prognostic clinical and genetic models of the risk of low bone mineral density using neural network training</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4337-1736</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ялаев</surname><given-names>Б. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Yalaev</surname><given-names>B. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ялаев Булат Илдусович, к.б.н.</p><p>117292, г. Москва, ул. Дмитрия Ульянова, д. 11</p></bio><bio xml:lang="en"><p>Yalaev B. Ildusovich, PhD</p><p>11 Dmitriya Ulyanov str., Moscow, 117292</p></bio><email xlink:type="simple">yalaev.bulat@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-7768-5223</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Новиков</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Novikov</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новиков Андрей Викторович</p><p>Москва</p></bio><bio xml:lang="en"><p>Novikov A. Viktorovich</p><p>Moscow</p></bio><email xlink:type="simple">eandnov@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7045-8215</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Минниахметов</surname><given-names>И. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Minniakhmetov</surname><given-names>I. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Минниахметов Илдар Рамилевич, к.б.н.</p><p>Москва</p></bio><bio xml:lang="en"><p>Minniakhmetov I. Ramilevich, PhD</p><p>Moscow</p></bio><email xlink:type="simple">minniakhmetov@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8643-850X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хусаинова</surname><given-names>Р. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Khusainova</surname><given-names>R. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хусаинова Рита Игоревна, д.б.н., проф.</p><p>Москва;</p><p>Уфа</p></bio><bio xml:lang="en"><p>Khusainova R. Igorevna, PhD, professor</p><p>Moscow;</p><p>Ufa</p></bio><email xlink:type="simple">ritakh@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр эндокринологии</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Endocrinology Research Centre</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр эндокринологии;&#13;
Институт биохимии и генетики Уфимского федерального исследовательского центра РАН</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Endocrinology Research Centre;&#13;
Institute of Biochemistry and Genetics-Subdivision of the Ufa Federal Research Centre of the Russian Academy of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>24</day><month>01</month><year>2024</year></pub-date><volume>70</volume><issue>6</issue><fpage>67</fpage><lpage>82</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Ялаев Б.И., Новиков А.В., Минниахметов И.Р., Хусаинова Р.И., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Ялаев Б.И., Новиков А.В., Минниахметов И.Р., Хусаинова Р.И.</copyright-holder><copyright-holder xml:lang="en">Yalaev B.I., Novikov A.V., Minniakhmetov I.R., Khusainova R.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.probl-endojournals.ru/jour/article/view/13421">https://www.probl-endojournals.ru/jour/article/view/13421</self-uri><abstract><p>ОБОСНОВАНИЕ. Остеопороз является распространенным возраст-зависимым заболеванием с инвалидизирующими последствиями, ранняя диагностика которого осложнена ввиду длительного и скрытого течения, что зачастую приводит к постановке диагноза только после случая перелома. В этой связи большие надежды возлагаются на передовые разработки в области технологий машинного обучения, направленные на прогнозирование остеопороза на ранней стадии развития, в том числе с применением больших массивов данных, содержащих информацию о генетических и клинических предикторах заболевания. Тем не менее включение ДНК-маркеров в модели прогнозирования сопряжено с рядом трудностей, связанных со сложной полигенной и гетерогенной природой заболевания. На данный момент прогностическая сила нейросетевых моделей недостаточна для их внедрения в современные протоколы диагностики остеопороза. Исследования в этой области единичны, но являются широко востребованными, поскольку их результаты представляют огромную значимость для профилактической медицины. Это приводит к необходимости поиска наиболее эффективных подходов машинного обучения и оптимизации отбора генетических маркеров в качестве входных параметров в нейросетевые модели.ЦЕЛЬ: оценить эффективность машинного обучения и нейросетевого анализа для разработки прогностических моделей риска развития остеопороза на основе клинических предикторов и ДНК-маркеров остеопоротических переломов.МАТЕРИАЛЫ И МЕТОДЫ. Прогностические модели обучены с использованием данных генотипов по 152 полиморфных ДНК-локусов и клинических параметров 701 женщины и 501 мужчины из Волго-Уральского региона России. В качестве входных параметров в модели включены антропометрические показатели, данные о гендерной принадлежности, уровне минеральной плотности костной ткани (МПКТ), а также результаты генотипирования полиморфных локусов генов-кандидатов и локусов репликации полногеномного поиска ассоциаций (GWAS) консорциума GEFOS.РЕЗУЛЬТАТЫ. Установлено, что наиболее высокой эффективности (AUC=0,81 для мужчин и AUC=0,82 для женщин на независимом датасете (англ. dataset — обработанный и структурированный массив данных) достигает модель прогнозирования низкого уровня минеральной плотности костной ткани, в которую вошли 6 полиморфных вариантов гена остеопротегерина (OPG) (rs2073618, rs2073617, rs7844539, rs3102735, rs3134069) и 5 полиморфных вариантов сайтов связывания микроРНК в мРНК таргетных генов, участвующих в костном метаболизме (COL11A1 — rs1031820, FGF2 — rs6854081, miR-146 — rs2910164, ZNF239 — rs10793442, SPARC — rs1054204 и VDR — rs11540149).ЗАКЛЮЧЕНИЕ. Результаты подтверждают перспективность применения машинного обучения для прогнозирования риска развития остеопороза на доклинической стадии заболевания на основе анализа клинических и генетических факторов.</p></abstract><trans-abstract xml:lang="en"><p>BACKGROUND: Osteoporosis is a common age-related disease with disabling consequences, the early diagnosis of which is difficult due to its long and hidden course, which often leads to diagnosis only after a fracture. In this regard, great expectations are placed on advanced developments in machine learning technologies aimed at predicting osteoporosis at an early stage of development, including the use of large data sets containing information on genetic and clinical predictors of the disease. Nevertheless, the inclusion of DNA markers in prediction models is fraught with a number of difficulties due to the complex polygenic and heterogeneous nature of the disease. Currently, the predictive power of neural network models is insufficient for their incorporation into modern osteoporosis diagnostic protocols. Studies in this area are sporadic, but are widely demanded, as their results are of great importance for preventive medicine. This leads to the need to search for the most effective machine learning approaches and optimise the selection of genetic markers as input parameters to neural network models.AIM: to evaluate the effectiveness of machine learning and neural network analysis to develop predictive risk models for osteoporosis based on clinical predictors and genetic markers of osteoporetic fractures.MATERIALS AND METHODS: The predictive models were trained using a database of genotyping and clinical characteristics of 701 women and 501 men living in the Volga-Ural region of Russia. Anthropometric parameters, data on gender, bone mineral density level, and the results of genotyping of 152 polymorphic loci of candidate genes and replication loci of the GEFOS consortium’s full genome-wide association search were included as input parameters.RESULTS: It was found that the model for predicting low bone mineral density, including 6 polymorphic variants of the OPG gene (rs2073618, rs2073617, rs7844539, rs3102735, rs3134069) and 5 polymorphic variants of microRNA binding sites in the mRNA of genes involved in bone metabolism (COL11A1 — rs1031820, FGF2 — rs6854081, miR-146 — rs2910164, ZNF239 — rs10793442, SPARC — rs1054204 and VDR — rs11540149) (AUC=0.81 for men and AUC=0.82 for women).CONCLUSION: The results confirm the promising application of machine learning to predict the risk of osteoporosis at the preclinical stage of the disease based on the analysis of clinical and genetic factors.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>остеопороз</kwd><kwd>машинное обучение</kwd><kwd>нейросеть</kwd><kwd>генетика</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteoporosis</kwd><kwd>machine learning</kwd><kwd>neural network</kwd><kwd>genetics</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена при поддержке Министерства науки и высшего образования Российской Федерации (соглашение № 075-15-2022-310 от 20 апреля 2022 г.).</funding-statement></funding-group></article-meta></front><back><ref-list><ref id="cit1"><element-citation><name><surname>Pisani</surname> <given-names>Paola</given-names> </name> <name><surname>Renna</surname> <given-names>Maria Daniela</given-names> </name> <name><surname>Conversano</surname> <given-names>Francesco</given-names> </name> <name><surname>Casciaro</surname> <given-names>Ernesto</given-names> </name> <name><surname>Di Paola</surname> <given-names>Marco</given-names> </name> <name><surname>Quarta</surname> <given-names>Eugenio</given-names> </name> <name><surname>Muratore</surname> <given-names>Maurizio</given-names> </name> <name><surname>Casciaro</surname> <given-names>Sergio</given-names> </name> <article-title>Major osteoporotic fragility fractures: Risk factor updates and societal impact</article-title> <source>World Journal of Orthopedics</source> <year>2016</year> <month>03</month> <fpage>171</fpage> <volume>7</volume> <issue>3</issue> <object-id pub-id-type="doi" specific-use="metadata">10.5312/wjo.v7.i3.171</object-id></element-citation></ref><ref id="cit2"><element-citation><name><surname>Salari</surname> <given-names>Nader</given-names> </name> <name><surname>Ghasemi</surname> <given-names>Hooman</given-names> </name> <name><surname>Mohammadi</surname> <given-names>Loghman</given-names> </name> <name><surname>Behzadi</surname> <given-names>Mohammad hasan</given-names> </name> <name><surname>Rabieenia</surname> <given-names>Elham</given-names> </name> <name><surname>Shohaimi</surname> <given-names>Shamarina</given-names> </name> <name><surname>Mohammadi</surname> <given-names>Masoud</given-names> </name> <article-title>The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis</article-title> <source>Journal of Orthopaedic Surgery and Research</source> <year>2021</year> <month>10</month> <volume>16</volume> <issue>1</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1186/s13018-021-02772-0</object-id></element-citation></ref><ref id="cit3"><element-citation><name><surname>Zaigrova</surname> <given-names>N K.</given-names> </name> <name><surname>Uryasev</surname> <given-names>O M.</given-names> </name> <name><surname>Shakhanov</surname> <given-names>A V.</given-names> </name> <name><surname>Tverdova</surname> <given-names>L V.</given-names> </name> <article-title>POSSIBILITY OF FRAX TOOL IN THE DIAGNOSTICS OF OSTEOPOROSIS</article-title> <source>I.P.Pavlov Russian Medical Biological Herald</source> <year>2017</year> <month>06</month> <fpage>62</fpage> <lpage>68</lpage> <volume>25</volume> <issue>1</issue> <object-id pub-id-type="doi" specific-use="metadata">10.23888/pavlovj2017162-68</object-id></element-citation></ref><ref id="cit4"><mixed-citation publication-type="commun" publication-format="web"><name><surname>Verbovoi</surname> <given-names>A.F.</given-names></name>, <name><surname>Pashentseva</surname> <given-names>A.V.</given-names></name>, <name><surname>Sharonova</surname> <given-names>L.A.</given-names></name> <article-title>Osteoporoz: sovremennoe sostoyanie problemy</article-title> // <source>Terapevticheskii arkhiv.</source> — <year>2017</year>. — T. <volume>89</volume>. — №<month>5</month>. — S. <fpage>90</fpage>-<lpage>97</lpage>.</mixed-citation></ref><ref id="cit5"><element-citation><name><surname>Lesnyak</surname> <given-names>O. M.</given-names> </name> <name><surname>Baranova</surname> <given-names>I. A.</given-names> </name> <name><surname>Belova</surname> <given-names>K. Yu.</given-names> </name> <name><surname>Gladkova</surname> <given-names>E. N.</given-names> </name> <name><surname>Evstigneeva</surname> <given-names>L. P.</given-names> </name> <name><surname>Ershova</surname> <given-names>O. B.</given-names> </name> <name><surname>Karonova</surname> <given-names>T. L.</given-names> </name> <name><surname>Kochish</surname> <given-names>A. Yu.</given-names> </name> <name><surname>Nikitinskaya</surname> <given-names>O. A.</given-names> </name> <name><surname>Skripnikova</surname> <given-names>I. A.</given-names> </name> <name><surname>Toroptsova</surname> <given-names>N. V.</given-names> </name> <name><surname>Aramisova</surname> <given-names>R. M.</given-names> </name> <article-title>OSTEOPOROSIS IN RUSSIAN FEDERATION: EPIDEMIOLOGY, SOCIO-MEDICAL AND ECONOMICAL ASPECTS (REVIEW)</article-title> <source>Traumatology and Orthopedics of Russia</source> <year>2018</year> <month>04</month> <fpage>155</fpage> <lpage>168</lpage> <volume>24</volume> <issue>1</issue> <object-id pub-id-type="doi" specific-use="metadata">10.21823/2311-2905-2018-24-1-155-168</object-id></element-citation></ref><ref id="cit6"><mixed-citation publication-type="commun" publication-format="web"><name><surname>Foger-Samwald</surname> <given-names>U</given-names></name>, <name><surname>Dovjak</surname> <given-names>P</given-names></name>, <name><surname>Azizi-Semrad</surname> <given-names>U</given-names></name>, et al. <article-title>Osteoporosis: Pathophysiology and therapeutic options.</article-title> <source>EXCLI J.</source> <year>2020</year>;<issue>19</issue>:<fpage>1017</fpage>-<lpage>1037</lpage> doi: https://doi.org/<object-id pub-id-type="doi" specific-use="metadata">10.17179/excli2020-2591</object-id></mixed-citation></ref><ref id="cit7"><element-citation><name><surname>Mäkitie</surname> <given-names>Riikka E.</given-names> </name> <name><surname>Costantini</surname> <given-names>Alice</given-names> </name> <name><surname>Kämpe</surname> <given-names>Anders</given-names> </name> <name><surname>Alm</surname> <given-names>Jessica J.</given-names> </name> <name><surname>Mäkitie</surname> <given-names>Outi</given-names> </name> <article-title>New Insights Into Monogenic Causes of Osteoporosis</article-title> <source>Frontiers in Endocrinology</source> <year>2019</year> <month>02</month> <volume>10</volume> <object-id pub-id-type="doi" specific-use="metadata">10.3389/fendo.2019.00070</object-id></element-citation></ref><ref id="cit8"><element-citation><name><surname>Estrada</surname> <given-names>Karol</given-names> </name> <name><surname>Styrkarsdottir</surname> <given-names>Unnur</given-names> </name> <name><surname>Evangelou</surname> <given-names>Evangelos</given-names> </name> <name><surname>Hsu</surname> <given-names>Yi-Hsiang</given-names> </name> <name><surname>Duncan</surname> <given-names>Emma L</given-names> </name> <name><surname>Ntzani</surname> <given-names>Evangelia E</given-names> </name> <name><surname>Oei</surname> <given-names>Ling</given-names> </name> <name><surname>Albagha</surname> <given-names>Omar M E</given-names> </name> <name><surname>Amin</surname> <given-names>Najaf</given-names> </name> <name><surname>Kemp</surname> <given-names>John P</given-names> </name> <name><surname>Koller</surname> <given-names>Daniel L</given-names> </name> <name><surname>Li</surname> <given-names>Guo</given-names> </name> <name><surname>Liu</surname> <given-names>Ching-Ti</given-names> </name> <name><surname>Minster</surname> <given-names>Ryan L</given-names> </name> <name><surname>Moayyeri</surname> <given-names>Alireza</given-names> </name> <name><surname>Vandenput</surname> <given-names>Liesbeth</given-names> </name> <name><surname>Willner</surname> <given-names>Dana</given-names> </name> <name><surname>Xiao</surname> <given-names>Su-Mei</given-names> </name> <name><surname>Yerges-Armstrong</surname> <given-names>Laura M</given-names> </name> <name><surname>Zheng</surname> <given-names>Hou-Feng</given-names> </name> <name><surname>Alonso</surname> <given-names>Nerea</given-names> </name> <name><surname>Eriksson</surname> <given-names>Joel</given-names> </name> <name><surname>Kammerer</surname> <given-names>Candace M</given-names> </name> <name><surname>Kaptoge</surname> <given-names>Stephen K</given-names> </name> <name><surname>Leo</surname> <given-names>Paul J</given-names> </name> <name><surname>Thorleifsson</surname> <given-names>Gudmar</given-names> </name> <name><surname>Wilson</surname> <given-names>Scott G</given-names> </name> <name><surname>Wilson</surname> <given-names>James F</given-names> </name> <name><surname>Aalto</surname> <given-names>Ville</given-names> </name> <name><surname>Alen</surname> <given-names>Markku</given-names> </name> <name><surname>Aragaki</surname> <given-names>Aaron K</given-names> </name> <name><surname>Aspelund</surname> <given-names>Thor</given-names> </name> <name><surname>Center</surname> <given-names>Jacqueline R</given-names> </name> <name><surname>Dailiana</surname> <given-names>Zoe</given-names> </name> <name><surname>Duggan</surname> <given-names>David J</given-names> </name> <name><surname>Garcia</surname> <given-names>Melissa</given-names> </name> <name><surname>Garcia-Giralt</surname> <given-names>Natàlia</given-names> </name> <name><surname>Giroux</surname> <given-names>Sylvie</given-names> </name> <name><surname>Hallmans</surname> <given-names>Göran</given-names> </name> <name><surname>Hocking</surname> <given-names>Lynne J</given-names> </name> <name><surname>Husted</surname> <given-names>Lise Bjerre</given-names> </name> <name><surname>Jameson</surname> <given-names>Karen A</given-names> </name> <name><surname>Khusainova</surname> <given-names>Rita</given-names> </name> <name><surname>Kim</surname> <given-names>Ghi Su</given-names> </name> <name><surname>Kooperberg</surname> <given-names>Charles</given-names> </name> <name><surname>Koromila</surname> <given-names>Theodora</given-names> </name> <name><surname>Kruk</surname> <given-names>Marcin</given-names> </name> <name><surname>Laaksonen</surname> <given-names>Marika</given-names> </name> <name><surname>Lacroix</surname> <given-names>Andrea Z</given-names> </name> <name><surname>Lee</surname> <given-names>Seung Hun</given-names> </name> <name><surname>Leung</surname> <given-names>Ping C</given-names> </name> <name><surname>Lewis</surname> <given-names>Joshua R</given-names> </name> <name><surname>Masi</surname> <given-names>Laura</given-names> </name> <name><surname>Mencej-Bedrac</surname> <given-names>Simona</given-names> </name> <name><surname>Nguyen</surname> <given-names>Tuan V</given-names> </name> <name><surname>Nogues</surname> <given-names>Xavier</given-names> </name> <name><surname>Patel</surname> <given-names>Millan S</given-names> </name> <name><surname>Prezelj</surname> <given-names>Janez</given-names> </name> <name><surname>Rose</surname> <given-names>Lynda M</given-names> </name> <name><surname>Scollen</surname> <given-names>Serena</given-names> </name> <name><surname>Siggeirsdottir</surname> <given-names>Kristin</given-names> </name> <name><surname>Smith</surname> <given-names>Albert V</given-names> </name> <name><surname>Svensson</surname> <given-names>Olle</given-names> </name> <name><surname>Trompet</surname> <given-names>Stella</given-names> </name> <name><surname>Trummer</surname> <given-names>Olivia</given-names> </name> <name><surname>van Schoor</surname> <given-names>Natasja M</given-names> </name> <name><surname>Woo</surname> <given-names>Jean</given-names> </name> <name><surname>Zhu</surname> <given-names>Kun</given-names> </name> <name><surname>Balcells</surname> <given-names>Susana</given-names> </name> <name><surname>Brandi</surname> <given-names>Maria Luisa</given-names> </name> <name><surname>Buckley</surname> <given-names>Brendan M</given-names> </name> <name><surname>Cheng</surname> <given-names>Sulin</given-names> </name> <name><surname>Christiansen</surname> <given-names>Claus</given-names> </name> <name><surname>Cooper</surname> <given-names>Cyrus</given-names> </name> <name><surname>Dedoussis</surname> <given-names>George</given-names> </name> <name><surname>Ford</surname> <given-names>Ian</given-names> </name> <name><surname>Frost</surname> <given-names>Morten</given-names> </name> <name><surname>Goltzman</surname> <given-names>David</given-names> </name> <name><surname>González-Macías</surname> <given-names>Jesús</given-names> </name> <name><surname>Kähönen</surname> <given-names>Mika</given-names> </name> <name><surname>Karlsson</surname> <given-names>Magnus</given-names> </name> <name><surname>Khusnutdinova</surname> <given-names>Elza</given-names> </name> <name><surname>Koh</surname> <given-names>Jung-Min</given-names> </name> <name><surname>Kollia</surname> <given-names>Panagoula</given-names> </name> <name><surname>Langdahl</surname> <given-names>Bente Lomholt</given-names> </name> <name><surname>Leslie</surname> <given-names>William D</given-names> </name> <name><surname>Lips</surname> <given-names>Paul</given-names> </name> <name><surname>Ljunggren</surname> <given-names>Östen</given-names> </name> <name><surname>Lorenc</surname> <given-names>Roman S</given-names> </name> <name><surname>Marc</surname> <given-names>Janja</given-names> </name> <name><surname>Mellström</surname> <given-names>Dan</given-names> </name> <name><surname>Obermayer-Pietsch</surname> <given-names>Barbara</given-names> </name> <name><surname>Olmos</surname> <given-names>José M</given-names> </name> <name><surname>Pettersson-Kymmer</surname> <given-names>Ulrika</given-names> </name> <name><surname>Reid</surname> <given-names>David M</given-names> </name> <name><surname>Riancho</surname> <given-names>José A</given-names> </name> <name><surname>Ridker</surname> <given-names>Paul M</given-names> </name> <name><surname>Rousseau</surname> <given-names>François</given-names> </name> <name><surname>lagboom</surname> <given-names>P Eline S</given-names> </name> <name><surname>Tang</surname> <given-names>Nelson L S</given-names> </name> <name><surname>Urreizti</surname> <given-names>Roser</given-names> </name> <name><surname>Van Hul</surname> <given-names>Wim</given-names> </name> <name><surname>Viikari</surname> <given-names>Jorma</given-names> </name> <name><surname>Zarrabeitia</surname> <given-names>María T</given-names> </name> <name><surname>Aulchenko</surname> <given-names>Yurii S</given-names> </name> <name><surname>Castano-Betancourt</surname> <given-names>Martha</given-names> </name> <name><surname>Grundberg</surname> <given-names>Elin</given-names> </name> <name><surname>Herrera</surname> <given-names>Lizbeth</given-names> </name> <name><surname>Ingvarsson</surname> <given-names>Thorvaldur</given-names> </name> <name><surname>Johannsdottir</surname> <given-names>Hrefna</given-names> </name> <name><surname>Kwan</surname> <given-names>Tony</given-names> </name> <name><surname>Li</surname> <given-names>Rui</given-names> </name> <name><surname>Luben</surname> <given-names>Robert</given-names> </name> <name><surname>Medina-Gómez</surname> <given-names>Carolina</given-names> </name> <name><surname>Th Palsson</surname> <given-names>Stefan</given-names> </name> <name><surname>Reppe</surname> <given-names>Sjur</given-names> </name> <name><surname>Rotter</surname> <given-names>Jerome I</given-names> </name> <name><surname>Sigurdsson</surname> <given-names>Gunnar</given-names> </name> <name><surname>van Meurs</surname> <given-names>Joyce B J</given-names> </name> <name><surname>Verlaan</surname> <given-names>Dominique</given-names> </name> <name><surname>Williams</surname> <given-names>Frances M K</given-names> </name> <name><surname>Wood</surname> <given-names>Andrew R</given-names> </name> <name><surname>Zhou</surname> <given-names>Yanhua</given-names> </name> <name><surname>Gautvik</surname> <given-names>Kaare M</given-names> </name> <name><surname>Pastinen</surname> <given-names>Tomi</given-names> </name> <name><surname>Raychaudhuri</surname> <given-names>Soumya</given-names> </name> <name><surname>Cauley</surname> <given-names>Jane A</given-names> </name> <name><surname>Chasman</surname> <given-names>Daniel I</given-names> </name> <name><surname>Clark</surname> <given-names>Graeme R</given-names> </name> <name><surname>Cummings</surname> <given-names>Steven R</given-names> </name> <name><surname>Danoy</surname> <given-names>Patrick</given-names> </name> <name><surname>Dennison</surname> <given-names>Elaine M</given-names> </name> <name><surname>Eastell</surname> <given-names>Richard</given-names> </name> <name><surname>Eisman</surname> <given-names>John A</given-names> </name> <name><surname>Gudnason</surname> <given-names>Vilmundur</given-names> </name> <name><surname>Hofman</surname> <given-names>Albert</given-names> </name> <name><surname>Jackson</surname> <given-names>Rebecca D</given-names> </name> <name><surname>Jones</surname> <given-names>Graeme</given-names> </name> <name><surname>Jukema</surname> <given-names>J Wouter</given-names> </name> <name><surname>Khaw</surname> <given-names>Kay-Tee</given-names> </name> <name><surname>Lehtimäki</surname> <given-names>Terho</given-names> </name> <name><surname>Liu</surname> <given-names>Yongmei</given-names> </name> <name><surname>Lorentzon</surname> <given-names>Mattias</given-names> </name> <name><surname>McCloskey</surname> <given-names>Eugene</given-names> </name> <name><surname>Mitchell</surname> <given-names>Braxton D</given-names> </name> <name><surname>Nandakumar</surname> <given-names>Kannabiran</given-names> </name> <name><surname>Nicholson</surname> <given-names>Geoffrey C</given-names> </name> <name><surname>Oostra</surname> <given-names>Ben A</given-names> </name> <name><surname>Peacock</surname> <given-names>Munro</given-names> </name> <name><surname>Pols</surname> <given-names>Huibert A P</given-names> </name> <name><surname>Prince</surname> <given-names>Richard L</given-names> </name> <name><surname>Raitakari</surname> <given-names>Olli</given-names> </name> <name><surname>Reid</surname> <given-names>Ian R</given-names> </name> <name><surname>Robbins</surname> <given-names>John</given-names> </name> <name><surname>Sambrook</surname> <given-names>Philip N</given-names> </name> <name><surname>Sham</surname> <given-names>Pak Chung</given-names> </name> <name><surname>Shuldiner</surname> <given-names>Alan R</given-names> </name> <name><surname>Tylavsky</surname> <given-names>Frances A</given-names> </name> <name><surname>van Duijn</surname> <given-names>Cornelia M</given-names> </name> <name><surname>Wareham</surname> <given-names>Nick J</given-names> </name> <name><surname>Cupples</surname> <given-names>L Adrienne</given-names> </name> <name><surname>Econs</surname> <given-names>Michael J</given-names> </name> <name><surname>Evans</surname> <given-names>David M</given-names> </name> <name><surname>Harris</surname> <given-names>Tamara B</given-names> </name> <name><surname>Kung</surname> <given-names>Annie Wai Chee</given-names> </name> <name><surname>Psaty</surname> <given-names>Bruce M</given-names> </name> <name><surname>Reeve</surname> <given-names>Jonathan</given-names> </name> <name><surname>Spector</surname> <given-names>Timothy D</given-names> </name> <name><surname>Streeten</surname> <given-names>Elizabeth A</given-names> </name> <name><surname>Zillikens</surname> <given-names>M Carola</given-names> </name> <name><surname>Thorsteinsdottir</surname> <given-names>Unnur</given-names> </name> <name><surname>Ohlsson</surname> <given-names>Claes</given-names> </name> <name><surname>Karasik</surname> <given-names>David</given-names> </name> <name><surname>Richards</surname> <given-names>J Brent</given-names> </name> <name><surname>Brown</surname> <given-names>Matthew A</given-names> </name> <name><surname>Stefansson</surname> <given-names>Kari</given-names> </name> <name><surname>Uitterlinden</surname> <given-names>André G</given-names> </name> <name><surname>Ralston</surname> <given-names>Stuart H</given-names> </name> <name><surname>Ioannidis</surname> <given-names>John P A</given-names> </name> <name><surname>Kiel</surname> <given-names>Douglas P</given-names> </name> <name><surname>Rivadeneira</surname> <given-names>Fernando</given-names> </name> <article-title>Genome-wide meta-analysis identifies 56 bone mineral density loci and reveals 14 loci associated with risk of fracture</article-title> <source>Nature Genetics</source> <year>2012</year> <month>04</month> <fpage>491</fpage> <lpage>501</lpage> <volume>44</volume> <issue>5</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1038/ng.2249</object-id></element-citation></ref><ref id="cit9"><element-citation><name><surname>Howard</surname> <given-names>Gabrielle M.</given-names> </name> <name><surname>Nguyen</surname> <given-names>Tuan V.</given-names> </name> <name><surname>Harris</surname> <given-names>Mark</given-names> </name> <name><surname>Kelly</surname> <given-names>Paul J.</given-names> </name> <name><surname>Eisman</surname> <given-names>John A.</given-names> </name> <article-title>Genetic and Environmental Contributions to the Association Between Quantitative Ultrasound and Bone Mineral Density Measurements: A Twin Study</article-title> <source>Journal of Bone and Mineral Research</source> <year>2006</year> <month>04</month> <fpage>1318</fpage> <lpage>1327</lpage> <volume>13</volume> <issue>8</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1359/jbmr.1998.13.8.1318</object-id></element-citation></ref><ref id="cit10"><element-citation> <article-title>Twenty bone-mineral-density loci identified by large-scale meta-analysis of genome-wide association studies</article-title> <source>Nature Genetics</source> <year>2009</year> <month>10</month> <fpage>1199</fpage> <lpage>1206</lpage> <volume>41</volume> <issue>11</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1038/ng.446</object-id></element-citation></ref><ref id="cit11"><element-citation><name><surname>Yalaev</surname> <given-names>Bulat</given-names> </name> <name><surname>Tyurin</surname> <given-names>Anton</given-names> </name> <name><surname>Prokopenko</surname> <given-names>Inga</given-names> </name> <name><surname>Karunas</surname> <given-names>Aleksandra</given-names> </name> <name><surname>Khusnutdinova</surname> <given-names>Elza</given-names> </name> <name><surname>Khusainova</surname> <given-names>Rita</given-names> </name> <article-title>Using a Polygenic Score to Predict the Risk of Developing Primary Osteoporosis</article-title> <source>International Journal of Molecular Sciences</source> <year>2022</year> <month>09</month> <fpage>10021</fpage> <volume>23</volume> <issue>17</issue> <object-id pub-id-type="doi" specific-use="metadata">10.3390/ijms231710021</object-id></element-citation></ref><ref id="cit12"><element-citation><name><surname>Ferizi</surname> <given-names>Uran</given-names> </name> <name><surname>Honig</surname> <given-names>Stephen</given-names> </name> <name><surname>Chang</surname> <given-names>Gregory</given-names> </name> <article-title>Artificial intelligence, osteoporosis and fragility fractures</article-title> <source>Current Opinion in Rheumatology</source> <year>2019</year> <month>05</month> <fpage>368</fpage> <lpage>375</lpage> <volume>31</volume> <issue>4</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1097/bor.0000000000000607</object-id></element-citation></ref><ref id="cit13"><mixed-citation publication-type="commun" publication-format="web"><name><surname>Kanis</surname> <given-names>JA</given-names></name> on behalf of the World Health Organization Scientific Group (World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK). <article-title>Assessment of osteoporosis at the primary health-care level. Technical Report.</article-title> <year>2007</year>. <source>World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield</source></mixed-citation></ref><ref id="cit14"><element-citation><name><surname>Kanis</surname> <given-names>John A.</given-names> </name> <name><surname>McCloskey</surname> <given-names>Eugene V.</given-names> </name> <name><surname>Johansson</surname> <given-names>Helena</given-names> </name> <name><surname>Oden</surname> <given-names>Anders</given-names> </name> <name><surname>Melton</surname> <given-names>L. Joseph</given-names> </name> <name><surname>Khaltaev</surname> <given-names>Nikolai</given-names> </name> <article-title>A reference standard for the description of osteoporosis</article-title> <source>Bone</source> <year>2007</year> <month>11</month> <fpage>467</fpage> <lpage>475</lpage> <volume>42</volume> <issue>3</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1016/j.bone.2007.11.001</object-id></element-citation></ref><ref id="cit15"><element-citation><name><surname>Ho-Le</surname> <given-names>Thao P.</given-names> </name> <name><surname>Center</surname> <given-names>Jacqueline R.</given-names> </name> <name><surname>Eisman</surname> <given-names>John A.</given-names> </name> <name><surname>Nguyen</surname> <given-names>Tuan V.</given-names> </name> <name><surname>Nguyen</surname> <given-names>Hung T.</given-names> </name> <article-title>Prediction of hip fracture in post-menopausal women using artificial neural network approach</article-title> <source>2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)</source> <year>2017</year> <month>09</month> <fpage>4207</fpage> <lpage>4210</lpage> <object-id pub-id-type="doi" specific-use="metadata">10.1109/embc.2017.8037784</object-id></element-citation></ref><ref id="cit16"><element-citation><name><surname>Ferizi</surname> <given-names>Uran</given-names> </name> <name><surname>Besser</surname> <given-names>Harrison</given-names> </name> <name><surname>Hysi</surname> <given-names>Pirro</given-names> </name> <name><surname>Jacobs</surname> <given-names>Joseph</given-names> </name> <name><surname>Rajapakse</surname> <given-names>Chamith S.</given-names> </name> <name><surname>Chen</surname> <given-names>Cheng</given-names> </name> <name><surname>Saha</surname> <given-names>Punam K.</given-names> </name> <name><surname>Honig</surname> <given-names>Stephen</given-names> </name> <name><surname>Chang</surname> <given-names>Gregory</given-names> </name> <article-title>Artificial Intelligence Applied to Osteoporosis: A Performance Comparison of Machine Learning Algorithms in Predicting Fragility Fractures From MRI Data</article-title> <source>Journal of Magnetic Resonance Imaging</source> <year>2018</year> <month>09</month> <fpage>1029</fpage> <lpage>1038</lpage> <volume>49</volume> <issue>4</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1002/jmri.26280</object-id></element-citation></ref><ref id="cit17"><element-citation><name><surname>Wu</surname> <given-names>Qing</given-names> </name> <name><surname>Nasoz</surname> <given-names>Fatma</given-names> </name> <name><surname>Jung</surname> <given-names>Jongyun</given-names> </name> <name><surname>Bhattarai</surname> <given-names>Bibek</given-names> </name> <name><surname>Han</surname> <given-names>Mira V.</given-names> </name> <name><surname>Greenes</surname> <given-names>Robert A.</given-names> </name> <name><surname>Saag</surname> <given-names>Kenneth G.</given-names> </name> <article-title>Machine learning approaches for the prediction of bone mineral density by using genomic and phenotypic data of 5130 older men</article-title> <source>Scientific Reports</source> <year>2021</year> <month>02</month> <volume>11</volume> <issue>1</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1038/s41598-021-83828-3</object-id></element-citation></ref><ref id="cit18"><element-citation><name><surname>Lewis</surname> <given-names>Cathryn M.</given-names> </name> <name><surname>Vassos</surname> <given-names>Evangelos</given-names> </name> <article-title>Polygenic risk scores: from research tools to clinical instruments</article-title> <source>Genome Medicine</source> <year>2020</year> <month>05</month> <volume>12</volume> <issue>1</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1186/s13073-020-00742-5</object-id></element-citation></ref><ref id="cit19"><element-citation><name><surname>Choi</surname> <given-names>Shing Wan</given-names> </name> <name><surname>Mak</surname> <given-names>Timothy Shin-Heng</given-names> </name> <name><surname>O’Reilly</surname> <given-names>Paul F.</given-names> </name> <article-title>Tutorial: a guide to performing polygenic risk score analyses</article-title> <source>Nature Protocols</source> <year>2020</year> <month>07</month> <fpage>2759</fpage> <lpage>2772</lpage> <volume>15</volume> <issue>9</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1038/s41596-020-0353-1</object-id></element-citation></ref><ref id="cit20"><element-citation><name><surname>Chen</surname> <given-names>Xinlei</given-names> </name> <name><surname>Liu</surname> <given-names>Guangping</given-names> </name> <name><surname>Wang</surname> <given-names>Shuxiang</given-names> </name> <name><surname>Zhang</surname> <given-names>Haiyang</given-names> </name> <name><surname>Xue</surname> <given-names>Peng</given-names> </name> <article-title>Machine learning analysis of gene expression profile reveals a novel diagnostic signature for osteoporosis</article-title> <source>Journal of Orthopaedic Surgery and Research</source> <year>2021</year> <month>03</month> <volume>16</volume> <issue>1</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1186/s13018-021-02329-1</object-id></element-citation></ref><ref id="cit21"><element-citation><name><surname>Kruse</surname> <given-names>Christian</given-names> </name> <name><surname>Eiken</surname> <given-names>Pia</given-names> </name> <name><surname>Vestergaard</surname> <given-names>Peter</given-names> </name> <article-title>Machine Learning Principles Can Improve Hip Fracture Prediction</article-title> <source>Calcified Tissue International</source> <year>2017</year> <month>02</month> <fpage>348</fpage> <lpage>360</lpage> <volume>100</volume> <issue>4</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1007/s00223-017-0238-7</object-id></element-citation></ref><ref id="cit22"><element-citation><name><surname>Rahim</surname> <given-names>Fakher</given-names> </name> <name><surname>Zaki Zadeh</surname> <given-names>Amin</given-names> </name> <name><surname>Javanmardi</surname> <given-names>Pouya</given-names> </name> <name><surname>Emmanuel Komolafe</surname> <given-names>Temitope</given-names> </name> <name><surname>Khalafi</surname> <given-names>Mohammad</given-names> </name> <name><surname>Arjomandi</surname> <given-names>Ali</given-names> </name> <name><surname>Ghofrani</surname> <given-names>Haniye Alsadat</given-names> </name> <name><surname>Shirbandi</surname> <given-names>Kiarash</given-names> </name> <article-title>Machine learning algorithms for diagnosis of hip bone osteoporosis: a systematic review and meta-analysis study</article-title> <source>BioMedical Engineering OnLine</source> <year>2023</year> <month>07</month> <volume>22</volume> <issue>1</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1186/s12938-023-01132-9</object-id></element-citation></ref><ref id="cit23"><element-citation><name><surname>Hsieh</surname> <given-names>Chung-Ho</given-names> </name> <name><surname>Lu</surname> <given-names>Ruey-Hwa</given-names> </name> <name><surname>Lee</surname> <given-names>Nai-Hsin</given-names> </name> <name><surname>Chiu</surname> <given-names>Wen-Ta</given-names> </name> <name><surname>Hsu</surname> <given-names>Min-Huei</given-names> </name> <name><surname>Li</surname> <given-names>Yu-Chuan (Jack)</given-names> </name> <article-title>Novel solutions for an old disease: Diagnosis of acute appendicitis with random forest, support vector machines, and artificial neural networks</article-title> <source>Surgery</source> <year>2010</year> <month>05</month> <fpage>87</fpage> <lpage>93</lpage> <volume>149</volume> <issue>1</issue> <object-id pub-id-type="doi" specific-use="metadata">10.1016/j.surg.2010.03.023</object-id></element-citation></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
