INSERM Research Unit 831 and Université de Lyon, Lyon, France.
Bone. 2010 Apr;46(4):1030-7. doi: 10.1016/j.bone.2009.12.015. Epub 2010 Jan 4.
Assessment of bone strength at the radius by micro-finite element analysis (muFEA) has already been associated with wrist fractures. In this study, the analysis has been extended to the distal tibia, and to a larger group of subjects to examine the association with several types of fragility fractures. We have compared muFEA based on in vivo HR-pQCT measurements of BMD and microarchitecture at the radius and tibia, in a case-control study involving 101 women with prevalent fragility fracture and 101 age-matched controls, from the OFELY cohort. Areal BMD was measured by DXA at the radius and the hip. All parameters were analyzed in a principal component (PC) analysis (PCA), and associations between PCs and fractures were computed as odds ratios (OR [95% CI]) per SD change. Radius (tibia) PCA revealed three independent components explaining 76% (77%) of the total variability of bone characteristics. The first PC describing bone strength and quantity, explained 50% (46%) of variance with an OR=1.84 [1.27-2.67] (2.92 [1.73-4.93]). The second PC including trabecular microarchitecture, explained 16% (10%) of variance, with OR=1.29 [0.90-1.87] (1.11 [0.82-1.52]). The third PC related to load distribution explained 10% (20%) of variance, with OR=1.54 [1.06-2.24] (1.32 [0.89-1.96]). Moreover, at the radius, vertebral fractures were associated with trabecular microarchitecture PC with OR=1.86 [1.14-3.03], whereas nonvertebral fractures were associated with bone strength and quantity PC with OR=2.03 [1.36-3.02]. At the tibia, both vertebral (OR=2.92 [1.61-5.28]) and nonvertebral fracture (2.64 [1.63-4.27]) were associated to bone strength and quantity PC. In conclusion, muFEA parameters at the radius and tibia were associated with all types of fragility fractures. We have also shown that muFEA parameters obtained with distal tibia data were associated with prevalent fractures with a similar magnitude that with parameters obtained at the radius.
通过微有限元分析（muFEA）评估桡骨的骨强度已经与腕部骨折相关。在这项研究中，我们将分析扩展到了胫骨，并对更大的研究对象群体进行了研究，以检查与多种类型的脆性骨折的相关性。我们比较了基于 HR-pQCT 测量的桡骨和胫骨骨密度和微观结构的 muFEA，这是一项涉及 101 名患有常见脆性骨折的女性和 101 名年龄匹配对照者的病例对照研究，这些数据来自 OFELY 队列。通过 DXA 在桡骨和髋部测量面积骨密度。所有参数均在主成分（PC）分析（PCA）中进行分析，并通过每标准差变化计算 PC 与骨折之间的比值比（OR [95%CI]）。桡骨（胫骨）PCA 揭示了三个独立的成分，可解释 76%（77%）的骨特征总变异性。描述骨强度和数量的第一 PC 解释了 50%（46%）的方差，OR=1.84 [1.27-2.67]（2.92 [1.73-4.93]）。包含小梁微观结构的第二 PC 解释了 16%（10%）的方差，OR=1.29 [0.90-1.87]（1.11 [0.82-1.52]）。与负荷分布相关的第三 PC 解释了 10%（20%）的方差，OR=1.54 [1.06-2.24]（1.32 [0.89-1.96]）。此外，在桡骨中，椎体骨折与小梁微观结构 PC 相关，OR=1.86 [1.14-3.03]，而非椎体骨折与骨强度和数量 PC 相关，OR=2.03 [1.36-3.02]。在胫骨中，椎体（OR=2.92 [1.61-5.28]）和非椎体（2.64 [1.63-4.27]）骨折均与骨强度和数量 PC 相关。总之，桡骨和胫骨的 muFEA 参数与所有类型的脆性骨折相关。我们还表明，使用胫骨数据获得的 muFEA 参数与桡骨参数一样，与常见骨折的相关性相似。
