Relationship of age to bone microstructure independent of areal bone mineral density.
Relationship of age to bone microstructure independent of areal bone mineral density.
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DOI：
10.1002/jbmr.1468
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发表时间：
2012-03
影响因子：
6.2
通讯作者：
Khosla, Sundeep
中科院分区：
文献类型：
--
作者：
Nicks, Kristy M.;Amin, Shreyasee;Atkinson, Elizabeth J.;Riggs, B. Lawrence;Melton, L. Joseph, III;Khosla, Sundeep
先前使用双能X射线骨密度仪(DXA)的研究表明，年龄是骨脆性和骨折风险的主要预测因子，独立于面骨密度(ABMD)。尽管这种不依赖aBMD的年龄效应被归因于糟糕的骨“质量”，但其结构基础仍不清楚。由于高分辨率外周定量计算机断层扫描(HRpQCT)可以评估骨的微结构，我们匹配了年轻和老年受试者的超远端骨密度，并通过HRpQCT评估了骨小梁或皮质微结构的可能差异。从社区成年人的年龄分层的随机样本中，44名女性和44名女性50岁(平均年龄，41.0岁)与44名女性≥50岁(平均年龄，62.7岁)通过超远端骨密度(平均±扫描电子显微镜，年轻和老年骨密度，分别为0.475±0.011和0.472±0.011克/厘米~2)相匹配，57名男性和50岁(平均年龄，41.3岁)与57名男性≥50岁(平均年龄，68.1岁；青年和老年骨密度均为0.571±0.008 g/cm~2)。在这些匹配的受试者中，小梁微结构参数没有性别差异。然而，在皮质微结构方面有显著差异(均P<；0.05)：与年轻受试者相比，老年女性和男性的皮质孔隙度(分别增加91%和56%)、总皮质孔体积(分别增加77%和61%)和平均皮质孔直径(分别增加9%和8%)显著增加。这些发现表明，匹配DXA aBMD的年轻和老年女性和男性具有相似的小梁微结构，但明显不同的皮质微结构，至少在以半径为代表的附件部位是不同的。需要进一步的研究来确定这种皮质微结构的恶化在多大程度上有助于年龄对骨质疏松性骨折远端和其他部位的骨脆性和骨折风险的aBMD非依赖性影响。
Previous studies using dual-energy x-ray absorptiometry (DXA) have demonstrated that age is a major predictor of bone fragility and fracture risk independent of areal bone mineral density (aBMD). While this aBMD-independent effect of age has been attributed to poor bone “quality”, the structural basis for this remains unclear. Since high resolution peripheral quantitative computed tomography (HRpQCT) can assess bone microarchitecture, we matched younger and older subjects for aBMD at the ultradistal radius and assessed for possible differences in trabecular or cortical microstructure by HRpQCT. From an age-stratified, random sample of community adults, 44 women < 50 years old (mean age, 41.0 years) were matched to 44 women ≥ 50 years old (mean age, 62.7 years) by ultradistal radius aBMD (mean ± SEM, younger and older aBMD, 0.475 ± 0.011 and 0.472 ± 0.011 g/cm2, respectively) and 57 men < 50 years (mean age, 41.3 years) were matched to 57 men ≥ 50 years (mean age, 68.1 years; younger and older aBMD, both 0.571 ± 0.008 g/cm2). In these matched subjects, there were no sex-specific differences in trabecular microstructural parameters. However, significant differences were noted in cortical microstructure (all P < 0.05): older women and men had increased cortical porosity (by 91% and 56%, respectively), total cortical pore volume (by 77% and 61%, respectively), and mean cortical pore diameter (by 9% and 8%, respectively) compared to younger subjects. These findings indicate that younger and older women and men matched for DXA aBMD have similar trabecular microarchitecture but clearly different cortical microstructure, at least at an appendicular site represented by the radius. Further studies are needed to define the extent to which this deterioration in cortical microstructure contributes to the aBMD-independent effect of age on bone fragility and fracture risk at the distal radius and other sites of osteoporotic fractures.
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影响因子：
2.2
作者：
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影响因子：
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