Bone Microarchitecture and Estimated Strength in 499 Adult Danish Women and Men: A Cross-Sectional, Population-Based High-Resolution Peripheral Quantitative Computed Tomographic Study on Peak Bone Structure

Abstract

High-resolution peripheral quantitative computed tomography (HR-pQCT) allows in vivo assessment of cortical and trabecular bone mineral density (BMD), geometry, and microarchitecture at the distal radius and tibia in unprecedented detail. In this cross-sectional study, we provide normative and descriptive HR-pQCT data from a large population-based sample of Danish Caucasian women and men (n = 499) aged 20-80 years. In young adults (<35 years), women (n = 100) compared to men (n = 64) had smaller total and cortical areas, inferior metric trabecular indices, higher network inhomogeneity, lower cortical porosity, and lower finite element estimated bone strength. The changes in parameters with age were estimated from multiple regression analyses. In men, with age the greatest changes (from parameter minimum or maximum) until 80 years were found for cortical porosity (1.91 IQR), BV/TV (-1.09 IQR), and trabecular thickness (-0.87 IQR) in the radius and BV/TV (-1.55 IQR), cortical BMD (-1.25 IQR), and cortical porosity (1.25 IQR) in the tibia. In women changes were most pronounced for cortical porosity (4.76 IQR), trabecular inhomogeneity (3.84 IQR), and cortical BMD (-2.86 IQR) in the radius and cortical BMD (-5.06 IQR), cortical porosity (3.86 IQR), and cortical area (-1.64 IQR) in the tibia. These findings emphasize the age- and sex-related differences in bone morphology, with men having a structural advantage over women from early adult life translating into superior indices of bone strength. With age women are further disadvantaged compared to men by greater decrements in cortical and trabecular architecture in the radius and cortical architecture in the tibia.

Bone turnover predicts change in volumetric bone density and bone geometry at the radius in men

“…A number of cross-sectional studies have looked at the influence of age on pQCT parameters in men [10–17]. In a cross-sectional study of 202 men aged 20–99 years and using a high-resolution pQCT, trabecular area/height at the radius increased with age by 28 %, while other parameters decreased with increasing age, including trabecular BMD (−32 %), trabecular thickness (−16 %), cortical area/height (−5 %), cortical BMD ( −15 %) and cortical thickness (−21 %) [11].…”

“…Peripheral quantitative computed tomography (pQCT) allows assessment of both bone geometry and volumetric BMD (vBMD). Data from cross-sectional studies, including data from the European Male Ageing Study (EMAS), suggest variously a lower distal radius vBMD and bone mineral content (BMC), thinner cortices and greater cross-sectional bone area with increasing age [10–17]. However, there are limitations to estimating true longitudinal change in bone parameters from cross-sectional data.…”

Compromised cortical bone compartment in type 2 diabetes mellitus patients with microvascular disease

“…Fifty-one patients who satisfied the inclusion/exclusion criteria were recruited to the study and matched for age, sex and height with 51 healthy controls who were recruited from a previous population-based study (18) aiming to establish HR-pQCT reference data (and are Total T2D patients in FDDB* (n=1470) Assessed for eligibility (every 5th)…”

Asymptomatic parental mosaicism for osteogenesis imperfecta associated with a new splice site mutation in COL1A2

“…Standard HR‐pQCT of the radius and tibia (Table 2) revealed normal geometry, volumetric bone mineral density, and microarchitecture, and most parameters do not differ significantly from age‐ and gender‐matched normal material 18. Again, no significant differences between the two sides were found.…”