Characterization of trabecular bone microstructure in premenopausal women with distal radius fractures.
Characterization of trabecular bone microstructure in premenopausal women with distal radius fractures.
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患有桡骨远端骨折的绝经前女性骨小梁微结构的特征。
DOI：
10.1007/s00198-017-4293-8
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Bouxsein,ML
中科院分区：
文献类型：
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作者：
Rozental,TD;Johannesdottir,F;Kempland,KC;Bouxsein,ML
采用单独的骨小梁切断法来确定绝经前腕部骨折妇女和非骨折对照组妇女骨小梁结构的差异。骨折受试者的骨小梁体积、数量、厚度和连通性均降低。发现年轻女性骨小梁微结构的改变为咨询和生活方式的改变提供了机会，以减少骨折风险。前言：绝经前女性桡骨远端骨折(DRF)患者的骨小梁微结构比非骨折对照组(CONT)差，但其骨小梁结构特征尚不清楚。主要结果变量包括桡骨远端和胫骨的小梁结构，通过对来自高分辨率外周定量CT图像的单个小梁板和小梁棒的体积分解来评估。小梁形态包括板和杆的数量、体积、厚度和连通性。DXA测量股骨颈骨密度(Fn ABMD)和超远端骨密度(UdR ABMD)。结果DRF和CONT在桡骨和胫骨的骨小梁形态不同(OR Per SD下降1.58~2.7)。在桡骨，当调整年龄和FN aBMD(OR=1.76-3.26)和年龄和UDR aBMD(OR=1.72-3.97)时，相关性仍然显著。调整骨小梁密度后，骨板体积分数、骨小梁数目和轴向排列的骨小梁仍与DRF相关(ORs=2.55~2.85)。轴向排列的骨小梁比例的曲线下面积(AUC)为0.74，而FN aBMD为0.60，UDR aBMD为0.65，骨小梁密度为0.69。在调整了年龄、FN aBMD或UDR aBMD后，钢板数、钢板-钢板交界处和轴向骨体积分数仍然与胫骨DRF相关(ORs=2.14-2.77)。AUCP.P.Junc.D为0.72，FNaBMD为0.61，UDRaBMD为0.66，骨小梁密度为0.70。结论绝经前DRF患者的骨小梁体积、数量、厚度和连通性均低于CONT。识别具有改变的微结构的年轻女性提供了改变生活方式以降低骨折风险的机会。
Individual trabecular segmentation was utilized to identify differences in trabecular bone structure in premenopausal women with wrist fractures and non-fracture controls. Fracture subjects had reduced trabecular plate volume, number, thickness, and connectivity. Identifying altered trabecular microarchitecture in young women offers opportunities for counseling and lifestyle modifications to reduce fracture risk.IntroductionPremenopausal women with distal radius fractures (DRF) have worse trabecular bone microarchitecture than non-fracture controls (CONT), yet the characteristics of their trabecular bone structure are unknown.MethodsPremenopausal women with DRF (n= 40) and CONT (n= 80) were recruited. Primary outcome variables included trabecular structure at the distal radius and tibia, assessed by volumetric decomposition of individual trabecular plates and rods from high-resolution peripheral quantitative CT images. Trabecular morphology included plate and rod number, volume, thickness, and connectivity. Areal bone mineral density (aBMD) of the femoral neck (FN aBMD), and ultradistal radius (UDR aBMD) were measured by DXA.ResultsTrabecular morphology differed between DRF and CONT at the radius and tibia (OR per SD decline 1.58–2.7). At the radius, associations remained significant when adjusting for age and FN aBMD (ORs = 1.76–3.26) and age and UDR aBMD (ORs = 1.72–3.97). Plate volume fraction, number and axially aligned trabeculae remained associated with DRF after adjustment for trabecular density (ORs = 2.55–2.85). Area under the curve (AUC) for discriminating DRF was 0.74 for the proportion of axially aligned trabeculae, compared with 0.60 for FN aBMD, 0.65 for UDR aBMD, and 0.69 for trabecular density. Plate number, plate-plate junction, and axial bone volume fraction remained associated with DRF at the tibia (ORs = 2.14–2.77) after adjusting for age, FN aBMD, or UDR aBMD. AUCP.P.Junc.Dwas 0.72 versus 0.61 for FNaBMD, 0.66 for UDRaBMD, and 0.70 for trabecular density.ConclusionPremenopausal women with DRF have lower trabecular plate volume, number, thickness, and connectivity than CONT. Identification of young women with altered microarchitecture offers opportunities for lifestyle modifications to reduce fracture risk.