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日益受到关注。我们的长期目标是开发与骨矿物质密度（BMD）相结合的新技术，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。当前研究的目的是确定一种新的微创方法，用于体内测量皮质骨材料的特性，是否可以识别那些有髋部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已经改变了皮质骨材料的特性，使她们容易受到这些损伤。我们进一步假设，这些改变的骨基质性质是无法检测到传统的测试方法，如骨密度。为了验证这一假设，我们提出了两个目标：目的1)通过一种称为参考点压痕的新型微创方法在体内评估，与没有骨折的女性相比，确定髋部骨折的女性是否改变了皮质骨组织特性；目的2)对比无骨折患者，通过参考点压痕在体内评估腕部骨折女性是否改变了皮质骨组织特性。我们将比较皮质骨组织的性质，作为评估体内参考点压痕在胫骨中部，在三组

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.