Skip to main content

Advertisement

SpringerLink
Log in

Age-related reference curves of volumetric bone density, structure, and biomechanical parameters adjusted for weight and height in a population of healthy women: an HR-pQCT study

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

In a cross-sectional cohort of 450 healthy women aged 20 to 85 years, data on the density, structure, and strength of the distal radius and tibia were obtained using high-resolution peripheral quantitative computed tomography (HR-pQCT) and were adjusted for age, weight, and height. Age-dependent patterns of change differed between the sites and between the trabecular and cortical compartments. In postmenopausal women, the trabecular bone remained relatively stable at the distal tibia, but the cortical compartment changed significantly. Cortical porosity exhibited a very weak correlation with stiffness.

Introduction

The aim of this study is to provide information on age-related, weight-related, and height-related changes in the volumetric bone mineral density (vBMD), structure, and biomechanical parameters of the cortical and trabecular compartments in a healthy female population using HR-pQCT.

Methods

For a cross-sectional Brazilian cohort of 450 women aged 20 to 85 years, age-related reference curves of the vBMD, structure, and biomechanical parameters of the distal radius (DR) and distal tibia (DT) were constructed and adjusted for weight and height, and comparisons between premenopausal and postmenopausal women were performed.

Results

Reference curves were obtained for all parameters. At the DR, age-related changes varied from −8.68% (cortical thickness [Ct.Th]) to 26.7% (trabecular separation [Tb.Sp]). At the DT, the changes varied from −12.4% (Ct.Th) to 26.3% (Tb.Sp). Cortical porosity (Ct.Po) exhibited the largest percent changes: 342.2% at the DR and 381.5% at the DT. In premenopausal women, Ct.Th remained constant; in postmenopausal women, structural trabecular parameters (trabecular number (Tb.N), trabecular thickness (Tb.Th), Tb.Sp) did not change, whereas cortical parameters and stiffness were significantly altered. Cortical vBMD showed the greatest absolute decrease at both sites, and the slopes were highly negative after menopause. Pearson correlations between stiffness (S) and HR-pCT parameters revealed a significant correlation between the densities and structures of the trabecular and cortical compartments. A weak correlation was observed between S and Ct.Po (DR r = −0.162, DT r = −0.273; p < 0.05).

Conclusions

These data provide reference curves from healthy women and demonstrate that density and structural and biomechanical parameters differ between the radius and tibia and between the trabecular and cortical compartments. In postmenopausal women, the trabecular bone remained relatively stable at the tibia site, whereas the cortical compartment changed significantly.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Delaisse JM (2014) The reversal phase of the bone-remodeling cycle: cellular prerequisites for coupling resorption and formation. Bonekey Rep 3:561–556

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Feng X, McDonald JM (2011) Disorders of bone remodeling. Annu Rev Pathol 6:121–145

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. Lancet 359(9321):1929–1936

    Article  PubMed  Google Scholar 

  4. Kaji H, Yamauchi M, Chihara K et al (2006) The threshold of bone mineral density for vertebral fracture in female patients with glucocorticoid-induced osteoporosis. Endocr J 53(1):27–34

    Article  CAS  PubMed  Google Scholar 

  5. Stein EM, Kepley A, Walker M, Nickolas TL, Nishiyama K, Zhou B et al (2014) Skeletal structure in postmenopausal women with osteopenia and fractures is characterized by abnormal trabecular plates and cortical thinning. J Bone Miner Res 29(5):1101–1109

    Article  PubMed  PubMed Central  Google Scholar 

  6. Stone KL, Seeley DG, Lui LY et al (2003) BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J Bone Miner Res 18(11):1947–1954

    Article  PubMed  Google Scholar 

  7. Patsch JM, Burghardt AJ, Kazakia G, Majumdar S (2011) Noninvasive imaging of bone microarchitecture. Ann N Y Acad Sci 1240:77–87

    Article  PubMed  PubMed Central  Google Scholar 

  8. Boutroy S, Bouxsein ML, Munoz F, Delmas PD (2005) In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 90(12):6508–6515

    Article  CAS  PubMed  Google Scholar 

  9. Engelke K, Stampa B, Timm W, Dardzinski B, de Papp AE, Genant HK et al (2012) Short-term in vivo precision of BMD and parameters of trabecular architecture at the distal forearm and tibia. Osteoporos Int 23(8):2151–2158

    Article  CAS  PubMed  Google Scholar 

  10. Fuller H, Fuller R, Pereira RM (2015) High resolution peripheral quantitative computed tomography for the assessment of morphological and mechanical bone parameters. Rev Bras Reumatol (English Edition) 55(4):352–362

    Article  Google Scholar 

  11. Boutroy S, Van Rietbergen B, Sornay-Rendu E, Munoz F, Bouxsein ML, Delmas PD (2008) Finite element analysis based on in vivo HR-pQCT images of the distal radius is associated with wrist fracture in postmenopausal women. J Bone Miner Res 23(3):392–399

    Article  PubMed  Google Scholar 

  12. Liu XS, Zhang XH, Sekhon KK, Adams MF, McMahon DJ, Bilezikian JP et al (2010) High-resolution peripheral quantitative computed tomography can assess microstructural and mechanical properties of human distal tibial bone. J Bone Miner Res 25(4):746–756

    CAS  PubMed  Google Scholar 

  13. Dalzell N, Kaptoge S, Morris N, Berthier A, Koller B, Braak L et al (2009) Bone micro-architecture and determinants of strength in the radius and tibia: age-related changes in a population-based study of normal adults measured with high-resolution pQCT. Osteoporos Int 20(10):1683–1694

    Article  CAS  PubMed  Google Scholar 

  14. Burt LA, Macdonald HM, Hanley DA, Boyd SK (2014) Bone microarchitecture and strength of the radius and tibia in a reference population of young adults: an HR-pQCT study. Arch Osteoporos 9(1):183

    Article  PubMed  Google Scholar 

  15. Burghardt AJ, Kazakia GJ, Ramachandran S, Link TM, Majumdar S (2010) Age- and gender-related differences in the geometric properties and biomechanical significance of intracortical porosity in the distal radius and tibia. J Bone Miner Res 25(5):983–993

    PubMed  Google Scholar 

  16. Vilayphiou N, Boutroy S, Sornay-Rendu E, Van Rietbergen B, Chapurlat R (2016) Age-related changes in bone strength from HR-pQCT derived microarchitectural parameters with an emphasis on the role of cortical porosity. Bone 83:233–240

    Article  PubMed  Google Scholar 

  17. Macdonald HM, Nishiyama KK, Kang J, Hanley DA, Boyd SK (2011) Age-related patterns of trabecular and cortical bone loss differ between sexes and skeletal sites: a population-based HR-pQCT study. J Bone Miner Res 26(1):50–62

    Article  PubMed  Google Scholar 

  18. Khosla S, Riggs BL, Atkinson EJ, Oberg AL, McDaniel LJ, Holets M et al (2006) Effects of sex and age on bone microstructure at the ultradistal radius: a population-based noninvasive in vivo assessment. J Bone Miner Res 21(1):124–131

    Article  PubMed  Google Scholar 

  19. Nicks KM, Amin S, Atkinson EJ, Riggs BL, Melton LJ 3rd, Khosla S (2012) Relationship of age to bone microstructure independent of areal bone mineral density. J Bone Miner Res 27(3):637–644

    Article  PubMed  PubMed Central  Google Scholar 

  20. Amin S, Khosla S. 2012 Sex- and age-related differences in bone microarchitecture in men relative to women assessed by high-resolution peripheral quantitative computed tomography. J Osteoporos.; 2012:129760.

  21. Boutroy S, Khosla S, Sornay-Rendu E, Zanchetta MB, McMahon DJ, Zhang CA, et al. 2016 Microarchitecture and peripheral BMD are impaired in postmenopausal Caucasian women with fracture independently of total hip T-score—an international multicenter study. J Bone Miner Res.

  22. Hansen S, Shanbhogue V, Folkestad L, Nielsen MM, Brixen K (2014) Bone microarchitecture and estimated strength in 499 adult Danish women and men: a cross-sectional, population-based high-resolution peripheral quantitative computed tomographic study on peak bone structure. Calcif Tissue Int 94(3):269–281

    Article  CAS  PubMed  Google Scholar 

  23. Fuchs SC, Guimarães SM, Sortica C, Wainberg F, Dias KO, Ughini M et al (2002) Reliability of race assessment based on the race of the ascendants: a cross-sectional study. BMC Public Health 2:1–5

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lopes JB, Fung LK, Cha CC, Gabriel GM, Takayama L, Figueiredo CP et al (2012) The impact of asymptomatic vertebral fractures on quality of life in older community-dwelling women: the São Paulo Ageing & Health Study. Clinics (São Paulo) 67(12):1401–1406

    Article  Google Scholar 

  25. Bhalla AK (2010) Management of osteoporosis in a pre-menopausal woman. Best Pract Res Clin Rheumatol 24(3):313–327

    Article  PubMed  Google Scholar 

  26. Eviö S, Tiitinen A, Laitinen K, Ylikorkala O, Välimäki MJ (2004) Effects of alendronate and hormone replacement therapy, alone and in combination, on bone mass and markers of bone turnover in elderly women with osteoporosis. J Clin Endocrinol Metab 89(2):626–631

    Article  PubMed  Google Scholar 

  27. Paupitz JA, Lima GL, Alvarenga JC, Oliveira RM, Bonfa E, Pereira RM (2016) Bone impairment assessed by HR-pQCT in juvenile-onset systemic lupus erythematosus. Osteoporos Int 27(5):1839–1848

    Article  CAS  PubMed  Google Scholar 

  28. Paggiosi MA, Eastell R, Walsh JS (2014) Precision of high-resolution peripheral quantitative computed tomography measurement variables: influence of gender, examination site, and age. Calcif Tissue Int 94(2):191–201

    Article  CAS  PubMed  Google Scholar 

  29. van Rietbergen B, Weinans H, Huiskes R, Odgaard A (1995) A new method to determine trabecular bone elastic properties and loading using micromechanical finite-element models. J Biomech 28:69–81

    Article  PubMed  Google Scholar 

  30. Macneil JA, Boyd SK (2008) Bone strength at the distal radius can be estimated from high-resolution peripheral quantitative computed tomography and the finite element method. Bone 42:1203–1213

    Article  PubMed  Google Scholar 

  31. Horber FF, Gruber B, Thomi F, Jensen EX, Jaeger P (1997) Effect of sex and age on bone mass, body composition and fuel metabolism in humans. Nutrition 13(6):524–534

    Article  CAS  PubMed  Google Scholar 

  32. Burt LA, Liang Z, Sajobi TT, Hanley DA, Boyd SK. 2016 Sex- and site-specific normative data curves for HR-pQCT. J Bone Miner Res.

  33. Hung VW, Zhu TY, Cheung WH, Fong TN, FW Y, Hung LK et al (2015) Age-related differences in volumetric bone mineral density, microarchitecture, and bone strength of distal radius and tibia in Chinese women: a high-resolution pQCT reference database study. Osteoporos Int 26(6):1691–1703

    Article  CAS  PubMed  Google Scholar 

  34. Walker-Bone K, D’Angelo S, Syddall HE, Palmer KT, Cooper C, Coggon D et al (2014) Exposure to heavy physical occupational activities during working life and bone mineral density at the hip at retirement age. Occup Environ Med 71(5):329–331

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Hunter GR, Plaisance EP, Fisher G (2014) Weight loss and bone mineral density. Curr Opin Endocrinol Diabetes Obes 21(5):358–362

    Article  PubMed  PubMed Central  Google Scholar 

  36. Sasimontonkul S, Bay BK, Pavol MJ (2007) Bone contact forces on the distal tibia during the stance phase of running. J Biomech 40(15):3503–3509

    Article  PubMed  Google Scholar 

  37. Wehner T, Claes L, Simon U (2009) Internal loads in the human tibia during gait. Clin Biomech (Bristol, Avon) 24(3):299–302

    Article  Google Scholar 

  38. Nicks KM, Amin S, Melton LJ 3rd, Atkinson EJ, McCready LK, Riggs BL et al (2013) Three-dimensional structural analysis of the proximal femur in an age-stratified sample of women. Bone 55(1):179–188

    Article  PubMed  PubMed Central  Google Scholar 

  39. Bala Y, Bui QM, Wang XF, Iuliano S, Wang Q, Ghasem-Zadeh A et al (2015) Trabecular and cortical microstructure and fragility of the distal radius in women. J Bone Miner Res 30(4):621–629

    Article  PubMed  Google Scholar 

  40. Nishiyama KK, Macdonald HM, Buie HR, Hanley DA, Boyd SK (2010) Postmenopausal women with osteopenia have higher cortical porosity and thinner cortices at the distal radius and tibia than women with normal aBMD: an in vivo HR-pQCT study. J Bone Miner Res 25(4):882–890

    PubMed  Google Scholar 

  41. Manske SL, Liu-Ambrose T, Cooper DM, Kontulainen S, Guy P, Forster BB et al (2009) Cortical and trabecular bone in the femoral neck both contribute to proximal femur failure load prediction. Osteoporos Int 20(3):445–453

    Article  CAS  PubMed  Google Scholar 

  42. Geusens P, Chapurlat R, Schett G, Ghasem-Zadeh A, Seeman E, de Jong J et al (2014) High-resolution in vivo imaging of bone and joints: a window to microarchitecture. Nat Rev Rheumatol 10(5):304–313

    Article  PubMed  Google Scholar 

  43. Silva MJ, Gibson LJ (1997) Modeling the mechanical behavior of vertebral trabecular bone: effects of age-related changes in microstructure. Bone 21(2):191–199

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Rheumatology Division, Faculdade Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3o andar, sala 3193, Sao Paulo, 01246-903, Brazil

    J. C. Alvarenga, H. Fuller, S. G. Pasoto & R. M. R. Pereira

Authors
  1. J. C. Alvarenga
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Fuller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. G. Pasoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. M. R. Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. M. R. Pereira.

Ethics declarations

Conflicts of interest

J.C. Alvarenga, H. Fuller, S.G. Pasoto and R.M.R. Pereira declare no conflict of interest for this article.

Electronic supplementary material

ESM 1

(DOCX 17 kb).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alvarenga, J.C., Fuller, H., Pasoto, S.G. et al. Age-related reference curves of volumetric bone density, structure, and biomechanical parameters adjusted for weight and height in a population of healthy women: an HR-pQCT study. Osteoporos Int 28, 1335–1346 (2017). https://doi.org/10.1007/s00198-016-3876-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-016-3876-0

Keywords

Search

Navigation