Determinants of forearm strength in postmenopausal women

Melton, L. Joseph; Riggs, B. Lawrence; Müller, Ralph; Achenbach, Sara J.; Christen, D. K.; Atkinson, Elizabeth J.; Amin, Shreyasee; Khosla, Sundeep

doi:10.1007/s00198-011-1540-2

Cited by 6 publications

(3 citation statements)

References 41 publications

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“…We found that total cross‐sectional area, trabecular vBMD, and cortical thickness were the strongest HR‐pQCT‐derived predictors of failure load at both the radius and tibia, with cortical porosity also associated with failure load at the tibia. These HR‐pQCT‐derived predictors of bone strength are similar to those identified in other populations including healthy postmenopausal women, young female athletes, and non‐athletes . Importantly, the predictors of failure load at the radius and tibia were the same in African‐American and white women.…”

Section: Discussionsupporting

confidence: 72%

Differences in skeletal microarchitecture and strength in African-American and white women

Putman

Lee

et al. 2013

Journal of Bone and Mineral Research

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African-American women have a lower risk of fracture than Caucasian women, and this difference is only partially explained by differences in DXA areal bone mineral density (aBMD). Little is known about racial differences in skeletal microarchitecture and the consequences for bone strength. To evaluate potential factors underlying this racial difference in fracture rates, we used high-resolution peripheral quantitative computed tomography (HR-pQCT) to assess cortical and trabecular bone microarchitecture and estimate bone strength using micro-finite element analysis in African-American (n=100) and Caucasian (n=173) women participating in the Study of Women's Health Across the Nation (SWAN). African-American women had larger and denser bones than Caucasians, with greater total area, aBMD, and total volumetric BMD (vBMD) at the radius and tibia metaphysis (p<0.05 for all). African-Americans had greater trabecular vBMD at the radius, but higher cortical vBMD at the tibia. Cortical microarchitecture tended to show the most pronounced racial differences, with higher cortical area, thickness, and volumes in African-Americans at both skeletal sites (p<0.05 for all), and lower cortical porosity in African-Americans at the tibia (p<0.05). African-American women also had greater estimated bone stiffness and failure load at both the radius and tibia. Differences in skeletal microarchitecture and estimated stiffness and failure load persisted even after adjustment for DXA aBMD. The densitometric and microarchitectural predictors of failure load at the radius and tibia were the same in African-American and Caucasian women. In conclusion, differences in bone microarchitecture and density contribute to greater estimated bone strength in African-Americans and probably explain, at least in part, the lower fracture risk of African-American women.

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Section: Discussionsupporting

confidence: 72%

Differences in skeletal microarchitecture and strength in African-American and white women

Putman

Lee

et al. 2013

Journal of Bone and Mineral Research

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“…Data from FEA of HR-pQCT have been reported in studies of postmenopausal women, but these data are not available for young female athletes with amenorrhea compared with EA and non-athletes [18]. Additionally, the contribution of cortical parameters and porosity to strength parameters in this population is not known.…”

Section: Introductionmentioning

confidence: 99%

Cortical microstructure and estimated bone strength in young amenorrheic athletes, eumenorrheic athletes and non-athletes

Ackerman

Putman

Guereca

et al. 2012

Bone

118

102

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CONTEXT Lower bone density in young amenorrheic athletes (AA) compared to eumenorrheic athletes (EA) and non-athletes may increase fracture risk during a critical time of bone accrual. Finite element analysis (FEA) is a unique tool to estimate bone strength in vivo, and the contribution of cortical microstructure to bone strength in young athletes is not well understood. OBJECTIVE We hypothesized that FEA-estimated stiffness and failure load are impaired in AA at the distal radius and tibia compared to EA and non-athletes despite weight-bearing exercise. DESIGN AND SETTING Cross-sectional study; Clinical Research Center SUBJECTS 34 female endurance athletes involved in weight-bearing sports (17 AA, 17 EA) and 16 non-athletes (14-21y) of comparable age, maturity and BMI OUTCOME MEASURES We used HR-pQCT images to assess cortical microarchitecture and FEA to estimate bone stiffness and failure load. RESULTS Cortical perimeter, porosity and trabecular area at the weight-bearing tibia were greater in both groups of athletes than non-athletes, whereas the ratio (%) of cortical to total area was lowest in AA. Despite greater cortical porosity in EA, estimated tibial stiffness and failure load was higher than in non-athletes. However, this advantage was lost in AA. At the non-weight-bearing radius, failure load and stiffness were lower in AA than non-athletes. After controlling for lean mass and menarchal age, athletic status accounted for 5-9% of the variability in stiffness and failure load, menarchal age for 8-23%, and lean mass for 12-37%. CONCLUSION AA have lower FEA-estimated bone strength at the distal radius than non-athletes, and lose the advantage of weight-bearing exercise seen in EA at the distal tibia.

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“…A small study of 72 obese men with metabolic syndrome showed that men with estradiol below the median (43 pmol/L) had lower trabecular number, greater trabecular separation and lower bone volume fraction than men with higher estradiol levels but these comparisons were unadjusted for body weight (41) . A study of postmenopausal women reported positive associations between estradiol and trabecular vBMD, cortical area and estimated strength of the ultra-distal forearm but these associations were not significant in the MV model (42) . Bioavailable testosterone was also related to cortical area in the univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Accelerated Bone Loss in Older Men: Effects on Bone Microarchitecture and Strength

Cauley

Burghardt

Harrison

et al. 2018

Journal of Bone and Mineral Research

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Accelerated bone loss (ABL) shown on routine dual-energy X-ray absorptiometry (DXA) may be accompanied by microarchitectural changes, increased cortical porosity, and lower bone strength. To test this hypothesis, we performed a cross-sectional study and used high-resolution peripheral quantitative computed tomography (HR-pQCT) scans (Scanco Medical AG, Brüttisellen, Switzerland) to measure estimated bone strength and microarchitecture in the distal radius and distal and diaphyseal tibia. We studied 1628 men who attended the year 14 exam of the Osteoporotic Fractures in Men (MrOS) study. We retrospectively characterized areal bone mineral density (aBMD) change from the year 7 to year 14 exam in three categories: "accelerated" loss, ≥10% loss at either the total hip or femoral neck (n = 299, 18.4%); "expected" loss, <10% (n = 1061, 65.2%), and "maintained" BMD, ≥0% (n = 268, 16.5%). The ABL cut-off was a safety alert established for MrOS. We used regression models to calculate adjusted mean HR-pQCT parameters in men with ABL, expected loss, or maintained BMD. Men who experienced ABL were older and had a lower body mass index and aBMD and experienced greater weight loss compared with other men. Total volumetric BMD and trabecular and cortical volumetric BMD were lower in men with ABL compared with the expected or maintained group. Men with ABL had significantly lower trabecular bone volume fraction (BV/TV), fewer trabeculae, and greater trabecular separation at both the distal radius and tibia than men with expected loss or who maintained aBMD, all p trend <0.001. Men with ABL had lower cortical thickness and lower estimated bone strength, but there was no difference in cortical porosity except at the tibia diaphyseal site. In summary, men with ABL have lower estimated bone strength, poorer trabecular microarchitecture, and thinner cortices than men without ABL but have similar cortical porosity. These impairments may lead to an increased risk of fracture. © 2018 American Society for Bone and Mineral Research.

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Determinants of forearm strength in postmenopausal women

Cited by 6 publications

References 41 publications

Differences in skeletal microarchitecture and strength in African-American and white women

Differences in skeletal microarchitecture and strength in African-American and white women

Cortical microstructure and estimated bone strength in young amenorrheic athletes, eumenorrheic athletes and non-athletes

Accelerated Bone Loss in Older Men: Effects on Bone Microarchitecture and Strength

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