Intracortical remodelling and porosity in the distal radius and post-mortem femurs of women: a cross-sectional study

Published on May 15, 2010in The Lancet79.323
· DOI :10.1016/S0140-6736(10)60320-0
Roger Zebaze27
Estimated H-index: 27
(University of Melbourne),
Ali Ghasem-Zadeh26
Estimated H-index: 26
(University of Melbourne)
+ 5 AuthorsEgo Seeman108
Estimated H-index: 108
(University of Melbourne)
Sources
Abstract
Summary Background Osteoporosis research has focused on vertebral fractures and trabecular bone loss. However, non-vertebral fractures at predominantly cortical sites account for 80% of all fractures and most fracture-related morbidity and mortality in old age. We aimed to re-examine cortical bone as a source of bone loss in the appendicular skeleton. Methods In this cross-sectional study, we used high-resolution peripheral CT to quantify and compare cortical and trabecular bone loss from the distal radius of adult women, and measured porosity using scanning electron microscopy. Exclusion criteria were diseases or prescribed drugs affecting bone metabolism. We also measured bone mineral density of post-mortem hip specimens from female cadavers using densitometry. Age-related differences in total, cortical, and trabecular bone mass, trabecular bone of cortical origin, and cortical and trabecular densities were calculated. Findings We investigated 122 white women with a mean age of 62·8 (range 27–98) years. Between ages 50 and 80 years (n=89), 72·1 mg (95% CI 67·7–76·4) hydroxyapatite (68%) of 106·5 mg hydroxyapatite of bone lost at the distal radius was cortical and 34·3 mg (30·5–37·8) hydroxyapatite (32%) was trabecular; 17·1 mg (11·7–22·5) hydroxyapatite (16%) of total bone loss occurred between ages 50 and 64 years (n=34) and 89·4 mg (83·7–101·1) hydroxyapatite (84%) after age 65 years (n=55). Remodelling within cortex adjacent to the marrow accounted for 49·9 mg (45·4–53·7) hydroxyapatite (47%) of bone loss. Between ages 50–64 years (n=34) and 80 years and older (n=33), cortical density decreased by 127·8 mg (93·1–162·1) hydroxyapatite per cm 3 (15%, p 3 (43%, p 3 (14%, p=0·06) before cortical remnants were excluded, but 68·7 mg (37·7–90·4) hydroxyapatite per cm 3 (52%, p Interpretation Accurate assessment of bone structure, especially porosity producing cortical remnants, could improve identification of individuals at high and low risk of fracture and therefore assist targeting of treatment. Funding Australia National Health and Medical Research Council.
📖 Papers frequently viewed together
References34
Newest
We measured indices of bone volume (cancellous, cortical) and bone surface (cancellous, endocortical, and intracortical) in intact full-thickness transiliac bone biopsies obtained from 144 healthy women aged 20-74 (35 black and 109 white, 62 premenopausal and 82 postmenopausal). The data were analyzed by two-way analysis of variance of the four groups defined by age/menopause and ethnicity and by linear regression of major variables on age. None of the interaction terms was significant, and none...
Source
#1Babul Borah (P&G: Procter & Gamble)H-Index: 11
#2T.E. Dufresne (P&G: Procter & Gamble)H-Index: 5
Last. Ego Seeman (University of Melbourne)H-Index: 108
view all 10 authors...
Nonvertebral fractures account for 80% of all fractures and their accompanying morbidity and mortality. Despite this, the effect of drug therapy on cortical morphology has received limited attention, partly because cortical bone is believed to remodel less and decrease less with age than trabecular bone. However, the haversian canals traversing the cortex provide a surface for remodeling that produces bone loss, porosity, and cortical fragility. We developed a new method of 3D micro-computed tom...
Source
#1Andrew J. Burghardt (UCSF: University of California, San Francisco)H-Index: 54
#2Galateia J. Kazakia (UCSF: University of California, San Francisco)H-Index: 27
Last. Sharmila Majumdar (University of California, Berkeley)H-Index: 105
view all 5 authors...
Cortical bone contributes the majority of overall bone mass and bears the bulk of axial loads in the peripheral skeleton. Bone metabolic disorders often are manifested by cortical microstructural changes via osteonal remodeling and endocortical trabecularization. The goal of this study was to characterize intracortical porosity in a cross-sectional patient cohort using novel quantitative computational methods applied to high-resolution peripheral quantitative computed tomography (HR-pQCT) images...
Source
#1Kyle K. Nishiyama (U of C: University of Calgary)H-Index: 27
#2Heather M. Macdonald (U of C: University of Calgary)H-Index: 31
Last. Steven K. Boyd (U of C: University of Calgary)H-Index: 51
view all 5 authors...
Increases in cortical porosity (Ct.Po) and decreases in cortical thickness (Ct.Th) are associated with increased bone fragility. The purpose of this study was to validate an autosegmentation method for high-resolution peripheral quantitative computed tomography (HR-pQCT) scans to measure Ct.Po and Ct.Th and use it to compare Ct.Po and Ct.Th between pre- and postmenopausal women with normal, osteopenic, and osteoporotic areal bone mineral density (aBMD). The Ct.Po and Ct.Th measurements were vali...
Source
#1Sheri Y. Nottestad (Creighton University)H-Index: 1
#2Julian J. Baumel (Creighton University)H-Index: 7
Last. Robert P. Heaney (Creighton University)H-Index: 118
view all 5 authors...
: The proportion of trabecular bone in human cadaver vertebrae was assessed by anatomic dissection. Thirty-two whole thoracic and lumbar vertebrae were obtained from 10 normal human postmenopausal female cadavers, 14 from 4 normal adult human male cadavers of similar age, and 8 from one female osteoporotic cadaver. Each vertebra was opened by saw cuts and separated into four tissue types: (1) body trabecular bone and marrow; (2) body cortical bone; (3) vertebral arch trabecular bone and marrow; ...
Source
#1Richard Eastell (Mayo Clinic)H-Index: 115
#2Lis Mosekilde (AU: Aarhus University)H-Index: 74
Last. B. L. Riggs (Mayo Clinic)H-Index: 81
view all 4 authors...
The concept that vertebral fractures are caused by excessive loss of cancellous bone has been challenged by a recent study (J Bone Min Res 2:221, 1987) suggesting that vertebral bodies are composed mainly of cortical bone rather than cancellous bone. To resolve disagreement we used two independent methods to quantify the proportions of cortical and cancellous bone in 400 μm thick sections of the bodies of the second lumbar vertebrae from six men (aged 21–58 years) and seven women (aged 25–58 yea...
Source
We Measured Indices Of Bone Volume (Cancellous And Cortical) And Bone Surface (Cancellous, Endocortical, And Intracortical) In Intact, Full-Thickness Transiliac Bone Biopsies Obtained From 47 Healthy White Women (23 Premenopausal And 24 Postmenopausal) And 82 Patients With Postmenopausal Osteoporosis. In The Normal Subjects There Was The Expected Loss Of Cancellous Bone With Age, Best Shown By A Reduction In Bone Surface/Tissue Volume, But No Fall In Cortical Thickness With Age Despite A Signifi...
Source
#1J.P. BilezikanH-Index: 1
#2L.G. RaiszH-Index: 1
Last. T.J. MartinH-Index: 1
view all 3 authors...
Principles of Bone Biology is an excellent single-source review of the rapidly expanding knowledge base of the biology of bone. Nearly 200 authors contributed to the 90 chapters in this book. The text is authoritative, comprehensive, scholarly, and up-to-date. The editors present us with a well-
Source
#1Babul Borah (P&G: Procter & Gamble)H-Index: 11
#2T.E. Dufresne (P&G: Procter & Gamble)H-Index: 5
Last. Ego Seeman (University of Melbourne)H-Index: 108
view all 9 authors...
Source
#1Ego Seeman (University of Melbourne)H-Index: 108
Publisher Summary Bones must resist deformation. Bone must also be flexible in order to absorb energy by changing shape, it must be able to shorten and widen in compression and lengthen and narrow in tension without cracking. Bone must also be light to allow mobility. Bone achieves the paradoxical properties of stiffness yet flexibility, strength yet lightness through its material composition and its structural design. This chapter deals with modeling and remodeling of the bone. The purpose of m...
Source
Cited By592
Newest
#1Haipeng Cen (Beihang University)H-Index: 1
#2Yan Yao (Beihang University)
Last. He Gong (Beihang University)H-Index: 2
view all 5 authors...
Abstract null null Background null Bone remodeling in the elderly is no longer balanced. As a result, the morphologies and mechanical properties of bone at different scales will change. These changes would affect the mechanical responses of bone, which might exacerbate the imbalance of bone remodeling and even cause age-related bone diseases. null null null Methods null Considering those changes, multiscale finite element (FE) models of bone in the young and the elderly were developed that inclu...
Source
#1Ming Ling (Fudan University)
#2Xianlong Li (Fudan University)H-Index: 1
Last. Yongqian Fan (Fudan University)H-Index: 1
view all 4 authors...
Few studies h ave discussed the association between cortical bone outside the fracture site and the fracture itself. Focusing on hip cortical thickness, this study revealed distinct distributions of the parameters for hip (trochanteric or femoral neck), vertebral, and peripheral osteoporotic fractures and suggested that the spatial distribution of hip cortical thickness was fracture-specific. PURPOSE Cortical bone is critical for bone strength. Hip cortical thickness is reported to be closely as...
Source
#1Wenqing Liang (ZJNU: Zhejiang Chinese Medical University)H-Index: 2
#2Xudong Wu (ZJNU: Zhejiang Chinese Medical University)H-Index: 2
Last. Fangming Xu (ZJNU: Zhejiang Chinese Medical University)H-Index: 2
view all 6 authors...
Bone remodeling, expressed as bone formation and turnover, is a complex and dynamic process closely related to its form and function. Different events, such as development, aging, and function, play a critical role in bone remodeling and metabolism. The ability of the bone to adapt to new loads and forces has been well known and has proven useful in orthopedics and insightful for research in bone and cell biology. Mechanical stimulation is one of the most important drivers of bone metabolism. In...
Source
#1Stuart J. Warden (IUPUI: Indiana University – Purdue University Indianapolis)H-Index: 57
#2Ziyue Liu (IUPUI: Indiana University – Purdue University Indianapolis)H-Index: 20
Last. Sharon M. Moe (IUPUI: Indiana University – Purdue University Indianapolis)H-Index: 70
view all 5 authors...
High-resolution peripheral quantitative computed tomography (HR-pQCT) is a powerful tool to assess bone health. To determine how an individual’s or population of interest’s HR-pQCT outcomes compare to expected, reference data are required. This study provides reference data for HR-pQCT measures acquired in a population of White adults. To provide age- and sex-specific reference data for high-resolution peripheral quantitative computed tomography (HR-pQCT) measures of the distal and diaphyseal ra...
Source
#1Xue Zhou (Tongji University)H-Index: 2
#2Erik Jan Cornel (Tongji University)H-Index: 7
Last. Jianzhong Du (Tongji University)H-Index: 49
view all 4 authors...
As the hardest connective tissue, bone tissue is an important part of the human body. However, with the increasing average age of the global population, the incidence of bone-related diseases has increased significantly. In view of the limitations of clinical diagnosis and treatment of bone-related diseases, nanomaterials that can be applied to bone-related diseases have attracted extensive attention. Among them, nanoparticles with the ability to specifically target bone tissues have become a re...
Source
#1Che-Hua Yang (NTUT: National Taipei University of Technology)H-Index: 7
#2N. Jeyaprakash (NTUT: National Taipei University of Technology)H-Index: 8
Last. Yu-Jing Tseng (NTUT: National Taipei University of Technology)
view all 3 authors...
The application of bone quality assessment has received extensive attention, and a large number of researchers continue to invest in related research activities. To get closer to the real situation, this study intends to investigate the long bones of cattle. A quantitative laser ultrasound visualization (QLUV) system was used to measure the images transmitted by the guided waves on the long bones, and the internal defects of the long bones were detected using wave propagation behavior. Then, lin...
Source
#1Garu A (Shimane University)H-Index: 2
#2Shozo Yano (Shimane University)H-Index: 32
Last. Toru Nabika (Shimane University)H-Index: 29
view all 11 authors...
Fragility fractures (FFxs), which are a common musculoskeletal injury in older adults, is associated with an increased frequency of falls. Both FFxs and falls may result from drugs, habits, and co-occurring diseases. We aimed to evaluate the effects of various diseases on the risk of FFx. This retrospective study included 1420 individuals aged ≥60 years. We evaluated the history of clinical FFx and diseases using a detailed questionnaire and a health examination. The risk of comorbidities was as...
Source
#1Jean-Gabriel Minonzio (University of Paris)H-Index: 21
#2Chao Han (University of Paris)H-Index: 1
Last. Quentin Grimal (University of Paris)H-Index: 25
view all 4 authors...
Quantitative UltraSound (QUS) methods have been introduced to assess cortical bone health at the radius and tibia through the assessment of Cortical Thickness (Ct.Th), Cortical Porosity (Ct.Po) and bulk wave velocities. Ultrasonic attenuation is another QUS parameter which is not currently used. We assess the feasibility of in vivo measurement of ultrasonic attenuation in cortical bone with a broadband transducer with 3.5 MHz-center frequency. Echoes from the periosteal and endosteal interfaces ...
Source
#9Kristy P. Robledo (USYD: University of Sydney)H-Index: 13
#10David Jesudason (University of Adelaide)H-Index: 12
Last. Mathis Grossmann (University of Melbourne)H-Index: 49
view all 13 authors...
Context Testosterone treatment increases bone mineral density (BMD) in hypogonadal men. Effects on bone microarchitecture, a determinant of fracture risk, are unknown. Objective Determine the effect of testosterone treatment on bone microarchitecture using high resolution-peripheral quantitative computed tomography (HR-pQCT). Design, setting, participants Men>50 years were recruited from six Australian centres. Interventions Injectable testosterone undecanoate or placebo over 2 years on the back...
Source
#1Philippe Paul Wagner (University of Lyon)H-Index: 1
#2Danielle E. Whittier (U of C: University of Calgary)H-Index: 5
Last. Pawel Szulc (University of Lyon)H-Index: 54
view all 6 authors...
CONTEXT High fracture risk in subjects with low muscle strength is attributed to high risk of fall. OBJECTIVE To study the association of muscle mass and physical performance with bone microarchitecture decline and risk of fall and nonvertebral fracture in men. DESIGN Prospective 8-year follow-up of a cohort. SETTING General population. PARTICIPANTS 821 volunteer men aged ≥60. INTERVENTIONS Hip areal bone mineral density (aBMD) and appendicular lean mass (ALM) were assessed at baseline by DXA. L...
Source
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.