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Abnormal microarchitecture and reduced stiffness at the radius and tibia in postmenopausal women with fractures.

著者 Stein EM , Liu XS , Nickolas TL , Cohen A , Thomas V , McMahon DJ , Zhang C , Yin PT , Cosman F , Nieves J , Guo XE , Shane E
J Bone Miner Res.2010 Jun 18 ; ():.
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Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.

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INTRODUCTION: Measurement of areal bone mineral density (aBMD) by dual energy x-ray absorptiometry (DXA) has been shown to predict fracture risk. High-resolution peripheral quantitative computed tomography (HR-pQCT) yields additional information about volumetric BMD (vBMD), microarchitecture and strength that may increase understanding of fracture susceptibility. METHODS: Women with (n = 68) and without (n = 101) a history of postmenopausal fragility fracture had areal BMD (aBMD) measured by DXA, trabecular and cortical vBMD and trabecular microarchitecture of the radius and tibia measured by HR-pQCT. Finite element analysis (FEA) of HR-pQCT scans was performed to estimate bone stiffness. RESULTS: DXA T-scores were similar in women with and without fracture at the spine, hip and 1/3 radius, but lower in fracture subjects at the ultradistal radius (p < 0.01). At the radius, fracture subjects had lower total density, cortical thickness, trabecular density, number, thickness, higher trabecular separation and network heterogeneity (p < 0.0001-0.04). At the tibia, total, cortical and trabecular density, cortical and trabecular thickness were lower in fracture subjects (p < 0.0001-0.03). The differences between groups were greater at the radius than the tibia for inner trabecular density, trabecular number, separation and network heterogeneity (p < 0.01-0.05). Stiffness was reduced in fracture subjects, more markedly at the radius (41-44%) than the tibia (15-20%). CONCLUSIONS: Women with fractures had reduced vBMD, microarchitectural deterioration and decreased strength. These differences were more prominent at the radius than tibia. HR-pQCT and FEA measurements of peripheral sites are associated with fracture prevalence and may increase understanding of the role of microarchitectural deterioration in fracture susceptibility. (c) 2010 American Society for Bone and Mineral Research.
PMID: 20564238 [PubMed - as supplied by publisher]
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