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Pashkova A, Hartman JM, Letuchy EM, Janz KF. Interscholastic Athletics and Bone Strength: The Iowa Bone Development Study. J Strength Cond Res 2022; 36:1271-1276. [PMID: 32459739 PMCID: PMC7686019 DOI: 10.1519/jsc.0000000000003646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Pashkova, A, Hartman, JM, Letuchy, EM, and Janz, KF. Interscholastic athletics and bone strength: the Iowa bone development study. J Strength Cond Res 36(5): 1271-1276, 2022-The objective of this study was to determine the relationship between adolescents' participation in various interscholastic sports and differences in bone strength outcomes. Subjects (N = 380) were recruited from the Iowa Bone Development Study and categorized based on sport participation into 3 power groups: no-power, low-power, and high-power. Sports such as basketball, cheerleading/poms, gymnastics, volleyball, track, football, tennis, and soccer were considered high-power. Peripheral quantitative computed tomography (pQCT) was used to determine bone measures of polar stress-strain index (measure of torsion strength), cortical content (measure of cortical bone size and area at the 66% tibia site), and bone strength index (measure of compression strength based on total bone density and area at the 4% tibia site). Adjusted pairwise comparison for group least squares means high-power sport participation compared with no-power sport participation showed significant differences in all bone strength outcomes for both men and women (p value < 0.01). There was a significant difference in all bone strength measures between low-power and no-power groups for men (p value < 0.05), but not women. Because of decreasing levels of physical activity in late adolescence, the promotion of high-power sports may be particularly important for optimal bone development in the final years before peak bone mass.
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Affiliation(s)
- Anna Pashkova
- Division of Medical Dietetics, The Ohio State University, Columbus, Ohio
| | - Jeffrey M Hartman
- Department of Exercise Science, Gardner-Webb University, Boiling Springs, North Carolina
| | - Elena M Letuchy
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa; and
| | - Kathleen F Janz
- Department of Epidemiology, University of Iowa, Iowa City, Iowa
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Dionyssiotis Y, Skarantavos G, Petropoulou K, Galanos A, Rapidi CA, Lyritis GP. Application of current sarcopenia definitions in spinal cord injury. J Musculoskelet Neuronal Interact 2019; 19:21-29. [PMID: 30839300 PMCID: PMC6454250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Little is known about how appropriate the working definitions of sarcopenia are in subjects with spinal cord injury (SCI). This study aimed to evaluate the application of current sarcopenia definitions in SCI. METHODS We compared 31 complete SCI men with 33 able-bodied age matched subjects. All were examined by whole body DXA (Norland XR 36, USA) regarding muscle and fat mass and by peripheral quantitative computed tomography (pQCT XCT-3000, Germany) in 66% of tibia's length (muscle cross sectional area, (CSA) in mm2). Low muscle mass was defined by skeletal muscle index, (SMI= appendicular lean mass (aLM)/height2 in Kg/m2) and by the residual method: relative aLM, 20th percentile of the distribution of residuals as the cutoff point, (RASM), respectively. CSA is a surrogate for force. RESULTS We found lower values on RASM (p<0.001), and SMI (p<0.001) compared to controls in SCI and difference in the rate of sarcopenia according to sarcopenia definitions. CSA was significantly decreased in SCI (p<0.001) and correlation with duration of paralysis was weak. CONCLUSION Current functional definitions of sarcopenia classify different individuals as sarcopenic. Sarcopenia was more prevalent in SCI. The sensitivity and specificity of using these measurements in SCI remain unclear.
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Affiliation(s)
- Yannis Dionyssiotis
- Physical Medicine and Rehabilitation Department, University Hospital of Ioannina, Ioannina, Greece,Laboratory for Research of the Musculoskeletal System, KAT Hospital, Kifissia, Greece,Hellenic Osteoporosis Foundation, Kifissia, Greece,Corresponding author: Yannis Dionyssiotis, MD, MSc., PhD, s. FEBPRM, Physical Medicine & Rehabilitation Department, University Hospital of Ioannina, Leoforos Stavrou Niarchou, 45500, Ioannina, Greece E-mail:
| | - Grigorios Skarantavos
- Rheumatology and Bone unit Department, 1st Orthopedic Department, General University Hospital ATTIKON, Athens, Greece
| | - Konstantina Petropoulou
- 2nd Physical Medicine and Rehabilitation Department, National Rehabilitation Center, Athens, Greece
| | - Antonios Galanos
- Laboratory for Research of the Musculoskeletal System, KAT Hospital, Kifissia, Greece
| | | | - George P. Lyritis
- Laboratory for Research of the Musculoskeletal System, KAT Hospital, Kifissia, Greece,Hellenic Osteoporosis Foundation, Kifissia, Greece
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Weatherholt AM, Warden SJ. Throwing enhances humeral shaft cortical bone properties in pre-pubertal baseball players: a 12-month longitudinal pilot study. J Musculoskelet Neuronal Interact 2018; 18:191-199. [PMID: 29855441 PMCID: PMC6016504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To explore throwing athletes as a prospective, within-subject controlled model for studying the response of the skeleton to exercise. METHODS Male pre-pubertal throwing athletes (n=12; age=10.3±0.6 yrs) had distal humerus cortical volumetric bone mineral density (Ct.vBMD), cortical bone mineral content (Ct.BMC), total area (Tt.Ar), cortical area (Ct.Ar), medullary area (Me.Ar), cortical thickness (Ct.Th) and polar moment of inertia (IP) assessed within their throwing (exercised) and nonthrowing (control) arms by peripheral quantitative computed tomography at baseline and 12 months. Throwing-to-nonthrowing arm percent differences (i.e. bilateral asymmetry) were compared over time. RESULTS Over 12 months, the throwing arm gained 4.3% (95% Cl=1.1% to 7.5%), 2.9% (95% Cl=0.3% to 5.4%), 3.9% (95% Cl=0.7% to 7.0%), and 8.2% (95% Cl=2.0% to 6.8%) more Ct.BMC, Ct.Ar, Tt.Ar, and IP than the nonthrowing arm, respectively (all p<0.05). There was no significant effect of throwing on Ct.vBMD, Ct.Th and Me.Ar (all p=0.18-0.82). CONCLUSION Throwing induced surface-specific cortical bone adaptation at the distal humeral diaphysis that contributed to a gain in estimated strength. These longitudinal pilot data support the utility of throwing athletes as a within-subject controlled model to explore factors influencing exercise-induced bone adaptation during the critical growing years.
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Affiliation(s)
- Alyssa M. Weatherholt
- Department of Kinesiology and Sport, Pott College of Science, Engineering, and Education, University of Southern Indiana, Evansville, IN 47712,Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN 46202, USA,Corresponding author: Alyssa M. Weatherholt, Department of Kinesiology and Sport, Pott College of Science, Engineering, and Education, University of Southern Indiana, 8600 University Boulevard, Evansville, Indiana 47712, USA E-mail:
| | - Stuart J. Warden
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN 46202, USA,Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN 46202, USA
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Jaworski M, Graff K. Peripheral quantitative computed tomography of the distal and proximal forearm in children and adolescents: bone densities, cross-sectional sizes and soft tissues reference data. J Musculoskelet Neuronal Interact 2018; 18:237-247. [PMID: 29855446 PMCID: PMC6016490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Peripheral quantitative computed tomography (pQCT) is gaining popularity in the field of paediatric bone densitometry, however, very little is known about reference limits. The purpose of this study was to develop country-specific reference data for bone densities, cross-sectional sizes, strength and regional tissue distribution measured by pQCT at the distal and proximal forearm in children and adolescents aged 5-19 yrs. METHODS Stratec XCT 2000L apparatus was used. Measurement sites were 4% and 66% of the forearm length on non-dominant arm. Studied group comprised 221 participants (103 girls) aged 4.5-19.5 yrs. The LMS method was used to fit percentile curves for each outcomes. RESULTS Smoothed percentile curves were developed for following outcomes: trabecular volumetric bone mineral density, total volumetric bone mineral density, distal total bone cross-sectional area, cortical volumetric bone mineral density, cortical cross-sectional area, proximal total bone cross-sectional area, polar strength strain index, fat cross-sectional area and muscle cross-sectional area. CONCLUSIONS In this study we present reference data for bone densities, cross-sectional size and strength as well as for regional tissue distribution measured by pQCT at the distal and proximal forearm in children 5-19 yrs in a way allowing simple calculation of reliable Z scores.
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Affiliation(s)
- Maciej Jaworski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland,Corresponding author: Maciej Jaworski, Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-430 Warsaw, Poland E-mail:
| | - Krzysztof Graff
- Rehabilitation Ward, The Children’s Memorial Health Institute, Warsaw, Poland,Faculty of Rehabilitation, Józef Pilsudski University of Physical Education, Warsaw, Poland
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Minett M, Binkley T, Weidauer L, Specker B. Changes in body composition and bone of female collegiate soccer players through the competitive season and off-season. J Musculoskelet Neuronal Interact 2017; 17:386-398. [PMID: 28250243 PMCID: PMC5383767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To assess body composition and bone changes pre- to post-season (pre-post) and post- to off-season (post-off) in female soccer athletes (SC). METHODS Outcomes were assessed using DXA and pQCT in 23 SC and 17 controls at three times throughout season. RESULTS SC, non-starters in particular, lost lean mass pre-post (-0.9±0.2 kg, p<0.01; not different from controls, p=0.2) and gained fat mass post-off (1.4±0.3 kg, p<0.01; differed from controls, p=0.01). Baseline femoral neck and hip aBMD were higher in SC than controls (both,p<0.04), but increased in controls more than SC in pre-post and decreased post-off. SC cortical bone mineral content (BMC), cortical area and periosteal circumference increased pre-post (all, p<0.01; differed from controls, p<0.05) and trabecular vBMD decreased post-off (-3.0±1.3 mg/cm3; p=0.02; not different from controls, p=0.4). Both SC and controls increased cortical BMC, cortical area, and thickness post-off (all, p<0.01). CONCLUSION Soccer players lost lean mass over the competitive season that was not recovered during off-season. Bone size increased pre- to post-season. Female soccer athletes experience body composition and bone geometry changes that differ depending on the time of season and on athlete's playing status. Evaluations of athletes at key times across the training season are necessary to understand changes that occur.
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Affiliation(s)
- M.M. Minett
- EA Martin Program in Human Nutrition, South Dakota State University, Brookings, SD, USA,Corresponding author: Maggie M. Minett, SWC Box 506, South Dakota State University, Brookings, SD 57007, USA E-mail:
| | - T.B. Binkley
- EA Martin Program in Human Nutrition, South Dakota State University, Brookings, SD, USA
| | - L.A. Weidauer
- EA Martin Program in Human Nutrition, South Dakota State University, Brookings, SD, USA
| | - B.L. Specker
- EA Martin Program in Human Nutrition, South Dakota State University, Brookings, SD, USA
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Wong A. A comparison of peripheral imaging technologies for bone and muscle quantification: a technical review of image acquisition. J Musculoskelet Neuronal Interact 2016; 16:265-282. [PMID: 27973379 PMCID: PMC5259568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The choice of an appropriate imaging technique to quantify bone, muscle, or muscle adiposity needs to be guided by a thorough understanding of its competitive advantages over other modalities balanced by its limitations. This review details the technical machinery and methods behind peripheral quantitative computed tomography (pQCT), high-resolution (HR)-pQCT, and magnetic resonance imaging (MRI) that drive successful depiction of bone and muscle morphometry, densitometry, and structure. It discusses a number of image acquisition settings, the challenges associated with using one versus another, and compares the risk-benefits across the different modalities. Issues related to all modalities including partial volume artifact, beam hardening, calibration, and motion assessment are also detailed. The review further provides data and images to illustrate differences between methods to better guide the reader in selecting an imaging method strategically. Overall, investigators should be cautious of the impact of imaging parameters on image signal or contrast-to-noise-ratios, and the need to report these settings in future publications. The effect of motion should be assessed on images and a decision made to exclude prior to segmentation. A more standardized approach to imaging bone and muscle on pQCT and MRI could enhance comparability across studies and could improve the quality of meta-analyses.
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Affiliation(s)
- A.K.O. Wong
- Joint Department of Medical Imaging, Toronto General Research Institute, University Health Network, Toronto, ON, Canada,McMaster University, Department of Medicine, Faculty of Health Sciences, Hamilton, ON, Canada,Corresponding author: Andy Kin On Wong, 200 Elizabeth St. Toronto General Hospital, 7EN-238, Toronto, ON M5G 2C4, Canada E-mail:
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Leung KS, Li YH, Liu Y, Wang H, Tam KF, Chow D, Wan Y, Ling S, Dai Z, Qin L, Cheung WH. Effect of daily short-duration weight-bearing on disuse-induced deterioration of musculoskeletal system. J Musculoskelet Neuronal Interact 2015; 15:207-14. [PMID: 26032214 PMCID: PMC5133725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To investigate deterioration of musculoskeletal system due to prolonged disuse and the potential of daily short-duration weight-bearing as countermeasures. METHODS Twenty-four adult male Sprague-Dawley rats were divided into Control Group (CG, no intervention), Tail-suspension Group (TG, tail-suspension without treatment), and Weight-Bearing Group (WBG, tail-suspension with 20 min/day, 5 days/week body weight loading). After four weeks of treatment, femur and tibia, soleus and extensor digitorum longus were evaluated for bone and muscle quality respectively. Tensile properties of bone-tendon insertion (BTI) were evaluated using patella-patellar tendon complex. RESULTS Disuse induced deterioration on bone, muscle, and BTI after four weeks. Compared with CG, TG and WBG showed significant decrease in bone mineral density (BMD) of trabecular bone in distal femur (4.3-15.2%), muscle mass (31.3-52.3%), muscle cross-sectional area (29.1-35%), and failure strength of BTI (23.9-29.4%). Tensile test showed that the failure mode was avulsion of bone at the BTI. No significant difference was detected between TG and WBG for all assessments on bone, muscle, and BTI. CONCLUSIONS Disuse caused deterioration of bone, muscle, and BTI while daily short-duration of weight-bearing did not prevent this deterioration. Mechanical stimulation with higher intensity and longer duration may be necessary to prevent musculoskeletal deterioration resulted from prolonged disuse.
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Affiliation(s)
- K-S. Leung
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
| | - Y-H. Li
- State key Lab of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, Beijing, PR China
| | - Y. Liu
- State key Lab of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, Beijing, PR China
| | - H. Wang
- State key Lab of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, Beijing, PR China
| | - K-F. Tam
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
| | - D.H.K. Chow
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
| | - Y. Wan
- State key Lab of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, Beijing, PR China
| | - S. Ling
- State key Lab of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, Beijing, PR China
| | - Z. Dai
- State key Lab of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, Beijing, PR China
| | - L. Qin
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China,The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, PR China,Corresponding author: Ling Qin, PhD, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong. E-mail:
| | - W-H. Cheung
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
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Reina P, Cointry G, Nocciolino L, Feldman S, Ferretti J, Rittweger J, Capozza R. Analysis of the independent power of age-related, anthropometric and mechanical factors as determinants of the structure of radius and tibia in normal adults. A pQCT study. J Musculoskelet Neuronal Interact 2015; 15:10-22. [PMID: 25730648 PMCID: PMC5123604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To compare the independent influence of mechanical and non-mechanical factors on bone features, multiple regression analyses were performed between pQCT indicators of radius and tibia bone mass, mineralization, design and strength as determined variables, and age or time since menopause (TMP), body mass, bone length and regional muscles' areas as selected determinant factors, in Caucasian, physically active, untrained healthy men and pre- and post-menopausal women. In men and pre-menopausal women, the strongest influences were exerted by muscle area on radial features and by both muscle area and bone length on the tibia. Only for women, was body mass a significant factor for tibia traits. In men and pre-menopausal women, mass/design/strength indicators depended more strongly on the selected determinants than the cortical vBMD did (p<0.01-0.001 vs n.s.), regardless of age. However, TMP was an additional factor for both bones (p<0.01-0.001). The selected mechanical factors (muscle size, bone lengths) were more relevant than age/TMP or body weight to the development of allometrically-related bone properties (mass/design/strength), yet not to bone tissue 'quality' (cortical vBMD), suggesting a determinant, rather than determined role for cortical stiffness. While the mechanical impacts of muscles and bone levers on bone structure were comparable in men and pre-menopausal women, TMP exerted a stronger impact than allometric or mechanical factors on bone properties, including cortical vBMD.
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Affiliation(s)
- P. Reina
- Center of P-Ca Metabolism Studies (CEMFoC), National University of Rosario (UNR), Argentine
| | - G.R. Cointry
- Center of P-Ca Metabolism Studies (CEMFoC), National University of Rosario (UNR), Argentine
| | - L. Nocciolino
- Center of P-Ca Metabolism Studies (CEMFoC), National University of Rosario (UNR), Argentine
| | - S. Feldman
- LABOATEM, Faculty of Medicine, UNR, Rosario
| | - J.L. Ferretti
- Center of P-Ca Metabolism Studies (CEMFoC), National University of Rosario (UNR), Argentine,Corresponding author: Dr. Ferretti, Jose Juan B Justo 1427 Rosario Santa Fe Argentina, 2000 E-mail:
| | - J. Rittweger
- Institute of Aerospace Medicine, German Space Center (DLR), Cologne, Germany
| | - R.F. Capozza
- Center of P-Ca Metabolism Studies (CEMFoC), National University of Rosario (UNR), Argentine
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Wong AKO, Cawthon PM, Peters KW, Cummings SR, Gordon CL, Sheu Y, Ensrud K, Petit M, Zmuda JM, Orwoll E, Cauley J. Bone-muscle indices as risk factors for fractures in men: the Osteoporotic Fractures in Men (MrOS) Study. J Musculoskelet Neuronal Interact 2014; 14:246-254. [PMID: 25198219 PMCID: PMC4197057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess bone-muscle (B-M) indices as risk factors for incident fractures in men. METHODS Participants of the Osteoporotic Fractures in Men (MrOS) Study completed a peripheral quantitative computed tomography scan at 66% of their tibial length. Bone macrostructure, estimates of bone strength, and muscle area were computed. Areal bone mineral density (aBMD) and body composition were assessed with dual-energy X-ray absorptiometry. Four year incident non-spine and clinical vertebral fractures were ascertained. B-M indices were expressed as bone-to-muscle ratios for: strength, mass and area. Discriminative power and hazards ratios (HR) for fractures were reported. RESULTS In 1163 men (age: 77.2±5.2 years, body mass index (BMI): 28.0±4.0 kg/m(2), 4.1±0.9 follow-up years, 7.7% of men ⋝1 fracture), B-M indices were smaller in fractured men except for bending and areal indices. Smaller B-M indices were associated with increased fracture risk (HR: 1.30 to 1.74) independent of age and BMI. Strength and mass indices remained significant after accounting for lumbar spine but not total hip aBMD. However, aBMD correlated significantly with B-M indices. CONCLUSION Mass and bending B-M indices are risk factors for fractures in men, but may not improve fracture risk prediction beyond that provided by total hip aBMD.
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Affiliation(s)
- A K O Wong
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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Abstract
OBJECTIVE To observe changes in hip, spine, and tibia bone characteristics in female cyclists over the course of 1 year of training. DESIGN Prospective observational study. SETTING Laboratory. PARTICIPANTS Female cyclists (n = 14) aged 26-41 years with at least 1 year of competition history and intent to compete in 10 or more races in the coming year. ASSESSMENT OF RISK FACTORS Women who train and compete in road cycling as their primary sport. MAIN OUTCOME MEASURES Total body fat-free and fat mass and lumbar spine and proximal femur areal bone mineral density (aBMD) and bone mineral content (BMC) assessments by dual-energy x-ray absorptiometry. Volumetric BMD and BMC of the tibia were measured by peripheral quantitative computed tomography at sites corresponding to 4%, 38%, 66%, and 96% of tibia length. Time points were baseline and after 12 months of training and competition. RESULTS Weight and body composition did not change significantly over 12 months. Total hip aBMD and BMC decreased by -1.4% ± 1.9% and -2.1% ± 2.3% (P < 0.02) and subtrochanter aBMD and BMC decreased by -2.1% ± 2.0% and -3.3% ± 3.7% (P < 0.01). There was a significant decrease in lumbar spine BMC (-1.1% ± 1.9%; P = 0.03). There were no significant bone changes in the tibia (P > 0.11). CONCLUSIONS Bone loss in female cyclists was site specific and similar in magnitude to losses previously reported in male cyclists. Research is needed to understand the mechanisms for bone loss in cyclists.
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Rajapakse CS, Phillips EA, Sun W, Wald MJ, Magland JF, Snyder PJ, Wehrli FW. Vertebral deformities and fractures are associated with MRI and pQCT measures obtained at the distal tibia and radius of postmenopausal women. Osteoporos Int 2014; 25:973-82. [PMID: 24221453 PMCID: PMC4746757 DOI: 10.1007/s00198-013-2569-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 10/24/2013] [Indexed: 11/26/2022]
Abstract
SUMMARY We investigated the association of postmenopausal vertebral deformities and fractures with bone parameters derived from distal extremities using MRI and pQCT. Distal extremity measures showed variable degrees of association with vertebral deformities and fractures, highlighting the systemic nature of postmenopausal bone loss. INTRODUCTION Prevalent vertebral deformities and fractures are known to predict incident further fractures. However, the association of distal extremity measures and vertebral deformities in postmenopausal women has not been fully established. METHODS This study involved 98 postmenopausal women (age range 60-88 years, mean 70 years) with DXA BMD T-scores at either the hip or spine in the range of -1.5 to -3.5. Wedge, biconcavity, and crush deformities were computed on the basis of spine MRI. Vertebral fractures were assessed using Eastell's criterion. Distal tibia and radius stiffness was computed using MRI-based finite element analysis. BMD at the distal extremities were obtained using pQCT. RESULTS Several distal extremity MRI and pQCT measures showed negative association with vertebral deformity on the basis of single parameter correlation (r up to 0.67) and two-parameter regression (r up to 0.76) models involving MRI stiffness and pQCT BMD. Subjects who had at least one prevalent vertebral fracture showed decreased MRI stiffness (up to 17.9 %) and pQCT density (up to 34.2 %) at the distal extremities compared to the non-fracture group. DXA lumbar spine BMD T-score was not associated with vertebral deformities. CONCLUSIONS The association between vertebral deformities and distal extremity measures supports the notion of postmenopausal osteoporosis as a systemic phenomenon.
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Affiliation(s)
- C S Rajapakse
- University of Pennsylvania School of Medicine, Philadelphia, PA, USA,
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Abstract
Variability in peripheral quantitative computed tomography (pQCT) measurement sites and outcome variables limit direct comparisons of results between studies. Furthermore, it is unclear what estimates of bone strength are most indicative of changes due to aging, disease, or interventions. The purpose of this study was to examine age and sex differences in estimates of tibia strength. An additional purpose of this study was to determine which tibia site or sites are most sensitive for detecting age and sex differences in tibia strength. Self-identifying Caucasian men (n=55) and women (n=59) aged 20-59yr had their tibias measured with pQCT from 5% to 85% of limb length in 10% increments distal to proximal. Bone strength index, strength strain index (SSI), moments of inertia (Ip, Imax, and Imin), and strength-to-mass ratios (polar moment of inertia to total bone mineral content [BMC] ratio [Ip:Tot.BMC] and strength strain index to total BMC ratio [SSI:Tot.BMC]) were quantified. There were significant (p<0.01) site effects for all strength variables and strength-to-mass ratios. Site×sex interaction effects were significant (p<0.05) for all strength variables. Men had greater (p<0.01) values than women for all strength variables. Sex differences in Ip, Imax, Ip:Tot.BMC, SSI, and SSI:Tot.BMC ratios were the smallest at the 15% site and peaked at various sites, depending on variable. Site×age interactions existed for Imax, Ip:Tot.BMC, and SSI:Tot.BMC. There were significant age effects, Imax, Ip:Tot.BMC, and SSI:Tot.BMC, as values were the lowest in the 20-29 age group. Age and sex differences varied by measurement site and variable, and larger sex differences existed for moments of inertia than SSI. Strength-to-mass ratios may reflect efficiency of the whole bone architecture.
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Affiliation(s)
- Vanessa D Sherk
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA.
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Tsampalieros A, Gupta P, Denburg MR, Shults J, Zemel BS, Mostoufi-Moab S, Wetzsteon RJ, Herskovitz RM, Whitehead KM, Leonard MB. Glucocorticoid effects on changes in bone mineral density and cortical structure in childhood nephrotic syndrome. J Bone Miner Res 2013; 28:480-8. [PMID: 23044926 PMCID: PMC3578070 DOI: 10.1002/jbmr.1785] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 09/14/2012] [Accepted: 09/20/2012] [Indexed: 12/13/2022]
Abstract
The impact of glucocorticoids (GC) on skeletal development has not been established. The objective of this study was to examine changes in volumetric bone mineral density (vBMD) and cortical structure over 1 year in childhood nephrotic syndrome (NS) and to identify associations with concurrent GC exposure and growth. Fifty-six NS participants, aged 5 to 21 years, were enrolled a median of 4.3 (0.5 to 8.1) years after diagnosis. Tibia peripheral quantitative computed tomography (pQCT) scans were obtained at enrollment and 6 and 12 months later. Sex, race, and age-specific Z-scores were generated for trabecular vBMD (TrabBMD-Z), cortical vBMD (CortBMD-Z), and cortical area (CortArea-Z) based on >650 reference participants. CortArea-Z was further adjusted for tibia length-for-age Z-score. Quasi-least squares regression was used to identify determinants of changes in pQCT Z-scores. At enrollment, mean TrabBMD-Z (-0.54 ± 1.32) was significantly lower (p = 0.0001) and CortBMD-Z (0.73 ± 1.16, p < 0.0001) and CortArea-Z (0.27 ± 0.91, p = 0.03) significantly greater in NS versus reference participants, as previously described. Forty-eight (86%) participants were treated with GC over the study interval (median dose 0.29 mg/kg/day). On average, TrabBMD-Z and CortBMD-Z did not change significantly over the study interval; however, CortArea-Z decreased (p = 0.003). Greater GC dose (p < 0.001), lesser increases in tibia length (p < 0.001), and lesser increases in CortArea-Z (p = 0.003) were independently associated with greater increases in CortBMD-Z. Greater increases in tibia length were associated with greater declines in CortArea-Z (p < 0.01); this association was absent in reference participants (interaction p < 0.02). In conclusion, GC therapy was associated with increases in CortBMD-Z, potentially related to suppressed bone formation and greater secondary mineralization. Conversely, greater growth and expansion of CortArea-Z (ie, new bone formation) were associated with declines in CortBMD-Z. Greater linear growth was associated with impaired expansion of cortical area in NS. Studies are needed to determine the fracture implications of these findings.
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Affiliation(s)
- Anne Tsampalieros
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
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Baker JF, Davis M, Alexander R, Zemel BS, Mostoufi-Moab S, Shults J, Sulik M, Schiferl DJ, Leonard MB. Associations between body composition and bone density and structure in men and women across the adult age spectrum. Bone 2013; 53:34-41. [PMID: 23238122 PMCID: PMC3552077 DOI: 10.1016/j.bone.2012.11.035] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 10/06/2012] [Accepted: 11/20/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND/PURPOSE The objective of this study was to identify independent associations between body composition and bone outcomes, including cortical structure and cortical and trabecular volumetric bone mineral density (vBMD) across the adult age spectrum. METHODS This cross-sectional study evaluated over 400 healthy adults (48% male, 44% black race), ages 21-78years. Multivariable linear regression models evaluated associations between whole-body DXA measures of lean body mass index (LBMI) and fat mass index (FMI) and tibia peripheral quantitative CT (pQCT) measures of cortical section modulus, cortical and trabecular vBMD and muscle density (as a measure of intramuscular fat), adjusted for age, sex, and race. All associations reported below were statistically significant (p<0.05). RESULTS Older age and female sex were associated with lower LBMI and muscle strength. Black race was associated with greater LBMI but lower muscle density. Greater FMI was associated with lower muscle density. Cortical section modulus was positively associated with LBMI and muscle strength and negatively associated with FMI. Adjustment for body composition eliminated the greater section modulus observed in black participants and attenuated the lower section modulus in females. Greater LBMI was associated with lower cortical BMD and greater trabecular BMD. FMI was not associated with either BMD outcome. Greater muscle density was associated with greater trabecular and cortical BMD. Associations between body composition and bone outcomes did not vary by sex (no significant tests for interaction). CONCLUSIONS These data highlight age-, sex- and race-specific differences in body composition, muscle strength and muscle density, and demonstrate discrete associations with bone density and structure. These data also show that age-, sex- and race-related patterns of bone density and strength are independent of differences in body composition. Longitudinal studies are needed to examine the temporal relations between changes in bone and body composition.
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Affiliation(s)
- Joshua F Baker
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Ashe MC, Gorman E, Khan KM, Brasher PM, Cooper DML, McKay HA, Liu-Ambrose T. Does frequency of resistance training affect tibial cortical bone density in older women? A randomized controlled trial. Osteoporos Int 2013; 24:623-32. [PMID: 22581292 PMCID: PMC3557371 DOI: 10.1007/s00198-012-2000-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 03/23/2012] [Indexed: 01/18/2023]
Abstract
SUMMARY This randomized controlled trial evaluated the effect of resistance training frequency (0, 1, and 2 times/week) on cortical volumetric bone mineral density (vBMD) at the tibia in older women. There was no mean difference in change in tibial cortical vBMD in older women who engaged in resistance training (RT) one or two times/week compared with the control group over 12 months after adjusting for baseline values. INTRODUCTION National guidelines recommend RT two to three times/week to optimize bone health. Our objective was to determine the effect of a 12-month intervention of three different RT frequencies on tibial volumetric cortical density (CovBMD) in healthy older women. METHODS We randomized participants to the following groups: (1) 2×/week balance and tone group (i.e., no resistance beyond body weight, BT), (2) 1×/week RT (RT1), and (3) 2×/week RT (RT2). Treatment allocation was concealed, and measurement team and the bone data analyst were blinded to group allocation. We used peripheral quantitative computed tomography to acquire one 2.3-mm scan at the 50 % tibia, and the primary outcome was CovBMD. Data were collected at baseline, 6 and 12 months, and we used linear mixed modeling to assess the effect at 12 months. RESULTS We assessed 147 participants; 100 women provided data at all three points. Baseline unadjusted mean (SD) tibial CovBMD (in milligrams per cubic centimeter) at the 50 % site was 1,077.4 (43.0) (BT), 1,087.8 (42.0) (RT1), and 1,058.7 (60.4) (RT2). At 12 months, there were no statistically significant differences (-0.45 to -0.17 %) between BT and RT groups for mean difference in change in tibial CovBMD for exercise interventions (BT, RT1, RT2) after adjusting for baseline tibial CovBMD. CONCLUSION We note no mean difference in change in tibial CovBMD in older women who engaged in RT one or two times/week compared with the control group over 12 months. It is unknown if RT of 3× or 4×/week would be enough to promote a statistically significant difference in change of bone density.
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Affiliation(s)
- M. C. Ashe
- Center for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1M9 Canada
- Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 3P1 Canada
- Department of Family Practice, UBC, Vancouver, BC V6T 1Z3 Canada
| | - E. Gorman
- Center for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1M9 Canada
- Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 3P1 Canada
- Department of Family Practice, UBC, Vancouver, BC V6T 1Z3 Canada
| | - K. M. Khan
- Center for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1M9 Canada
- Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 3P1 Canada
- Department of Family Practice, UBC, Vancouver, BC V6T 1Z3 Canada
- School of Human Kinetics, UBC, Vancouver, BC V6T 1Z1 Canada
| | - P. M. Brasher
- Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 3P1 Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver, BC V5Z 1M9 Canada
| | - D. M. L. Cooper
- Department of Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, SK Canada
| | - H. A. McKay
- Center for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1M9 Canada
- Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 3P1 Canada
- Department of Family Practice, UBC, Vancouver, BC V6T 1Z3 Canada
- Department of Orthopaedics, UBC, Vancouver, BC V5Z 1M9 Canada
| | - T. Liu-Ambrose
- Center for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1M9 Canada
- Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 3P1 Canada
- Department of Physical Therapy, UBC, Vancouver, BC V6T1Z3 Canada
- Brain Research Centre, UBC, Vancouver, BC V6T 2B5 Canada
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Gregson CL, Sayers A, Lazar V, Steel S, Dennison EM, Cooper C, Smith GD, Rittweger J, Tobias JH. The high bone mass phenotype is characterised by a combined cortical and trabecular bone phenotype: findings from a pQCT case-control study. Bone 2013; 52:380-8. [PMID: 23103330 PMCID: PMC3526774 DOI: 10.1016/j.bone.2012.10.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Revised: 08/26/2012] [Accepted: 10/19/2012] [Indexed: 11/19/2022]
Abstract
High bone mass (HBM), detected in 0.2% of DXA scans, is characterised by a mild skeletal dysplasia largely unexplained by known genetic mutations. We conducted the first systematic assessment of the skeletal phenotype in unexplained HBM using pQCT in our unique HBM population identified from screening routine UK NHS DXA scans. pQCT measurements from the mid and distal tibia and radius in 98 HBM cases were compared with (i) 65 family controls (constituting unaffected relatives and spouses), and (ii) 692 general population controls. HBM cases had substantially greater trabecular density at the distal tibia (340 [320, 359] mg/cm(3)), compared to both family (294 [276, 312]) and population controls (290 [281, 299]) (p<0.001 for both, adjusted for age, gender, weight, height, alcohol, smoking, malignancy, menopause, steroid and estrogen replacement use). Similar results were obtained at the distal radius. Greater cortical bone mineral density (cBMD) was observed in HBM cases, both at the midtibia and radius (adjusted p<0.001). Total bone area (TBA) was higher in HBM cases, at the distal and mid tibia and radius (adjusted p<0.05 versus family controls), suggesting greater periosteal apposition. Cortical thickness was increased at the mid tibia and radius (adjusted p<0.001), implying reduced endosteal expansion. Together, these changes resulted in greater predicted cortical strength (strength strain index [SSI]) in both tibia and radius (p<0.001). We then examined relationships with age; tibial cBMD remained constant with increasing age amongst HBM cases (adjusted β -0.01 [-0.02, 0.01], p=0.41), but declined in family controls (-0.05 [-0.03, -0.07], p<0.001) interaction p=0.002; age-related changes in tibial trabecular BMD, CBA and SSI were also divergent. In contrast, at the radius HBM cases and controls showed parallel age-related declines in cBMD and trabecular BMD. HBM is characterised by increased trabecular BMD and by alterations in cortical bone density and structure, leading to substantial increments in predicted cortical bone strength. In contrast to the radius, neither trabecular nor cortical BMD declined with age in the tibia of HBM cases, suggesting attenuation of age-related bone loss in weight-bearing limbs contributes to the observed bone phenotype.
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Key Words
- hbm, high bone mass
- nhs, national health service
- pqct, peripheral quantitative computed tomography
- oa, osteoarthritis
- l1, 1st lumbar vertebra
- cbmd, cortical bone mineral density
- tbmd, trabecular bone mineral density
- tba, total bone area
- cba, cortical bone area
- ssi, strength strain index
- sd, standard deviation
- pve, partial volume effect
- high bone mass
- pqct
- cortical
- trabecular
- age
- bmd
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Affiliation(s)
- Celia L. Gregson
- Musculoskeletal Research Unit, University of Bristol, Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
- Corresponding author at: Musculoskeletal Research Unit, University of Bristol, Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK. Fax: + 44 117 3235936.
| | - Adrian Sayers
- School of Social and Community Based Medicine, University of Bristol, Canynge Hall, 39 Whately Road, Bristol BS8 2PS, UK
| | - Victor Lazar
- Centre for Magnetic Resonance Investigations, Hull and East Yorkshire NHS Trust, Anlaby Road, Hull HU3 2JZ, UK
| | - Sue Steel
- Hull and East Yorkshire NHS Trust, Anlaby Road, Hull HU3 2JZ, UK
| | - Elaine M. Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - George Davey Smith
- MRC Centre for Causal Analyses in Translational Epidemiology (CAiTE). School of Social and Community Based Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Jörn Rittweger
- Institute for Biomedical Research into Human Movement and Health, Manchester Metropolitan University, All Saints Building, All Saints Manchester M15 6BH, UK
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Jon H. Tobias
- Musculoskeletal Research Unit, University of Bristol, Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK
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17
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Sayers A, Fraser WD, Lawlor DA, Tobias JH. 25-Hydroxyvitamin-D3 levels are positively related to subsequent cortical bone development in childhood: findings from a large prospective cohort study. Osteoporos Int 2012; 23:2117-28. [PMID: 22080378 PMCID: PMC3406315 DOI: 10.1007/s00198-011-1813-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 09/19/2011] [Indexed: 11/30/2022]
Abstract
UNLABELLED In exploring relationships between vitamin D status in childhood and cortical bone, little relationship was observed with plasma concentrations of 25-hydroxyvitamin-D(2) [25(OH)D(2)], whereas 25-hydroxyvitamin-D(3) [25(OH)D(3)] was positively related to cortical bone mineral content (BMC(C)) and cortical thickness, suggesting D(3) exerts a beneficial effect on cortical bone development in contrast to D(2). INTRODUCTION The study is aimed to determine whether vitamin D status in childhood is related to cortical bone development by examining prospective relationships between plasma concentrations of 25(OH)D(2) and 25(OH)D(3) at 7.6, 9.9 or 11.8 years and peripheral quantitative computed tomography (pQCT) measurements of the mid-tibia at age 15.5 years, in children from the Avon Longitudinal Study of Parents and Children. METHODS Relationships between vitamin D status and pQCT outcomes were analysed by bootstrap linear regression, adjusted for age, sex, body composition, socioeconomic position and physical activity, in 2,247 subjects in whom all covariates were available. 25(OH)D(3) was also adjusted for season and 25(OH)D(2), and 25(OH)D(2) for 25(OH)D(3). RESULTS 25(OH)D(3) was positively related to BMC(C) [0.066(0.009,0.122), P = 0.02], whereas no association was seen with 25(OH)D(2) [-0.008(-0.044,0.027), P = 0.7] [beta (with 95% CI) represents SD changes per doubling of vitamin D], P = 0.03 for difference in associations of 25(OH)D(2) and 25(OH)D(3) with BMC(C). There were also differences in associations with cortical geometry, since 25(OH)D(3) was positively related to cortical thickness [0.11(0.04, 0.19), P = 0.002], whereas no association was seen with 25(OH)D(2) [-0.04(-0.08,0.009), P = 0.1], P = 0.0005 for difference. These relationships translated into differences in biomechanical strength as reflected by buckling ratio, which was positively related to 25(OH)D(2) [0.06(0.01,0.11), P = 0.02] indicating less resistance to buckling, but inversely related to 25(OH)D(3) [-0.1(-0.19,-0.02), P = 0.03], P = 0.001 for difference. CONCLUSIONS In contrast to 25(OH)D(2), 25(OH)D(3) was positively related to subsequent cortical bone mass and predicted strength. In vitamin D-deficient children in whom supplementation is being considered, our results suggest that D(3) should be used in preference to D(2).
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Affiliation(s)
- A. Sayers
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
- Musculoskeletal Research Unit, Avon Orthopaedic Centre, Southmead Hospital, Bristol, BS10 5NB UK
| | - W. D. Fraser
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - D. A. Lawlor
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - J. H. Tobias
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
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18
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Sherk VD, Bemben DA, Bemben MG, Anderson MA. Age and sex differences in tibia morphology in healthy adult Caucasians. Bone 2012; 50:1324-31. [PMID: 22449446 PMCID: PMC4082662 DOI: 10.1016/j.bone.2012.03.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Revised: 02/21/2012] [Accepted: 03/07/2012] [Indexed: 11/28/2022]
Abstract
UNLABELLED Variability in peripheral Quantitative Computed Tomography (pQCT) measurement sites limits direct comparisons of results between studies. Further, it is unclear what estimates of bone strength are most indicative of changes due to aging, disease, or interventions. The purpose of this study was to examine age group and sex differences in tibia morphology. Additional purposes of this study were to determine which tibia site or sites are most sensitive for detecting age and sex differences. METHODS Self-identifying Caucasian men (n=55) and women (n=59) ages 20-59 years and separated by decades had their non-dominant tibias measured with pQCT (Stratec XCT 3000) at every 10% of the limb length from 5% to 85% (distal to proximal). Volumetric BMD and BMC of the total, cortical and trabecular bone were determined, as well as periosteal (PeriC) and endosteal (EndoC) circumferences, and cortical thickness (CTh). RESULTS There were significant (p<0.01) site effects for all BMC, vBMD, PeriC and EndoC measures. Large sex differences (men>women) in Tot.BMC (21-28%) were paralleled by differences in Cort.BMC (21-25%) (p<0.01). Site∗sex interaction effects were significant (p<0.05) for BMC (peak sex difference: 5%, 15%, 25%, 85% sites) and circumference (peak sex difference: 65% site) variables. CTh and total vBMD were lowest (p<0.05) in 50-59 year group, and EndoC was highest in the 50-59 year group. Site∗age interactions existed for Cort.vBMD, Tot.BMC (85% site), and EndoC (25%, 35%, 55%-85% sites). Correcting for bone free lean body mass (BFLBM) greatly reduced sex differences, eliminating sex∗site interaction effects, but sex main effects remained significant. Correcting for BFLBM did not eliminate age effects. CONCLUSION The magnitude of age and sex differences in tibia variables varied by measurement site demonstrating the need for standardization of measurement sites.
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Affiliation(s)
- Vanessa D Sherk
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA.
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19
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McCormack LA, Binkley TL, Specker BL. Effect of level of farm mechanization early in life on bone later in life. J Musculoskelet Neuronal Interact 2012; 12:7-15. [PMID: 22373946 PMCID: PMC8237463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To determine whether an active rural lifestyle during childhood and adolescence, defined as low farm mechanization, was associated with bone measures later in life. METHODS DXA bone data from total body, hip and spine, and pQCT data from 4% and 20% distal radius were obtained on 330 individuals (157 women) aged 20-66 years who farmed at least 75% of their lives. Primary bone outcomes included areal bone mineral density (aBMD), aBMD Z-scores, cortical and trabecular volumetric BMD, cortical thickness and periosteal circumference. Relationship between bone and recall of level of farm mechanization as a child was determined after stratifying by sex and controlling for covariates. RESULTS Controlling for covariates, females from low mechanized farms had higher femoral neck (FN) bone area (p=0.03) than those on high or moderate mechanized farms. No group differences in pQCT ulna measurements or z-scores were found in either gender. CONCLUSION A low farm mechanization level (high physical activity) prior to 20 years of age is associated with greater FN bone area in females. Future research that includes type and amount of physical activity performed will contribute to growing knowledge of how and when regular physical activity during childhood and adolescence affects adult bone health.
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Affiliation(s)
- L A McCormack
- E.A. Martin Program in Human Nutrition, South Dakota State University, Brookings, South Dakota 57006, United States
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20
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Cole ZA, Harvey NC, Kim M, Ntani G, Robinson SM, Inskip HM, Godfrey KM, Cooper C, Dennison EM. Increased fat mass is associated with increased bone size but reduced volumetric density in pre pubertal children. Bone 2012; 50:562-7. [PMID: 21600324 PMCID: PMC3678245 DOI: 10.1016/j.bone.2011.05.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 04/21/2011] [Accepted: 05/03/2011] [Indexed: 11/19/2022]
Abstract
Recent studies have shown that obesity is associated with an increased risk of fracture in both adults and children. It has been suggested that, despite greater bone size, obese individuals may have reduced true volumetric density; however this is difficult to assess using two dimensional techniques such as DXA. We evaluated the relationship between fat mass, and bone size and density, in a population cohort of children in whom DXA and pQCT measurements had been acquired. We recruited 530 children at 6 years old from the Southampton Women's Survey. The children underwent measurement of bone mass at the whole body, lumbar spine and hip, together with body composition, by DXA (Hologic Discovery, Hologic Inc., Bedford, MA, USA). In addition 132 of these children underwent pQCT measurements at the tibia (Stratec XCT2000, Stratec Biomedical Systems, Birkenfeld, Germany). Significant positive associations were observed between total fat mass and both bone area (BA) and bone mineral content (BMC) at the whole body minus head, lumbar spine and hip sites (all p<0.0001). When true volumetric density was assessed using pQCT data from the tibia, fat mass (adjusted for lean mass) was negatively associated with both trabecular and cortical density (β=-14.6 mg/mm(3) per sd, p=0.003; β=-7.7 mg/mm(3) per sd, p=0.02 respectively). These results suggest that fat mass is negatively associated with volumetric bone density at 6 years old, independent of lean mass, despite positive associations with bone size.
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Affiliation(s)
- Z A Cole
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK.
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21
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Barbour KE, Zmuda JM, Horwitz MJ, Strotmeyer ES, Boudreau R, Evans RW, Ensrud KE, Gordon CL, Petit MA, Patrick AL, Cauley JA. The association of serum 25-hydroxyvitamin D with indicators of bone quality in men of Caucasian and African ancestry. Osteoporos Int 2011; 22:2475-85. [PMID: 21104232 PMCID: PMC3539808 DOI: 10.1007/s00198-010-1481-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Accepted: 10/25/2010] [Indexed: 11/26/2022]
Abstract
UNLABELLED We examined the association of serum 25-hydroxyvitamin D [25(OH)D] with indices of bone quality in older men. Positive associations for 25(OH)D and bone mineral density, content, cortical thickness, and axial and polar strength strain indices were observed among Caucasians; however, among men of African descent findings were either null or negative. INTRODUCTION There are limited data on serum 25(OH)D and bone measures in men of African ancestry. To better understand racial differences in vitamin D status and bone health, a cross-sectional study among 446 Caucasian men in the US and 496 men of African ancestry in Tobago (age ≥ 65 years) was conducted. METHODS Serum 25(OH)D (liquid chromatography and tandem mass spectrometry) was measured, and peripheral quantitative computed tomography scans were administered. Bone measures estimated included trabecular and cortical volumetric bone mineral density (vBMD), bone mineral content (BMC), bone geometry (cross-sectional area and cortical thickness), and polar and axial strength strain indices (SSIp and SSIx). RESULTS Men of African ancestry had higher 25(OH)D than Caucasians (34.7 vs. 27.6 ng/ml, p < 0.01). Among Caucasians, 25(OH)D was positively (p trend < 0.05) associated with cortical vBMD, total BMC, cortical thickness, SSIp, and SSIx at the distal radius after adjustment for potential confounders. Similar patterns were observed at the distal tibia. In contrast, in men of African ancestry, there was an inverse association (p trend < 0.05) between 25(OH)D and the cross-sectional area, and SSIx. Race modified (p for interaction < 0.05) the association between 25(OH)D and total BMC, cross-sectional area, SSIp, SSIx, and trabecular vBMD of the radius. In men of African ancestry, there was evidence of a threshold effect (at approximately 18 ng/ml) for 25(OH)D on tibial total BMC and cortical thickness. CONCLUSIONS More studies are needed to better comprehend these race differences for 25(OH)D and bone density, geometry, and indices of bone strength.
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Affiliation(s)
- Kamil E. Barbour
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joseph M. Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mara J Horwitz
- Division of Endocrinology and Metabolism at the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Elsa S. Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rhobert W. Evans
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kristine E. Ensrud
- Minneapolis VA Medical Center, Rheumatology (111 R), One Veterans Drive, Minneapolis, 55417 MN, USA
| | | | - Moira A. Petit
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Alan L. Patrick
- Tobago Health Studies Office, Scarborough, Tobago, Trinidad & Tobago
| | - Jane A. Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Napoli N, Pedone C, Pozzilli P, Lauretani F, Bandinelli S, Ferrucci L, Incalzi RA. Effect of ghrelin on bone mass density: the InChianti study. Bone 2011; 49:257-63. [PMID: 21501701 PMCID: PMC5119485 DOI: 10.1016/j.bone.2011.03.772] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 03/22/2011] [Accepted: 03/25/2011] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Ghrelin is a stomach secreted hormone, believed to play an important role in energy balance and in food intake. Experimental studies have shown a positive effect of ghrelin on bone metabolism, but both in vivo and clinical findings have been contradictory. We aimed to investigate the effect of ghrelin on volumetric BMD in a large cohort of elderly subjects. METHODS We have studied 401 women (mean age 75.1years, range 65-94) and 306 men (mean age 73.9years, range 65-94) from the InChianti study, which included measurements of BMD using quantitative CT of the tibia and of body composition using bio impedancemetry. Serum ghrelin was measured using ELISA. We excluded participants with diabetes, hyperthyroidism, using hormone replacement or glucocorticoid therapy. We evaluated the correlation of ghrelin with total, trabecular, and cortical BMD using Pearson's coefficient, and linear regression models to estimate the association between ghrelin and BMD controlling for potential confounders. RESULTS In women, after correction for potential confounders, ghrelin was associated with trabecular BMD (β=7.08, P<0.02), but not with total or cortical BMD. In men, adjusted multivariable models showed a nearly significant association between serum ghrelin and trabecular BMD (β=4.99, P=0.069) and no association with either cortical or total BMD. CONCLUSIONS Serum ghrelin is positively correlated with trabecular BMD in a cohort of elderly healthy Italian women. The fact that trabecular is more metabolically active than cortical bone and the larger number of females might explain this selective association.
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Affiliation(s)
- Nicola Napoli
- Division of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Italy
- Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, MO, USA
| | - Claudio Pedone
- Centro per la Salute dell'Anziano, Area di Geriatria, Università Campus Bio-Medico di Roma, Italy
- Corresponding author at: Centro per la Salute dell'Anziano, Area di Geriatria, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy. (C. Pedone)
| | - Paolo Pozzilli
- Division of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Italy
| | - Fulvio Lauretani
- Geriatric Unit and Laboratory of Movement Analysis, Geriatric Rehabilitation Department, University Hospital of Parma, Parma, Italy
| | - Stefania Bandinelli
- Geriatric Rehabilitation Unit, Azienda Sanitaria di Firenze, Florence, Italy
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Raffaele Antonelli Incalzi
- Centro per la Salute dell'Anziano, Area di Geriatria, Università Campus Bio-Medico di Roma, Italy
- Fondazione San Raffaele, Cittadella della Carità, Taranto, Italy
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Abstract
UNLABELLED Development of optimal skeletal strength should decrease adult bone fragility. Nongymnasts (NON): were compared with girls exposed to gymnastics during growth (EX/GYM: ), using peripheral quantitative computed tomography (pQCT) to evaluate postmenarcheal bone geometry, density, and strength. Pre- and perimenarcheal gymnastic loading yields advantages in indices of postmenarcheal bone geometry and skeletal strength. INTRODUCTION Two prior studies using pQCT have reported bone density and size advantages in Tanner I/II gymnasts, but none describe gymnasts' bone properties later in adolescence. The current study used pQCT to evaluate whether girls exposed to gymnastics during late childhood growth and perimenarcheal growth exhibited greater indices of distal radius geometry, density, and skeletal strength. METHODS Postmenarcheal subjects underwent 4% and 33% distal radius pQCT scans, yielding: 1) vBMD and cross-sectional areas (CSA) (total bone, compartments); 2) polar strength-strain index; 3) index of structural strength in axial compression. Output was compared for EX/GYM: vs. NON: , adjusting for gynecological age and stature (maturity and body size), reporting means, standard errors, and significance. RESULTS Sixteen postmenarcheal EX/GYM: (age 16.7 years; gynecological age 3.4 years) and 13 NON: (age 16.2 years; gynecological age 3.6 years) were evaluated. At both diaphysis and metaphysis, EX/GYM: exhibited greater CSA and bone strength indices than NON; EX/GYM: exhibited 79% larger intramedullary CSA than NON: (p < 0.05). EX/GYM: had significantly higher 4% trabecular vBMD; differences were not detected for 4% total vBMD and 33% cortical vBMD. CONCLUSIONS Following pre-/perimenarcheal gymnastic exposure, relative to nongymnasts, postmenarcheal EX/GYM: demonstrated greater indices of distal radius geometry and skeletal strength (metaphysis and diaphysis) with greater metaphyseal trabecular vBMD; larger intramedullary cavity size was particularly striking.
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Affiliation(s)
- J N Dowthwaite
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Institute for Human Performance, 505 Irving Avenue, Rm 3206, Syracuse, NY 13210, USA.
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Napoli N, Pedone C, Pozzilli P, Lauretani F, Ferrucci L, Incalzi RA. Adiponectin and bone mass density: The InCHIANTI study. Bone 2010; 47:1001-5. [PMID: 20804877 PMCID: PMC4623316 DOI: 10.1016/j.bone.2010.08.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 08/12/2010] [Accepted: 08/16/2010] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Adiponectin serum concentration has been reported to be inversely correlated with bone mineral density (BMD) in humans. The data on this issue, however, are biased by small study sample size and lack of controlling for body composition. METHODS We used data from the third follow-up of the InCHIANTI study, which included measurements of BMD using quantitative CT of the tibia and of body composition using bioimpedenziometry. Serum adiponectin was measured using radioimmunoassay. We excluded participants with diabetes, hyperthyroidism, using hormone replacement or corticosteroid therapy. We evaluated the correlation of adiponectin with total, trabecular, and cortical BMD using Pearson's coefficient, and linear regression models to estimate the association between adiponectin and BMD controlling for potential confounders (age, body mass index, alcohol intake, fat mass, smoking). RESULTS Our sample was made up of 320 men (mean age: 67 years, SD: 15.8, range: 29-97 years) and 271 postmenopausal women (mean age: 76 years, SD: 8.2, range: 42-97 years). In men, serum adiponectin was not independently associated with BMD. In women, after correction for potential confounders, adiponectin was associated with total (β=-0.626, P<0.001), trabecular (β=-0.696, P<0.001), and cortical (β=-1.076, P=0.001) BMD. CONCLUSION Our results show that adiponectin is inversely associated with bone mass in women. Further studies are needed to confirm these findings prospectively and then to clarify the explanatory mechanisms.
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Affiliation(s)
- Nicola Napoli
- Division of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Italy
- Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, MO, USA
| | - Claudio Pedone
- Centro per la Salute dell’Anziano, Area di Geriatria Università Campus Bio-Medico di Roma, Italy
- Corresponding author: Centro per la Salute dell’ Anziano, Area di Geriatria, Università Campus Biomedico, Via Alvaro del Portillo, 21 00128 Roma, Italy. (C. Pedone)
| | - Paolo Pozzilli
- Division of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Italy
| | | | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Raffaele Antonelli Incalzi
- Centro per la Salute dell’Anziano, Area di Geriatria Università Campus Bio-Medico di Roma, Italy
- Fondazione San Raffaele - Cittadella delta Carità, Taranto, Italy
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Laskey MA, de Bono S, Zhu D, Shaw CN, Laskey PJ, Ward KA, Prentice A. Evidence for enhanced characterization of cortical bone using novel pQCT shape software. J Clin Densitom 2010; 13:247-55. [PMID: 20670880 PMCID: PMC2935963 DOI: 10.1016/j.jocd.2010.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 04/28/2010] [Accepted: 05/12/2010] [Indexed: 11/27/2022]
Abstract
Bone shape, mass, structural geometry, and material properties determine bone strength. This study describes novel software that uses peripheral quantitative computed tomography (pQCT) images to quantify cortical bone shape and investigates whether the combination of shape-sensitive and manufacturer's software enhances the characterization of tibiae from contrasting populations. Existing tibial pQCT scans (4% and 50% sites) from Gambian (n=38) and British (n=38) women were used. Bone mass, cross-sectional area (CSA), and geometry were determined using manufacturer's software; cross-sectional shape was quantified using shape-sensitive software. At 4% site, Gambian women had lower total bone mineral content (BMC: -15.4%), CSA (-13.4%), and trabecular bone mineral density (BMD: -19%), but higher cortical subcortical BMD (6.1%). At 50% site, Gambian women had lower cortical BMC (-7.6%), cortical CSA (-12.6%), and mean cortical thickness (-15.0%), but higher cortical BMD (4.9%) and endosteal circumference (8.0%). Shape-sensitive software supported the finding that Gambian women had larger tibial endosteal circumference (9.8%), thinner mean cortical thickness (-26.5%) but smaller periosteal circumference (-5.6%). Shape-sensitive software revealed that Gambian women had tibiae with shorter maximum width (-7.6%) and thinner cortices (-22% to -41.2%) and more closely resembled a circle or ellipse. Significant differences remained after adjusting for age, height, and weight. In conclusion, shape-sensitive software enhanced the characterization of tibiae in 2 contrasting groups of women.
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Dudley-Javoroski S, Shields RK. Longitudinal changes in femur bone mineral density after spinal cord injury: effects of slice placement and peel method. Osteoporos Int 2010; 21:985-95. [PMID: 19707702 PMCID: PMC2875776 DOI: 10.1007/s00198-009-1044-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Accepted: 07/27/2009] [Indexed: 02/07/2023]
Abstract
SUMMARY Surveillance of femur metaphysis bone mineral density (BMD) decline after spinal cord injury (SCI) may be subject to slice placement error of 2.5%. Adaptations to anti-osteoporosis measures should exceed this potential source of error. Image analysis parameters likewise affect BMD output and should be selected strategically in longitudinal studies. INTRODUCTION Understanding the longitudinal changes in bone mineral density (BMD) after spinal cord injury (SCI) is important when assessing new interventions. We determined the longitudinal effect of SCI on BMD of the femur metaphysis. To facilitate interpretation of longitudinal outcomes, we (1) determined the BMD difference associated with erroneous peripheral quantitative computed tomography (pQCT) slice placement, and (2) determined the effect of operator-selected pQCT peel algorithms on BMD. METHODS pQCT images were obtained from the femur metaphysis (12% of length from distal end) of adult subjects with and without SCI. Slice placement errors were simulated at 3 mm intervals and were processed in two ways (threshold-based vs. concentric peel). RESULTS BMD demonstrated a rapid decline over 2 years post-injury. BMD differences attributable to operator-selected peel methods were large (17.3% for subjects with SCI). CONCLUSIONS Femur metaphysis BMD declines after SCI in a manner similar to other anatomic sites. Concentric (percentage-based) peel methods may be most appropriate when special sensitivity is required to detect BMD adaptations. Threshold-based methods may be more appropriate when asymmetric adaptations are observed.
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Barbour KE, Zmuda JM, Strotmeyer ES, Horwitz MJ, Boudreau R, Evans RW, Ensrud KE, Petit MA, Gordon CL, Cauley JA. Correlates of trabecular and cortical volumetric bone mineral density of the radius and tibia in older men: the Osteoporotic Fractures in Men Study. J Bone Miner Res 2010; 25:1017-28. [PMID: 20200975 PMCID: PMC3153367 DOI: 10.1002/jbmr.6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Quantitative computed tomography (QCT) can estimate volumetric bone mineral density (vBMD) and distinguish trabecular from cortical bone. Few comprehensive studies have examined correlates of vBMD in older men. This study evaluated the impact of demographic, anthropometric, lifestyle, and medical factors on vBMD in 1172 men aged 69 to 97 years and enrolled in the Osteoporotic Fractures in Men Study (MrOS). Peripheral quantitative computed tomography (pQCT) was used to measure vBMD of the radius and tibia. The multivariable linear regression models explained up to 10% of the variance in trabecular vBMD and up to 9% of the variance in cortical vBMD. Age was not correlated with radial trabecular vBMD. Correlates associated with both cortical and trabecular vBMD were age (-), caffeine intake (-), total calcium intake (+), nontrauma fracture (-), and hypertension (+). Higher body weight was related to greater trabecular vBMD and lower cortical vBMD. Height (-), education (+), diabetes with thiazolidinedione (TZD) use (+), rheumatoid arthritis (+), using arms to stand from a chair (-), and antiandrogen use (-) were associated only with trabecular vBMD. Factors associated only with cortical vBMD included clinic site (-), androgen use (+), grip strength (+), past smoker (-), and time to complete five chair stands (-). Certain correlates of trabecular and cortical vBMD differed among older men. An ascertainment of potential risk factors associated with trabecular and cortical vBMD may lead to better understanding and preventive efforts for osteoporosis in men.
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Affiliation(s)
- Kamil E Barbour
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Sheu Y, Cauley JA, Bunker CH, Wheeler VW, Patrick AL, Gordon CL, Kammerer CM, Zmuda JM. Correlates of trabecular and cortical volumetric BMD in men of African ancestry. J Bone Miner Res 2009; 24:1960-8. [PMID: 19453259 DOI: 10.1359/jbmr.090522] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
QCT provides a measure of volumetric BMD (vBMD) and distinguishes trabecular from cortical bone. Few studies have determined the factors related to vBMD in men, especially among men of African heritage. This study evaluated the relationship of anthropometric, medical, and behavioral factors and vBMD in a population-based cohort of men of African ancestry (n = 1901) >or=40 yr of age who had undergone screening for prostate cancer for the first time. Trabecular and cortical vBMD were measured at the radius and tibia by pQCT. Multiple linear regression analysis identified age, height, body weight, cigarette smoking, history of diabetes, fracture, and prostate cancer as the independent correlates of vBMD. However, associations with several variables differed between cortical and trabecular vBMD and between the radius and tibia. Longitudinal studies are needed to gain a better understanding of the mechanisms underlying these differential associations that may show new insight into the etiology of trabecular and cortical bone loss in men.
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Wetzsteon RJ, Shults J, Zemel BS, Gupta PU, Burnham JM, Herskovitz RM, Howard KM, Leonard MB. Divergent effects of glucocorticoids on cortical and trabecular compartment BMD in childhood nephrotic syndrome. J Bone Miner Res 2009; 24:503-13. [PMID: 19016583 DOI: 10.1359/jbmr.081101] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Glucocorticoid (GC) effects on skeletal development have not been established. The objective of this pQCT study was to assess volumetric BMD (vBMD) and cortical dimensions in childhood steroid-sensitive nephrotic syndrome (SSNS), a disorder with minimal independent deleterious skeletal effects. Tibia pQCT was used to assess trabecular and cortical vBMD, cortical dimensions, and muscle area in 55 SSNS (age, 5-19 yr) and >650 control participants. Race-, sex-, and age-, or tibia length-specific Z-scores were generated for pQCT outcomes. Bone biomarkers included bone-specific alkaline phosphatase and urinary deoxypyridinoline. SSNS participants had lower height Z-scores (p < 0.0001) compared with controls. In SSNS, Z-scores for cortical area were greater (+0.37; 95% CI = 0.09, 0.66; p = 0.01), for cortical vBMD were greater (+1.17; 95% CI = 0.89, 1.45; p < 0.0001), and for trabecular vBMD were lower (-0.60; 95% CI, = -0.89, -0.31; p < 0.0001) compared with controls. Muscle area (+0.34; 95% CI = 0.08, 0.61; p = 0.01) and fat area (+0.56; 95% CI = 0.27, 0.84; p < 0.001) Z-scores were greater in SSNS, and adjustment for muscle area eliminated the greater cortical area in SSNS. Bone formation and resorption biomarkers were significantly and inversely associated with cortical vBMD in SSNS and controls and were significantly lower in the 34 SSNS participants taking GCs at the time of the study compared with controls. In conclusion, GCs in SSNS were associated with significantly greater cortical vBMD and cortical area and lower trabecular vBMD, with evidence of low bone turnover. Lower bone biomarkers were associated with greater cortical vBMD. Studies are needed to determine the fracture implications of these varied effects.
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Bhupathiraju SN, Alekel DL, Stewart JW, Hanson LN, Shedd KM, Reddy MB, Hanson KB, Van Loan MD, Genschel U, Koehler KJ. Relationship of circulating total homocysteine and C-reactive protein to trabecular bone in postmenopausal women. J Clin Densitom 2007; 10:395-403. [PMID: 17662632 PMCID: PMC2131712 DOI: 10.1016/j.jocd.2007.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2007] [Revised: 05/30/2007] [Accepted: 06/12/2007] [Indexed: 11/29/2022]
Abstract
Homocysteine (Hcy) and C-reactive protein (CRP) are novel risk factors for osteoporosis. The purpose of this analysis was to determine the relationship of Hcy and CRP to volumetric trabecular bone, but also to assess their relationship to areal composite bone in healthy postmenopausal women (N=184). We used peripheral quantitative computed tomography to assess volumetric bone at the distal tibia and dual-energy X-ray absorptiometry to assess areal composite bone at the proximal femur and lumbar spine. Multiple regression revealed that 22% of the variability in trabecular bone mineral content (F=9.59, p<or=0.0001) was accounted for by weight (12.4%; p<or=0.0001), hemoglobin (5.5%; p=0.0006), uric acid (4.2%; p=0.003), and blood glucose (1.5%; p=0.07). Multiple regression revealed that 5.4% of the variability in trabecular bone mineral density (F=3.36; p=0.020) was accounted for by hemoglobin (4.2%; p=0.006) and Hcy (1.5%; not significant, p=0.10). Total Hcy and CRP were not significantly related to trabecular bone, perhaps because these were nonosteoporotic women. However, our results suggested a weak but negative relationship between Hcy and trabecular bone. Further investigation is needed to examine the relationship of Hcy as an endogenous bioactive molecule to trabecular bone loss in early postmenopausal women and the response of trabecular bone to dietary intervention.
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Affiliation(s)
- Shilpa N Bhupathiraju
- Department of Food Science and Human Nutrition, Human Metabolic Unit, Center for Designing Foods to Improve Nutrition, Iowa State University, Ames, IA 50011, USA
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Wallace JM, Rajachar RM, Allen MR, Bloomfield SA, Robey PG, Young MF, Kohn DH. Exercise-induced changes in the cortical bone of growing mice are bone- and gender-specific. Bone 2007; 40:1120-7. [PMID: 17240210 PMCID: PMC2729655 DOI: 10.1016/j.bone.2006.12.002] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Revised: 11/02/2006] [Accepted: 12/01/2006] [Indexed: 10/23/2022]
Abstract
Fracture risk and mechanical competence of bone are functions of bone mass and tissue quality, which in turn are dependent on the bone's mechanical environment. Male mice have a greater response to non-weight-bearing exercise than females, resulting in larger, stronger bones compared with control animals. The aim of this study was to test the hypothesis that short-term weight-bearing running during growth (21 days starting at 8 weeks of age; 30 min/day; 12 m/min; 5 degrees incline; 7 days/week) would similarly have a greater impact on cross-sectional geometry and mechanical competence in the femora and tibiae of male mice versus females. Based on the orientation of the legs during running and the proximity of the tibia to the point of impact, this response was hypothesized to be greatest in the tibia. Exercise-related changes relative to controls were assayed by four-point bending tests, while volumetric bone mineral density and cross-sectional geometry were also assessed. The response to running was bone- and gender-specific, with male tibiae demonstrating the greatest effects. In male tibiae, periosteal perimeter, endocortical perimeter, cortical area, medial-lateral width and bending moment of inertia increased versus control mice suggesting that while growth is occurring in these mice between 8 and 11 weeks of age, exercise accelerated this growth resulting in a greater increase in bone tissue over the 3 weeks of the study. Exercise increased tissue-level strain-to-failure and structural post-yield deformation in the male tibiae, but these post-yield benefits came at the expense of decreased yield deformation, structural and tissue-level yield strength and tissue-level ultimate strength. These results suggest that exercise superimposed upon growth accelerated growth-related increases in tibial cross-sectional dimensions. Exercise also influenced the quality of this forming bone, significantly impacting structural and tissue-level mechanical properties.
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Affiliation(s)
- Joseph M. Wallace
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | - Rupak M. Rajachar
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | - Matthew R. Allen
- Texas A&M University, Department of Health and Kinesiology; College Station, TX
| | - Susan A. Bloomfield
- Texas A&M University, Department of Health and Kinesiology; College Station, TX
| | - Pamela G. Robey
- National Institutes of Health, National Institute of Dental and Craniofacial Research, Craniofacial and Skeletal Diseases Branch, Department of Health and Human Services; Bethesda, MD
| | - Marian F. Young
- National Institutes of Health, National Institute of Dental and Craniofacial Research, Craniofacial and Skeletal Diseases Branch, Department of Health and Human Services; Bethesda, MD
| | - David H. Kohn
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI
- Department of Biologic and Materials Sciences, University of Michigan, Ann Arbor, MI
- National Institutes of Health, National Institute of Dental and Craniofacial Research, Craniofacial and Skeletal Diseases Branch, Department of Health and Human Services; Bethesda, MD
- Corresponding Author: David H. Kohn, Ph.D., University of Michigan, Department of Biologic & Materials Sciences, 1011 N. University Ave., Ann Arbor, MI 48109-1078, Ph: (734) 764-2206, Fax: (734) 647-2110, E-mail:
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Lauretani F, Bandinelli S, Russo C, Maggio M, Di Iorio A, Cherubini A, Maggio D, Ceda G, Valenti G, Guralnik J, Ferrucci L. Correlates of bone quality in older persons. Bone 2006; 39:915-21. [PMID: 16709469 PMCID: PMC2646095 DOI: 10.1016/j.bone.2006.03.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2006] [Revised: 03/16/2006] [Accepted: 03/27/2006] [Indexed: 02/04/2023]
Abstract
PURPOSE OF THE STUDY In a population-based sample of older persons, we studied the relationship between tibial bone density and geometry and factors potentially affecting osteoporosis. METHODS Of the 1260 participants aged 65 years or older eligible for the InCHIANTI study, 1155 received an interview and 915 (79.2%) had complete data on tibial QCT scans and other variables used in the analysis presented here. The final study population included 807 persons (372 men and 435 women, age range 65-96 years) after exclusion of participants affected by bone diseases or treated with drugs that interfere with bone metabolism. RESULTS In both sexes, calf cross-sectional muscle area (CSMA) was significantly and independently associated with total bone cross-sectional area (tCSA) and cortical bone cross-sectional area (cCSA) but not with trabecular or cortical volumetric bone mineral density (vBMD). Bioavailable testosterone (Bio-T) was independently associated with both trabecular and cortical vBMD in both sexes. In women, independently of confounders, 25(OH)-vitamin D was positively associated with tCSA and cortical vBMD, while PTH was negatively associated with cortical vBMD. IL-1 beta was negatively correlated with cortical vBMD in women, while TNF-alpha was associated with enhanced bone geometrical adaptation in men. CONCLUSIONS Physiological parameters that are generically considered risk factors for osteoporosis were associated with specific bone parameters assessed by tibial QCT. Factors known to be associated with increased bone reabsorption, such as 25(OH)-vitamin D, PTH and Bio-T, affected mainly volumetric BMD, while factors associated with bone mechanical stimulation, such as CSMA, affected primarily bone geometry. Our results also suggested that pro-inflammatory cytokines might be considered as markers of bone resorption.
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Affiliation(s)
| | | | | | - M. Maggio
- Longitudinal Studies Section, Clinical Research Branch, Gerontology Research Center, National Institute on Aging (NIH), Longitudinal Studies Section, 5600 Nathan Shock Drive, Baltimore, MD 21224-6825, USA
| | - A. Di Iorio
- Laboratory of Clinical Epidemiology, Department of Medicine and Sciences of Aging, University G. D’Annunzio, Chieti, Italy
| | - A. Cherubini
- Institute of Gerontology and Geriatrics, Perugia University Medical School, Perugia, Italy
| | - D. Maggio
- Institute of Gerontology and Geriatrics, Perugia University Medical School, Perugia, Italy
| | - G.P. Ceda
- Department of Internal Medicine and Biomedical Sciences, Section of Geriatrics, University of Parma, Italy
| | - G. Valenti
- Department of Internal Medicine and Biomedical Sciences, Section of Geriatrics, University of Parma, Italy
| | - J.M. Guralnik
- Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, MD 21224, USA
| | - L. Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, Gerontology Research Center, National Institute on Aging (NIH), Longitudinal Studies Section, 5600 Nathan Shock Drive, Baltimore, MD 21224-6825, USA
- Corresponding author. Fax: +1 410 5588321. E-mail address: (L. Ferrucci)
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Abstract
At the mid-radius, pre-pubertal asthmatic children had smaller periosteal and endosteal circumferences and thicker cortical shells compared to controls, when assessed by peripheral quantitative computed tomography. Asthmatics had diminished periosteal expansion for muscle size, suggesting that asthma, its treatment, or its effects on physical activity had resulted in impaired adaptation of bone to muscle loading. Alterations in cortical bone geometry might explain the increased fracture risk in asthmatic children.
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Affiliation(s)
- J L Quick
- Department of Paediatric Medicine, Saint Mary's Hospital for Women & Children, Central Manchester & Manchester Children's Hospitals NHS Trust, Manchester, UK
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Khosla S, Riggs BL, Atkinson EJ, Oberg AL, McDaniel LJ, Holets M, Peterson JM, Melton LJ. Effects of sex and age on bone microstructure at the ultradistal radius: a population-based noninvasive in vivo assessment. J Bone Miner Res 2006; 21:124-31. [PMID: 16355281 PMCID: PMC1352156 DOI: 10.1359/jbmr.050916] [Citation(s) in RCA: 389] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2005] [Revised: 09/08/2005] [Accepted: 09/30/2005] [Indexed: 01/12/2023]
Abstract
UNLABELLED In a population-based cross-sectional study, we examined effects of sex and age on bone microstructure at the wrist using high-resolution 3-D pQCT. Compared with women, men had thicker trabeculae in young adulthood and had less microstructural damage with aging. These findings may contribute to the virtual immunity of men to age-related increases in wrist fractures. INTRODUCTION Although changes in bone microstructure contribute to fracture risk independently of BMD, it has not heretofore been possible to assess this noninvasively in population-based studies. MATERIALS AND METHODS We used high-resolution 3-D pQCT imaging (voxel size, 89 mum) to define, in a random sample of women (n = 324) and men (n = 278) 21-97 years of age, sex and age effects on bone microstructure at the wrist. RESULTS Relative to young women (age, 20-29 years), young men had greater trabecular bone volume/tissue volume (BV/TV; by 26%, p = 0.001) and trabecular thickness (TbTh; by 28%, p < 0.001) but similar values for trabecular number (TbN) and trabecular separation (TbSp). Between ages 20 and 90 years, cross-sectional decreases in BV/TV were similar in women (-27%) and in men (-26%), but whereas women had significant decreases in TbN (-13%) and increases in TbSp (+24%), these parameters had little net change over life in men (+7% and -2% for TbN and TbSp, respectively; p < 0.001 versus women). However, TbTh decreased to a greater extent in men (-24%) than in women (-18%; p = 0.010 versus men). CONCLUSIONS Whereas decreases with age in trabecular BV/TV are similar in men and women, the structural basis for the decrease in trabecular volume is quite different between the sexes. Thus, over life, women undergo loss of trabeculae with an increase in TbSp, whereas men begin young adult life with thicker trabeculae and primarily sustain trabecular thinning with no net change in TbN or TbSp. Because decreases in TbN have been shown to have a much greater impact on bone strength compared with decreases in TbTh, these findings may help explain the lower life-long risk of fractures in men, and specifically, their virtual immunity to age-related increases in distal forearm fractures.
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Affiliation(s)
- Sundeep Khosla
- Endocrine Research Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
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