TY - JOUR
T1 - The trabecular effect
T2 - A population-based longitudinal study on age and sex differences in bone mineral density and vertebral load bearing capacity
AU - Oppenheimer-Velez, Marianna L.
AU - Giambini, Hugo
AU - Rezaei, Asghar
AU - Camp, Jon J.
AU - Khosla, Sundeep
AU - Lu, Lichun
N1 - Publisher Copyright:
© 2018
PY - 2018/6
Y1 - 2018/6
N2 - Background: Approximately 16–24% of postmenopausal women are affected by vertebral fractures, negatively affecting their quality of life. Trabecular and cortical bones in vertebrae decline differently with age, thus having a distinct impact on vertebral failure loads. The purpose of this study was to investigate the effect of trabecular and cortical volumetric bone mineral density loss over time on estimated failure loads; and to evaluate the effect of sex and age. Method: Fracture properties from a cohort of 82 patients were evaluated for L1–L3 vertebrae at baseline and 6th year using an image-based method that implements axial rigidity analysis. Cortical and trabecular volumetric bone mineral density were obtained, as well as their individual contribution to total failure load. Regression analyses were performed to determine the effect of age and sex on volumetric bone mineral density and failure loads. Findings: Decline in trabecular and cortical volumetric bone mineral density, and failure load was sex-dependent (p ≤ 0.0095). Cortical and trabecular volumetric bone mineral density reduced 2.08 (g/cm3)/year and 2.02 (g/cm3)/year, respectively. A 1012 N difference in failure load, ~70% attributed to trabecular bone, was found between men and women of similar age. Over 6 years, this difference increased by 287 N. Areal bone mineral density measured by dual X-ray absorptiometry explained ~60% of the vertebral failure load. Interpretation: Trabecular bone has a significantly greater effect than cortical bone on the structural integrity and load bearing capacity of vertebrae. This might lead to a higher incidence of fragility fractures in osteoporotic women. Our non-invasive, quantitative computed tomography image-based approach may improve prevention, monitoring, and management of fractures.
AB - Background: Approximately 16–24% of postmenopausal women are affected by vertebral fractures, negatively affecting their quality of life. Trabecular and cortical bones in vertebrae decline differently with age, thus having a distinct impact on vertebral failure loads. The purpose of this study was to investigate the effect of trabecular and cortical volumetric bone mineral density loss over time on estimated failure loads; and to evaluate the effect of sex and age. Method: Fracture properties from a cohort of 82 patients were evaluated for L1–L3 vertebrae at baseline and 6th year using an image-based method that implements axial rigidity analysis. Cortical and trabecular volumetric bone mineral density were obtained, as well as their individual contribution to total failure load. Regression analyses were performed to determine the effect of age and sex on volumetric bone mineral density and failure loads. Findings: Decline in trabecular and cortical volumetric bone mineral density, and failure load was sex-dependent (p ≤ 0.0095). Cortical and trabecular volumetric bone mineral density reduced 2.08 (g/cm3)/year and 2.02 (g/cm3)/year, respectively. A 1012 N difference in failure load, ~70% attributed to trabecular bone, was found between men and women of similar age. Over 6 years, this difference increased by 287 N. Areal bone mineral density measured by dual X-ray absorptiometry explained ~60% of the vertebral failure load. Interpretation: Trabecular bone has a significantly greater effect than cortical bone on the structural integrity and load bearing capacity of vertebrae. This might lead to a higher incidence of fragility fractures in osteoporotic women. Our non-invasive, quantitative computed tomography image-based approach may improve prevention, monitoring, and management of fractures.
KW - Age
KW - Fracture risk
KW - Osteoporosis
KW - Quantitative computed tomography
KW - Sex
KW - Trabecular bone
UR - http://www.scopus.com/inward/record.url?scp=85046032025&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85046032025&partnerID=8YFLogxK
U2 - 10.1016/j.clinbiomech.2018.03.022
DO - 10.1016/j.clinbiomech.2018.03.022
M3 - Article
C2 - 29698852
AN - SCOPUS:85046032025
SN - 0268-0033
VL - 55
SP - 73
EP - 78
JO - Clinical Biomechanics
JF - Clinical Biomechanics
ER -