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Absolute values of cortical porosity and trabecular density are used to estimate fracture risk, but these values are the net result of their growth-related assembly and age-related deterioration. Because bone loss affects both cortical and trabecular bone, we hypothesized that a surrogate measure of bone fragility should capture the age-related deterioration of both traits, and should do so independently of their peak values. Accordingly, we developed a structural fragility score (SFS), which quantifies the increment in distal radial cortical porosity and decrement in trabecular density relative to their premenopausal mean values in 99 postmenopausal women with forearm fractures and 105 controls using HR-pQCT. We expressed the results as odds ratios (ORs; 95% CI). Cortical porosity was associated with fractures in the presence of deteriorated trabecular density (OR 2.30; 95% CI, 1.30 to 4.05; = 0.004), but not if trabecular deterioration was absent (OR 0.96; 95% CI, 0.50 to 1.86; = 0.91). Likewise, trabecular density was associated with fractures in the presence of high cortical porosity (OR 3.35; 95% CI, 1.85 to 6.07; < 0.0001), but not in its absence (OR 1.60; 95% CI, 0.78 to 3.28; = 0.20). The SFS, which captures coexisting cortical and trabecular deterioration, was associated with fractures (OR 4.52; 95% CI, 2.17 to 9.45; < 0.0001). BMD was associated with fracture before accounting for the SFS (OR 5.79; 95% CI, 1.24 to 27.1; = 0.026), not after (OR 4.38; 95% CI, 0.48 to 39.9; = 0.19). The SFS was associated with fracture before (OR 4.67; 95% CI, 2.21 to 9.88) and after (OR 3.94; 95% CI, 1.80 to 8.6) accounting for BMD (both s < 0.0001). The disease of bone fragility is captured by cortical and trabecular deterioration: A measurement of coexisting cortical and trabecular deterioration is likely to identify women at risk for fracture more robustly than absolute values of cortical porosity, trabecular density, or BMD. © 2018 The Authors. Published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.
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http://dx.doi.org/10.1002/jbm4.10078 | DOI Listing |
Bone
December 2024
Center of Bone Biology, Institute for Anatomy, Faculty of Medicine, University of Belgrade, Serbia; Dr Subotica starijeg 4, 11000 Belgrade, Serbia. Electronic address:
Objectives: Alcoholic bone disease has been recognized in contemporary literature as a systemic effect of chronic ethanol consumption. However, evidence about the specific influence of alcoholic liver cirrhosis (ALC) on mandible bone quality is scarce. The aim of this study was to explore microstructural, compositional, cellular, and mechanical properties of the mandible in ALC individuals compared with a healthy control group.
View Article and Find Full Text PDFJ Mech Behav Biomed Mater
December 2024
Centre for Precision Engineering Material and Manufacturing Research (PEM Research Centre), Atlantic Technological University, Ash Lane, Sligo, F91 YW50, Ireland; School of Mechanical Engineering, Technological University Dublin, Dublin, Ireland.
Quant Imaging Med Surg
December 2024
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background: Quantitative assessment of cortical bone microstructure is crucial for the evaluation of osteoporosis, yet current clinical methods such as dual-energy X-ray absorptiometry (DXA) have many limitations. The quantitative assessment without radiation can be achieved by ultrashort echo time (UTE) magnetic resonance imaging (MRI), where double-echo UTE has high clinical feasibility. However, related studies have mainly focused on distal extremities, and there is a lack of studies on the proximal femur.
View Article and Find Full Text PDFBone
December 2024
Department of Mechanical Engineering, Indian Institute of Technology Ropar, Rupnagar, Punjab, 140001, India; Department of Biomedical Engineering, Indian Institute of Technology Ropar, Rupnagar, Punjab 140001, India. Electronic address:
Both trabecular and cortical bone undergo changes at multiple scales. We previously demonstrated the multi-scale changes in trabecular bone quality that contribute to bone fragility in type 2 diabetes (T2D). The link between increased fragility in T2D and multi-scale changes in cortical bone and their interaction with glycation remains unclear.
View Article and Find Full Text PDFJ Bone Miner Res
December 2024
Erasmus MC Bone Center, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
X-linked osteoporosis, caused by PLS3 genetic variants, is a rare bone disease, clinically affecting mainly men. Limited data are available on bone microarchitecture and genotype-phenotype correlations in this disease. Our aims were to assess bone microarchitecture and strength in adults with PLS3 variants using high-resolution peripheral quantitative computed tomography (HR-pQCT) and to explore differences in the phenotype from HR-pQCT between PLS3 variants.
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