Abnormal Microarchitecture and Reduced Stiffness at the Radius and Tibia in Postmenopausal Women With Fractures
Abnormal Microarchitecture and Reduced Stiffness at the Radius and Tibia in Postmenopausal Women With Fractures
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DOI：
10.1002/jbmr.152
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发表时间：
2010-12-01
影响因子：
6.2
通讯作者：
Shane, Elizabeth
中科院分区：
文献类型：
--
作者：
Stein, Emily M.;Liu, X. Sherry;Shane, Elizabeth
通过双能X线吸收测定法（DXA）测量面骨矿物质密度（aBMD）已被证明可预测骨折风险。高分辨率外周定量计算机断层扫描（HR-pQCT）可提供有关体积BMD（vBMD）、微结构可能增加对骨折易感性的理解的女性（n=68）和无（n=101）绝经后脆性骨折史，具有通过DXA测量的aBMD和通过HR-pQCT测量的桡骨和胫骨的骨小梁和皮质vBMD和骨小梁微结构，进行HR-pQCT扫描的有限元分析（FEA）以估计骨硬度，DXA T-评分在有和没有脊柱骨折的妇女中相似，桡骨远端骨折组骨密度、骨皮质厚度、骨小梁密度、骨小梁数目、骨小梁厚度、骨小梁间距、骨小梁网状结构异质性均显著低于桡骨远端骨折组（P <0.01（p <0.001至0.04）胫骨、总骨、皮质骨，骨折组骨小梁密度、骨皮质和骨小梁厚度均较低（p <0.0001至0.03）两组间的内骨小梁密度、数量、骨小梁分离、和网络异质性（p <0.01 ~ 0.05）骨折患者的僵硬度降低，桡骨处更明显（41%至44%）（15%至20%）骨折女性vBMD降低，微结构恶化，这些差异在桡骨比在胫骨HR处更突出，外周部位的pQCT和FEA测量与骨折发生率相关，并可能增加对微结构的作用的理解。骨折易感性恶化（C）2010年美国骨与矿物质研究学会
Measurement of areal bone mineral density (aBMD) by dual-energy x-ray absorptiometry (DXA) has been shown to predict fracture risk High-resolution peripheral quantitative computed tomography (HR-pQCT) yields additional information about volumetric BMD (vBMD), microarchitecture, and strength that may increase understanding of fracture susceptibility Women with (n=68) and without (n=101) a history of postmenopausal fragility fracture had aBMD measured by DXA and trabecular and cortical vBMD and trabecular microarchitecture of the radius and tibia measured by HR-pQCT Finite-element analysis (FEA) of HR-pQCT scans was performed to estimate bone stiffness DXA T-scores were similar in women with and without fracture at the spine, hip, and one-third radius but lower in patients with fracture at the ultradistal radius (p < 01) At the radius fracture, patients had lower total density, cortical thickness, trabecular density, number, thickness, higher trabecular separation and network heterogeneity (p < 0001 to 04) At the tibia, total, cortical, and trabecular density and cortical and trabecular thickness were lower in fracture patients (p < 0001 to 03) The differences between groups were greater at the radius than at the tibia for inner trabecular density, number, trabecular separation, and network heterogeneity (p < 01 to 05) Stiffness was reduced in fracture patients, more markedly at the radius (41% to 44%) than at the tibia (15% to 20%) Women with fractures had reduced vBMD, microarchitectural deterioration, and decreased strength These differences were more prominent at the radius than at the tibia HR-pQCT and FEA measurements of peripheral sites are associated with fracture prevalence and may increase understanding of the role of microarchitectural deterioration in fracture susceptibility (C) 2010 American Society for Bone and Mineral Research