Self-perceived Fracture Risk in the Global Longitudinal Study of Osteoporosis in Women: Its Correlates and Relationship with Bone Microarchitecture

Litwic, Anna; Westbury, Leo; Carter, S.; Ward, Kate; Cooper, Cyrus; Dennison, Elaine

doi:10.1007/s00223-020-00680-9

Cited by 12 publications

(20 citation statements)

References 18 publications

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“…Roles of trabecular bone micro-structure in determining bone strength and fracture-risk have been convincingly established in histologic studies (Parfitt et al 1983, Kleerekoper et al 1985, Moore et al 1992, Legrand et al 2000, Sornay-Rendu et al 2017, Litwic et al 2020.…”

Section: Introductionmentioning

confidence: 98%

A comparative study of trabecular bone micro-structural measurements using different CT modalities

Guha¹,

Klintström²,

Klintström³

et al. 2020

Phys. Med. Biol.

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Osteoporosis, characterized by reduced bone mineral density and micro-architectural degeneration, significantly enhances fracture-risk. There are several viable methods for trabecular bone micro-imaging, which widely vary in terms of technology, reconstruction principle, spatial resolution, and acquisition time. We have performed an excised cadaveric bone specimen study to evaluate different CT-imaging modalities for trabecular bone microstructural analysis. Excised cadaveric bone specimens from the distal radius were scanned using micro-CT and four in vivo CT imaging modalities: HR-pQCT, dental CBCT, wholebody MDCT, and extremity CBCT. A new algorithm was developed to optimize soft thresholding parameters for individual in vivo CT modalities for computing quantitative bone volume fraction maps. Finally, agreement of trabecular bone micro-structural measures, derived from different in vivo CT imaging, with reference measures from micro-CT imaging was examined. Observed values of most trabecular measures, including trabecular bone volume, network area, transverse and plate-rod micro-structure, thickness, and spacing, for in vivo CT modalities were higher than their micro-CT-based reference values. In general, HR-pQCT-based trabecular bone measures were closer to their reference values as compared to other in vivo CT modalities. Despite large differences in observed values of measures among modalities, high linear correlation (r Î [0.94 0.99]) was found between micro-CT and in vivo CT-derived measures of trabecular bone volume, transverse and plate micro-structural volume, and network area. All HR-pQCT-derived trabecular measures, except the erosion index, showed high correlation (r Î [0.91 0.99]). The plate-width measure showed a higher correlation (r Î [0.72 0.91]) among in vivo and micro-CT modalities than its counterpart binary plate-rod characterization-based measure erosion index (r Î [0.65 0.81]). Although a strong correlation was observed between micro-structural measures from in vivo and micro-CT imaging, large shifts in their values for in vivo modalities warrant proper scanner calibration prior to adopting in multi-site and longitudinal studies.

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Section: Introductionmentioning

confidence: 98%

A comparative study of trabecular bone micro-structural measurements using different CT modalities

Guha¹,

Klintström²,

Klintström³

et al. 2020

Phys. Med. Biol.

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“…Dual‐energy X‐ray absorptiometry (DXA) computed BMD is clinically used to detect osteoporosis. It is known that BMD explains 60%–70% of the bone's mechanical competence and the remaining is contributed by several other factors such as trabecular bone (Tb) strength and microstructural basis 4–7 …”

Section: Introductionmentioning

confidence: 99%

“…It is known that BMD explains 60%-70% of the bone's mechanical competence and the remaining is contributed by several other factors such as trabecular bone (Tb) strength and microstructural basis. [4][5][6][7] Finite element (FE) analysis (FEA) is widely used to compute Tb mechanical properties from high-resolution three-dimensional (3-D) images. [8][9][10][11][12][13] It has been shown that Tb modulus measures computed from FEA on micro-CT scans highly correlate with experimentally observed values, and often, micro-CT-based FEA is considered a gold-standard method for estimating Tb mechanical properties.…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis of trabecular bone microstructure using CT imaging and continuum mechanical modeling

et al. 2022

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Purpose Osteoporosis is a bone disease associated with enhanced bone loss, microstructural degeneration, and fracture‐risk. Finite element (FE) modeling is used to estimate trabecular bone (Tb) modulus from high‐resolution three‐dimensional (3‐D) imaging modalities including micro‐computed tomography (CT), magnetic resonance imaging (MRI), and high‐resolution peripheral quantitative CT (HR‐pQCT). This paper validates an application of voxel‐based continuum finite element analysis (FEA) to predict Tb modulus from clinical CT imaging under a condition similar to in vivo imaging by comparing with measures derived by micro‐CT and experimental approaches. Method Voxel‐based continuum FEA methods for CT imaging were implemented using linear and nonlinear models and applied on distal tibial scans under a condition similar to in vivo imaging. First, tibial axis in a CT scan was aligned with the coordinate z‐axis at 150 μm isotropic voxels. FEA was applied on an upright cylindrical volume of interests (VOI) with its axis coinciding with the tibial bone axis. Voxel volume, edge, and vertex elements and their connectivity were defined as per the isotropic image grid. A calibration phantom was used to calibrate CT numbers in Hounsfield unit to bone mineral density (BMD) values, which was then converted into calcium hydroxyapatite (CHA) density. Mechanical properties at each voxel volume element was defined using its ash‐density defined on CT‐derived CHA density. For FEA, the bottom surface of the cylindrical VOI was fixed and a constant displacement was applied along the z‐direction at each vertex element on the top surface to simulate a physical axial compressive loading condition. Finally, a Poisson's ratio of 0.3 was applied, and Tb modulus (MPa) was computed as the ratio of average von Mises stress (MPa) of volume elements on the top surface and the applied displacement. FEA parameters including mesh element size, substep number, and different tolerance values were optimized. Results CT‐derived Tb modulus values using continuum FEA showed high linear correlation with the micro‐CT‐derived reference values (r ∈ [0.87 0.90]) as well as experimentally measured values (r ∈ [0.80 0.87]). Linear correlation of computed modulus with their reference values using continuum FEA with linear modeling was comparable with that obtained by nonlinear modeling. Nonlinear continuum FEA‐based modulus values (mean of 1087.2 MPa) showed greater difference from their reference values (mean of 1498.9 MPa using micro‐CT‐based FEA) as compared with linear continuum methods. High repeat CT scan reproducibility (intra‐class correlation [ICC] = 0.98) was observed for computed modulus values using both linear and nonlinear continuum FEA. It was observed that high stress regions coincide with Tb microstructure as fuzzily characterized by BMD values. Distributions of von Mises stress over Tb microstructure and marrow regions were significantly different (p < 10–8). Conclusion Voxel‐based continuum FEA offers surrogate measures of Tb modulus fr...

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“…At the age postmenopause there is an evidence of the risk of osteoporosis and hip fractures in the women. The self-perception osteoporosis results certain behavior like advance medical consultation, bone mineral density screening, medication which may lead to advance health care and improve the bone health [15].…”

Section: Introductionmentioning

confidence: 99%

Association between osteoporosis Knowledge and Food Habits in Female University Students of Lahore

Din¹,

Thind²

2022

JCSR

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Background: Osteoporosis is a general metabolic disorder which causes many musculoskeletal issues and reduces the quality of life in the elderly population which usually progresses at the age between 30 to 40 years in both males and females. Recent studies suggested some of the associated factors like age, low bone mineral density, sex family history of fracture, less dietary intake of vitamin D, and abnormal thyroid function, these factors are the leading cause of osteoporosis especially in females. It is also indicated that along with other associated factors poor living style, malnutrition and the bad food habits leads to form osteoporosis which contributes in the loss of bone mass in post-menopausal stage of women Objective: To determine the association between osteoporosis knowledge and food habits in female university students of Lahore. Methodology: After the approval from the research committee of University an analytical cross sectional study was conducted using the Osteoporosis knowledge assessment tool (OKAT) &Adolescent food habits checklist tool (AFHC) to collect data from 138 students. The collection of data was carried by online Google forms because the university was closed due to the pandemic situation. Results: Mean knowledge score was found 9.9 with SD 4.8. Majority of the participants were found having average Knowledge good Knowledge (33.3% and 32.6%). Mean AFHC score was found 12.1 with SD±4.5. Increasing score indicates higher good food habits’ value and r value indicates that there is association between osteoporosis knowledge and food habits. Conclusion: This study concluded that there is a strong positive correlation between osteoporosis knowledge and food habits.

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Self-perceived Fracture Risk in the Global Longitudinal Study of Osteoporosis in Women: Its Correlates and Relationship with Bone Microarchitecture

Cited by 12 publications

References 18 publications

A comparative study of trabecular bone micro-structural measurements using different CT modalities

A comparative study of trabecular bone micro-structural measurements using different CT modalities

Finite element analysis of trabecular bone microstructure using CT imaging and continuum mechanical modeling

Association between osteoporosis Knowledge and Food Habits in Female University Students of Lahore

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