Abnormal microarchitecture and reduced stiffness at the radius and tibia in postmenopausal women with fractures. Academic Article uri icon

Overview

abstract

  • Measurement of areal bone mineral density (aBMD) by dual-energy x-ray absorptiometry (DXA) has been shown to predict fracture risk. High-resolution peripheral quantitative computed tomography (HR-pQCT) yields additional information about volumetric BMD (vBMD), microarchitecture, and strength that may increase understanding of fracture susceptibility. Women with (n = 68) and without (n = 101) a history of postmenopausal fragility fracture had aBMD measured by DXA and trabecular and cortical vBMD and trabecular microarchitecture of the radius and tibia measured by HR-pQCT. Finite-element analysis (FEA) of HR-pQCT scans was performed to estimate bone stiffness. DXA T-scores were similar in women with and without fracture at the spine, hip, and one-third radius but lower in patients with fracture at the ultradistal radius (p < .01). At the radius fracture, patients had lower total density, cortical thickness, trabecular density, number, thickness, higher trabecular separation and network heterogeneity (p < .0001 to .04). At the tibia, total, cortical, and trabecular density and cortical and trabecular thickness were lower in fracture patients (p < .0001 to .03). The differences between groups were greater at the radius than at the tibia for inner trabecular density, number, trabecular separation, and network heterogeneity (p < .01 to .05). Stiffness was reduced in fracture patients, more markedly at the radius (41% to 44%) than at the tibia (15% to 20%). Women with fractures had reduced vBMD, microarchitectural deterioration, and decreased strength. These differences were more prominent at the radius than at the tibia. HR-pQCT and FEA measurements of peripheral sites are associated with fracture prevalence and may increase understanding of the role of microarchitectural deterioration in fracture susceptibility. © 2010 American Society for Bone and Mineral Research.

authors

  • Stein, Emily
  • Liu, X Sherry
  • Nickolas, Thomas L
  • Cohen, Adi
  • Thomas, Valerie
  • McMahon, Donald J
  • Zhang, Chiyuan
  • Yin, Perry T
  • Cosman, Felicia
  • Nieves, Jeri
  • Guo, X Edward
  • Shane, Elizabeth

publication date

  • June 18, 2010

Research

keywords

  • Fractures, Bone
  • Postmenopause
  • Radius
  • Tibia

Identity

PubMed Central ID

  • PMC3149820

Scopus Document Identifier

  • 78649625265

Digital Object Identifier (DOI)

  • 10.1002/jbmr.152

PubMed ID

  • 20564238

Additional Document Info

volume

  • 25

issue

  • 12