Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites

B. Lawrence Riggs, L. Joseph Melton, Richard A. Robb, Jon J. Camp, Elizabeth J. Atkinson, James M. Peterson, Peggy A. Rouleau, Cynthia H McCollough, Mary L. Bouxsein, Sundeep Khosla

Research output: Contribution to journalArticle

566 Citations (Scopus)

Abstract

In a population-based, cross-sectional study, we assessed age- and sex-specific changes in bone structure by QCT. Over life, the cross-sectional area of the vertebrae and proximal femur increased by ∼15% in both sexes, whereas vBMD at these sites decreased by 39-55% and 34-46%, respectively, with greater decreases in women than in men. Introduction: The changes in bone structure and density with aging that lead to fragility fractures are still unclear. Materials and Methods: In an age- and sex-stratified population sample of 373 women and 323 men (age, 20-97 years), we assessed bone geometry and volumetric BMD (vBMD) by QCT at the lumbar spine, femoral neck, distal radius, and distal tibia. Results: In young adulthood, men had 35-42% larger bone areas than women (p < 0.001), consistent with their larger body size. Bone area increased equally over life in both sexes by ∼15% (p < 0.001) at central sites and by ∼16% and slightly more in men at peripheral sites. Decreases in trabecular vBMD began before midlife and continued throughout life (p < 0.001), whereas cortical vBMD decreases began in midlife. Average decreases in trabecular vBMD were greater in women (-55%) than in men (-46%, p < 0.001) at central sites, but were similar (-24% and -26%, respectively) at peripheral sites. With aging, cortical area decreased slightly, and the cortex was displaced outwardly by periosteal and endocortical bone remodeling. Cortical vBMD decreased over life more in women (∼25%) than in men (∼18%, p < 0.001), consistent with menopausal-induced increases in bone turnover and bone porosity. Conclusions: Age-related changes in bone are complex. Some are beneficial to bone strength, such as periosteal apposition with outward cortical displacement. Others are deleterious, such as increased subendocortical resorption, increased cortical porosity, and, especially, large decreases in trabecular vBMD that may be the most important cause of increased skeletal fragility in the elderly. Our findings further suggest that the greater age-related decreases in trabecular and cortical vBMD and perhaps also their smaller bone size may explain, in large part, why fragility fractures 7re more common in elderly women than in elderly men.

Original languageEnglish (US)
Pages (from-to)1945-1954
Number of pages10
JournalJournal of Bone and Mineral Research
Volume19
Issue number12
DOIs
StatePublished - Dec 2004

Fingerprint

Sex Characteristics
Bone Density
Bone and Bones
Population
Bone Remodeling
Porosity
Spine
Femur Neck
Body Size
Tibia
Femur
Cross-Sectional Studies

Keywords

  • Aging
  • BMD
  • Bone densitometry
  • Bone geometry
  • Bone QCT
  • Menopause
  • Osteoporosis

ASJC Scopus subject areas

  • Surgery

Cite this

Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. / Riggs, B. Lawrence; Melton, L. Joseph; Robb, Richard A.; Camp, Jon J.; Atkinson, Elizabeth J.; Peterson, James M.; Rouleau, Peggy A.; McCollough, Cynthia H; Bouxsein, Mary L.; Khosla, Sundeep.

In: Journal of Bone and Mineral Research, Vol. 19, No. 12, 12.2004, p. 1945-1954.

Research output: Contribution to journalArticle

Riggs, B. Lawrence ; Melton, L. Joseph ; Robb, Richard A. ; Camp, Jon J. ; Atkinson, Elizabeth J. ; Peterson, James M. ; Rouleau, Peggy A. ; McCollough, Cynthia H ; Bouxsein, Mary L. ; Khosla, Sundeep. / Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. In: Journal of Bone and Mineral Research. 2004 ; Vol. 19, No. 12. pp. 1945-1954.
@article{cf8515b4839c4e1a908e2778200a0761,
title = "Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites",
abstract = "In a population-based, cross-sectional study, we assessed age- and sex-specific changes in bone structure by QCT. Over life, the cross-sectional area of the vertebrae and proximal femur increased by ∼15{\%} in both sexes, whereas vBMD at these sites decreased by 39-55{\%} and 34-46{\%}, respectively, with greater decreases in women than in men. Introduction: The changes in bone structure and density with aging that lead to fragility fractures are still unclear. Materials and Methods: In an age- and sex-stratified population sample of 373 women and 323 men (age, 20-97 years), we assessed bone geometry and volumetric BMD (vBMD) by QCT at the lumbar spine, femoral neck, distal radius, and distal tibia. Results: In young adulthood, men had 35-42{\%} larger bone areas than women (p < 0.001), consistent with their larger body size. Bone area increased equally over life in both sexes by ∼15{\%} (p < 0.001) at central sites and by ∼16{\%} and slightly more in men at peripheral sites. Decreases in trabecular vBMD began before midlife and continued throughout life (p < 0.001), whereas cortical vBMD decreases began in midlife. Average decreases in trabecular vBMD were greater in women (-55{\%}) than in men (-46{\%}, p < 0.001) at central sites, but were similar (-24{\%} and -26{\%}, respectively) at peripheral sites. With aging, cortical area decreased slightly, and the cortex was displaced outwardly by periosteal and endocortical bone remodeling. Cortical vBMD decreased over life more in women (∼25{\%}) than in men (∼18{\%}, p < 0.001), consistent with menopausal-induced increases in bone turnover and bone porosity. Conclusions: Age-related changes in bone are complex. Some are beneficial to bone strength, such as periosteal apposition with outward cortical displacement. Others are deleterious, such as increased subendocortical resorption, increased cortical porosity, and, especially, large decreases in trabecular vBMD that may be the most important cause of increased skeletal fragility in the elderly. Our findings further suggest that the greater age-related decreases in trabecular and cortical vBMD and perhaps also their smaller bone size may explain, in large part, why fragility fractures 7re more common in elderly women than in elderly men.",
keywords = "Aging, BMD, Bone densitometry, Bone geometry, Bone QCT, Menopause, Osteoporosis",
author = "Riggs, {B. Lawrence} and Melton, {L. Joseph} and Robb, {Richard A.} and Camp, {Jon J.} and Atkinson, {Elizabeth J.} and Peterson, {James M.} and Rouleau, {Peggy A.} and McCollough, {Cynthia H} and Bouxsein, {Mary L.} and Sundeep Khosla",
year = "2004",
month = "12",
doi = "10.1359/JBMR.040916",
language = "English (US)",
volume = "19",
pages = "1945--1954",
journal = "Journal of Bone and Mineral Research",
issn = "0884-0431",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites

AU - Riggs, B. Lawrence

AU - Melton, L. Joseph

AU - Robb, Richard A.

AU - Camp, Jon J.

AU - Atkinson, Elizabeth J.

AU - Peterson, James M.

AU - Rouleau, Peggy A.

AU - McCollough, Cynthia H

AU - Bouxsein, Mary L.

AU - Khosla, Sundeep

PY - 2004/12

Y1 - 2004/12

N2 - In a population-based, cross-sectional study, we assessed age- and sex-specific changes in bone structure by QCT. Over life, the cross-sectional area of the vertebrae and proximal femur increased by ∼15% in both sexes, whereas vBMD at these sites decreased by 39-55% and 34-46%, respectively, with greater decreases in women than in men. Introduction: The changes in bone structure and density with aging that lead to fragility fractures are still unclear. Materials and Methods: In an age- and sex-stratified population sample of 373 women and 323 men (age, 20-97 years), we assessed bone geometry and volumetric BMD (vBMD) by QCT at the lumbar spine, femoral neck, distal radius, and distal tibia. Results: In young adulthood, men had 35-42% larger bone areas than women (p < 0.001), consistent with their larger body size. Bone area increased equally over life in both sexes by ∼15% (p < 0.001) at central sites and by ∼16% and slightly more in men at peripheral sites. Decreases in trabecular vBMD began before midlife and continued throughout life (p < 0.001), whereas cortical vBMD decreases began in midlife. Average decreases in trabecular vBMD were greater in women (-55%) than in men (-46%, p < 0.001) at central sites, but were similar (-24% and -26%, respectively) at peripheral sites. With aging, cortical area decreased slightly, and the cortex was displaced outwardly by periosteal and endocortical bone remodeling. Cortical vBMD decreased over life more in women (∼25%) than in men (∼18%, p < 0.001), consistent with menopausal-induced increases in bone turnover and bone porosity. Conclusions: Age-related changes in bone are complex. Some are beneficial to bone strength, such as periosteal apposition with outward cortical displacement. Others are deleterious, such as increased subendocortical resorption, increased cortical porosity, and, especially, large decreases in trabecular vBMD that may be the most important cause of increased skeletal fragility in the elderly. Our findings further suggest that the greater age-related decreases in trabecular and cortical vBMD and perhaps also their smaller bone size may explain, in large part, why fragility fractures 7re more common in elderly women than in elderly men.

AB - In a population-based, cross-sectional study, we assessed age- and sex-specific changes in bone structure by QCT. Over life, the cross-sectional area of the vertebrae and proximal femur increased by ∼15% in both sexes, whereas vBMD at these sites decreased by 39-55% and 34-46%, respectively, with greater decreases in women than in men. Introduction: The changes in bone structure and density with aging that lead to fragility fractures are still unclear. Materials and Methods: In an age- and sex-stratified population sample of 373 women and 323 men (age, 20-97 years), we assessed bone geometry and volumetric BMD (vBMD) by QCT at the lumbar spine, femoral neck, distal radius, and distal tibia. Results: In young adulthood, men had 35-42% larger bone areas than women (p < 0.001), consistent with their larger body size. Bone area increased equally over life in both sexes by ∼15% (p < 0.001) at central sites and by ∼16% and slightly more in men at peripheral sites. Decreases in trabecular vBMD began before midlife and continued throughout life (p < 0.001), whereas cortical vBMD decreases began in midlife. Average decreases in trabecular vBMD were greater in women (-55%) than in men (-46%, p < 0.001) at central sites, but were similar (-24% and -26%, respectively) at peripheral sites. With aging, cortical area decreased slightly, and the cortex was displaced outwardly by periosteal and endocortical bone remodeling. Cortical vBMD decreased over life more in women (∼25%) than in men (∼18%, p < 0.001), consistent with menopausal-induced increases in bone turnover and bone porosity. Conclusions: Age-related changes in bone are complex. Some are beneficial to bone strength, such as periosteal apposition with outward cortical displacement. Others are deleterious, such as increased subendocortical resorption, increased cortical porosity, and, especially, large decreases in trabecular vBMD that may be the most important cause of increased skeletal fragility in the elderly. Our findings further suggest that the greater age-related decreases in trabecular and cortical vBMD and perhaps also their smaller bone size may explain, in large part, why fragility fractures 7re more common in elderly women than in elderly men.

KW - Aging

KW - BMD

KW - Bone densitometry

KW - Bone geometry

KW - Bone QCT

KW - Menopause

KW - Osteoporosis

UR - http://www.scopus.com/inward/record.url?scp=20244381352&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20244381352&partnerID=8YFLogxK

U2 - 10.1359/JBMR.040916

DO - 10.1359/JBMR.040916

M3 - Article

C2 - 15537436

AN - SCOPUS:20244381352

VL - 19

SP - 1945

EP - 1954

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - 12

ER -