Intrinsic bone qualities in fragility fracture patients: mass, microarchitecture, mineralization and damage accumulation

脆性骨折患者的内在骨质量：质量、微结构、矿化和损伤积累

• 批准号: nhmrc : 399305
• 负责人: Dr Julia Kuliwaba
• 金额: $ 29.81万
• 依托单位: The University of Adelaide
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Project Grants
• 财政年份: 2006
• 资助国家: 澳大利亚
• 起止时间: 2006-01-01 至 2008-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/intrinsic-bone-qualities-damage-accumulation/77356
• 关键词: Intrinsic; bone; qualities; fragility; fracture

Osteoporosis drug therapies have been associated with a significant reduction in fragility fracture. Patients receiving osteoporosis drugs, which have different effects on BMD, may have similar reductions in fractures. Furthermore, patients with fragility fractures may have abnormalities in bone structural and material properties. Changes to the process of bone renewal, due to drug therapy, may explain why fracture risk decreases where no detectable change to the structure of bone has been detected. It has also been shown that when bone renewal is suppressed microdamage accumulates in bone tissue, leading to reduced bone toughness. The toughness of bone is of primary importance in relation to fragility fractures, and it has been shown that the fatigue strength and fracture toughness (work to fracture) reduce considerably with age. This proposed study would seek to elucidate the role of bone tissue-level properties in determining bone quality for human subjects: patients with fragility hip fractures on no osteoporosis drugs therapy, hip fracture patients on osteoporosis drugs therapies, and normal age- and sex-matched individuals. Our laboratory has extensive experience in the analysis of the structure of human bone tissue. Recently, we have developed novel and unique techniques to assess bone quality, using micro-CT, backscatter SEM imaging, confocal microscopy and immunohistochemistry. This multifaceted study will identify at the bone tissue-level the structural mechanisms (micro-architecture, mineralisation, and microscopic cracking) that are indicative of the efficacy of fragility fracture drugs. Better understanding of the mechanisms by which bones are less likely to fracture will enable better targeting of osteoporosis drug therapy to individuals at risk of fragility fracture.

骨质疏松症药物治疗与脆性骨折的显著减少有关。接受骨质疏松症药物治疗的患者，对BMD有不同的影响，可能有类似的骨折减少。此外，脆性骨折患者可能存在骨结构和材料特性异常。由于药物治疗导致的骨更新过程的变化可以解释为什么在骨结构没有检测到变化的情况下骨折风险降低。也已经表明，当骨更新受到抑制时，微损伤在骨组织中积累，导致骨韧性降低。骨的韧性对于脆性骨折至关重要，并且已经表明疲劳强度和断裂韧性（断裂功）随着年龄的增长而显著降低。这项拟议的研究将试图阐明骨组织水平特性在确定人类受试者骨质量中的作用：未接受骨质疏松药物治疗的脆性髋部骨折患者，接受骨质疏松药物治疗的髋部骨折患者，以及正常年龄和性别匹配的个体。我们的实验室在人体骨组织结构分析方面拥有丰富的经验。最近，我们开发了新颖独特的技术来评估骨质量，使用显微CT，背散射SEM成像，共聚焦显微镜和免疫组织化学。这项多方面的研究将在骨组织水平上确定表明脆性骨折药物疗效的结构机制（微结构，矿化和微观开裂）。更好地了解骨骼不太可能骨折的机制将使骨质疏松症药物治疗更好地针对有脆性骨折风险的个体。