Age- and Sex-Related Volumetric Density Differences in Trabecular and Cortical Bone of the Proximal Femur in Healthy Population

Overview

Journal J Bone Metab

Date 2024 Dec 19

PMID 39701108

Authors

Maria Lorena Brance

Fernando Daniel Saravi

Muriel M Henriquez

Maria Silvia Larroude

Jorge E Jacobo

Sebastian Abalo Araujo

Vanesa Longobardi

Maria Belen Zanchetta

Maria Rosa Ulla

Florencia Martos

Helena Salerni

Beatriz Oliveri

Marina Soledad Bonanno

Naraline Luna Meneses

Pilar Diaz Baclini

Luis A Ramirez Stieben

Silvana Di Gregorio

Lucas R Brun

Affiliations

Soon will be listed here.

Abstract

Background: There are age- and sex-related increases in the prevalence of osteoporosis. Bone densitometry based on dual energy X-ray absorptiometry (DXA) is the gold standard for the assessment of bone mineral density (BMD). Three-dimensional (3D) analysis of the proximal femur (3D-DXA) allows discrimination between cortical and trabecular compartments, and it has shown a good correlation with computed tomography. We aimed to assess age- and sex-related volumetric density differences in trabecular and cortical bone using 3D-DXA and determine the reference intervals for integral volumetric (v)BMD within the Argentine population.

Methods: Healthy female and male adult subjects (N=1,354) from Argentina were included. Hip BMD was measured using DXA, and 3D analysis was performed using 3D-Shaper software. The integral vBMD, cortical surface BMD, and trabecular vBMD (trab vBMD) were measured.

Results: The study population included 73.9% women (N=1,001) and 26.13% men (N=353). We found a significant decrease in integral vBMD between 20 and 90 years in both sexes (women, -23.1%; men, -16.6%). Bone loss indicated in the integral vBMD results was mainly due to a decrease in trabecular bone in both sexes (women, -33.4%; men, -27.7%). The age-related loss of cortical bone density was less and was limited to the female population, without no age-related differences in men. Moreover, 3D-DXA allowed us to propose reference intervals for integral vBMD.

Conclusions: We found age- and sex-related bone loss between 20 and 90 years in an Argentine cohort via integral vBMD measurements using 3D-DXA, mainly due to decreases in trabecular bone in both sexes. The age-related loss of cortical bone density was less and was limited to the female population.

References

Cooper C, Westlake S, Harvey N, Javaid K, Dennison E, Hanson M . Review: developmental origins of osteoporotic fracture. Osteoporos Int. 2005; 17(3):337-47. DOI: 10.1007/s00198-005-2039-5. View

Brance M, Pons-Estel B, Quagliato N, Jorfen M, Berbotto G, Cortese N . Trabecular and cortical bone involvement in rheumatoid arthritis by DXA and DXA-based 3D modelling. Osteoporos Int. 2020; 32(4):705-714. DOI: 10.1007/s00198-020-05641-4. View

Diaz Curiel M, Carrasco de la Pena J, Honorato Perez J, Perez Cano R, RAPADO A, Ruiz Martinez I . Study of bone mineral density in lumbar spine and femoral neck in a Spanish population. Multicentre Research Project on Osteoporosis. Osteoporos Int. 1997; 7(1):59-64. DOI: 10.1007/BF01623462. View

Loffler M, Jacob A, Valentinitsch A, Rienmuller A, Zimmer C, Ryang Y . Improved prediction of incident vertebral fractures using opportunistic QCT compared to DXA. Eur Radiol. 2019; 29(9):4980-4989. PMC: 6682570. DOI: 10.1007/s00330-019-06018-w. View

Lotz J, Cheal E, Hayes W . Stress distributions within the proximal femur during gait and falls: implications for osteoporotic fracture. Osteoporos Int. 1995; 5(4):252-61. DOI: 10.1007/BF01774015. View

Dudle A, Gugler Y, Pretterklieber M, Ferrari S, Lippuner K, Zysset P . 2D-3D reconstruction of the proximal femur from DXA scans: Evaluation of the 3D-Shaper software. Front Bioeng Biotechnol. 2023; 11:1111020. PMC: 10014626. DOI: 10.3389/fbioe.2023.1111020. View

. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001; 285(6):785-95. DOI: 10.1001/jama.285.6.785. View

ORourke D, Beck B, Harding A, Watson S, Pivonka P, Martelli S . Assessment of femoral neck strength and bone mineral density changes following exercise using 3D-DXA images. J Biomech. 2021; 119:110315. DOI: 10.1016/j.jbiomech.2021.110315. View

Looker A, Borrud L, Hughes J, Fan B, Shepherd J, Melton 3rd L . Lumbar spine and proximal femur bone mineral density, bone mineral content, and bone area: United States, 2005-2008. Vital Health Stat 11. 2013; (251):1-132. View

10.

Lewiecki E, Betah D, Humbert L, Libanati C, Oates M, Shi Y . 3D-modeling from hip DXA shows improved bone structure with romosozumab followed by denosumab or alendronate. J Bone Miner Res. 2024; 39(4):473-483. PMC: 11262148. DOI: 10.1093/jbmr/zjae028. View

11.

Nishiyama K, Ito M, Harada A, Boyd S . Classification of women with and without hip fracture based on quantitative computed tomography and finite element analysis. Osteoporos Int. 2013; 25(2):619-26. DOI: 10.1007/s00198-013-2459-6. View

12.

Shuhart C, Yeap S, Anderson P, Jankowski L, Lewiecki E, Morse L . Executive Summary of the 2019 ISCD Position Development Conference on Monitoring Treatment, DXA Cross-calibration and Least Significant Change, Spinal Cord Injury, Peri-prosthetic and Orthopedic Bone Health, Transgender Medicine, and Pediatrics. J Clin Densitom. 2019; 22(4):453-471. DOI: 10.1016/j.jocd.2019.07.001. View

13.

Fong Y, Huang Y, B Gilbert P, Permar S . chngpt: threshold regression model estimation and inference. BMC Bioinformatics. 2017; 18(1):454. PMC: 5644082. DOI: 10.1186/s12859-017-1863-x. View

14.

Tamayo J, Diaz R, Lazcano-Ponce E, Munoz M, Huitron G, Halley E . Reference values for areal bone mineral density among a healthy Mexican population. Salud Publica Mex. 2009; 51 Suppl 1:S56-83. DOI: 10.1590/s0036-36342009000700010. View

15.

Schuit S, van der Klift M, Weel A, de Laet C, Burger H, Seeman E . Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone. 2004; 34(1):195-202. DOI: 10.1016/j.bone.2003.10.001. View

16.

Takada J, Okimoto N, Tsukamoto M, Akatsuka T, Takebayashi T, Iba K . Effects of differences in dose and frequency of teriparatide on bone structure in Proximal Femur. - Analysis by DXA-based 3D-modeling (3D-SHAPER Software) -TRIPLE-BONE study (The effects of TeRIParatide preparation on bone mineraL density increase.... Arch Osteoporos. 2024; 19(1):55. DOI: 10.1007/s11657-024-01415-1. View

17.

Wu F, Wills K, Laslett L, Oldenburg B, Seibel M, Jones G . Cut-points for associations between vitamin D status and multiple musculoskeletal outcomes in middle-aged women. Osteoporos Int. 2016; 28(2):505-515. DOI: 10.1007/s00198-016-3754-9. View

18.

Engelke K, Lang T, Khosla S, Qin L, Zysset P, Leslie W . Clinical Use of Quantitative Computed Tomography (QCT) of the Hip in the Management of Osteoporosis in Adults: the 2015 ISCD Official Positions-Part I. J Clin Densitom. 2015; 18(3):338-58. DOI: 10.1016/j.jocd.2015.06.012. View

19.

Harris E, Boyd J . On dividing reference data into subgroups to produce separate reference ranges. Clin Chem. 1990; 36(2):265-70. View

20.

Humbert L, Winzenrieth R, Di Gregorio S, Thomas T, Vico L, Malouf J . 3D Analysis of Cortical and Trabecular Bone From Hip DXA:Precision and Trend Assessment Interval in PostmenopausalWomen. J Clin Densitom. 2018; 22(2):214-218. DOI: 10.1016/j.jocd.2018.05.001. View