Utility of Cortical Bone Tissue Properties in the Assessment of Fracture Risk

描述(由申请人提供)：随着人口老龄化，充分识别有骨质疏松性骨折风险的患者是一个日益令人担忧的问题。我们的长期目标是开发新的技术，与骨矿密度(BMD)相结合，将更好地识别有骨折风险的患者，并允许临床实施预防骨折的策略。本研究的目的是确定一种新的微创体内测量皮质骨材料特性的方法是否可以识别那些有髋关节和手腕脆性骨折风险的人。我们的工作假设是，患有脆性骨折的女性改变了皮质骨材料的特性，使她们容易受到这些伤害。我们进一步假设，这些改变的骨基质属性不能用传统的检测方法检测到，例如骨密度。为了验证这一假设，我们提出了两个目的：目的1)确定与没有骨折的女性相比，髋部骨折的女性是否改变了皮质骨组织特性，通过一种名为参考点压痕的新的微创方法在体内进行评估；以及目的2)确定与没有骨折的患者相比，腕部骨折的妇女是否改变了体内通过参考点压痕评估的皮质骨组织特性。我们将比较三组患者的皮质骨组织特性，通过在胫骨中段的活体参考点压痕进行评估。 绝经后妇女：1)最近发生髋部骨折者(n=50)；2)最近发生腕部骨折者(n=50)；以及3)年龄相仿且无骨折病史的对照组(n=50)。此外，我们还将通过DXA评估髋部和脊柱的骨密度，以及临床特征，包括维生素D状况、服药史和生活方式因素(例如吸烟、酒精和体力活动)。该项目的成功完成将为微创活体骨压痕测量作为评估骨折风险的工具的可能的临床应用提供新的信息。

DESCRIPTION (provided by applicant): Adequately identifying patients at risk for osteoporotic fractures is a growing concern as our population ages. Our long term goal is to develop novel techniques, which in conjunction with bone mineral density (BMD), will better identify patients at risk for fracture and allow the clinical implementation of strategies to prevent fractures. The objective of the current study is to determine whether a novel minimally invasive method for in vivo measurement of cortical bone material properties can identify those who are at risk for fragility fractures of the hip and wrist. Our working hypothesis is that women with fragility fractures have altered cortical bone material properties that make them susceptible to these injuries. We further hypothesize that these altered bone matrix properties are not detectable with traditional testing methods, such as BMD. To test this hypothesis, we propose two aims: Aim 1) Determine whether women with hip fractures have altered cortical bone tissue properties, as assessed in vivo by a new minimally invasive approach called reference point indentation, compared to women without fractures; and Aim 2) Determine whether women with wrist fractures have altered cortical bone tissue properties, as assessed in vivo by reference point indentation compared to patients without fractures. We will compare cortical bone tissue properties, as assessed by in vivo reference point indentation at the mid-tibia, in three groups of postmenopausal women: 1) those with recent hip fractures (n=50); 2) those with recent wrist fractures (n=50) and 3) age-similar controls without a history of fracture (n=50). In addition, we will assess hip and spine BMD by DXA as well as clinical characteristics, including vitamin D status, medication history, and lifestyle factors (e.g., smoking, alcohol, and physical activity). Successful completion of this project will provide novel information about possible clinical utilit of minimally invasive, in vivo bone indentation measurements as a tool to assess fracture risk.