Effects of sex and age on bone microstructure at the ultradistal radius: A population-based noninvasive in vivo assessment
Effects of sex and age on bone microstructure at the ultradistal radius: A population-based noninvasive in vivo assessment
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DOI：
10.1359/jbmr.050916
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发表时间：
2006-01-01
影响因子：
6.2
通讯作者：
Melton, LJ
中科院分区：
文献类型：
--
作者：
Khosla, S;Riggs, BL;Melton, LJ
虽然骨微结构的改变与骨密度无关，但迄今为止还不可能在基于人群的研究中对其进行无创评估。材料和方法：我们使用高分辨率三维pQCT成像（体素大小，89 μ m）来确定，在21-97岁的随机样本中，女性（n = 324）和男性（n = 278），性别和年龄对腕部骨骼微观结构的影响。结果：与年轻女性（年龄，20-29岁）相比，年轻男性的小梁骨体积/组织体积（BV/TV）和小梁厚度（TbTh）比年轻女性大26%，p = 0.001，但小梁数量（TbN）和小梁分离（TbSp）的数值相似。在20至90岁之间，女性BV/TV的横断面下降（-27%）与男性相似（-26%），但女性TbN显著下降（-13%），TbSp显著增加（+24%），这些参数在男性中几乎没有净变化（TbN和TbSp分别为+7%和-2%，与女性相比p < 0.001）。然而，TbTh在男性中的下降幅度（-24%）大于女性（-18%;p = 0:010 vs .男性）。结论：尽管男女小梁体积随年龄的下降是相似的，但男女小梁体积下降的结构基础却有很大不同。因此，随着年龄的增长，女性小梁逐渐减少，TbSp增加，而男性小梁开始变厚，主要维持小梁变薄，TbN或TbSp没有变化。由于TbN的减少对骨强度的影响比TbTh的减少要大得多，这些发现可能有助于解释男性终生骨折风险较低的原因，特别是他们对与年龄相关的前臂远端骨折增加的实际免疫。
Introduction: Although changes in bone microstructure contribute to fracture risk independently of BMD, it has not heretofore been possible to assess this noninvasively in population-based studies.Materials and Methods: We used high-resolution 3-D pQCT imaging (voxel size, 89 mu m) to define, in a random sample of women (n = 324) and men (n = 278) 21-97 years of age, sex and age effects on bone microstructure at the wrist.Results: Relative to young women (age, 20-29 years), young men had greater trabecular bone volume/tissue volume (BV/TV; by 26%, p = 0.001) and trabecular thickness (TbTh; by 28%, p < 0.001) but similar values for trabecular number (TbN) and trabecular separation (TbSp). Between ages 20 and 90 years, cross-sectional decreases in BV/TV were similar in women (-27%) and in men (-26%), but whereas women had significant decreases in TbN (-13%) and increases in TbSp (+24%), these parameters had little net change over life in men (+7% and -2% for TbN and TbSp, respectively; p < 0.001 versus women). However, TbTh decreased to a greater extent in men (-24%) than in women (-18%; p = 0:010 versus men).Conclusions: Whereas decreases with age in trabecular BV/TV are similar in men and women, the structural basis for the decrease in trabecular volume is quite different between the sexes. Thus, over life, women undergo loss of trabeculae, with an increase in TbSp, whereas men begin young adult life with thicker trabeculae and primarily sustain trabecular thinning with no net change in TbN or TbSp. Because decreases in TbN have been shown to have a much greater impact on bone strength compared with decreases in TbTh, these findings may help explain the lower life-long risk of fractures in men, and specifically, their virtual immunity to age-related increases in distal forearm fractures.