Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany. Laboratory for Anthropology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Serbia.
Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany.
J Gerontol A Biol Sci Med Sci. 2015 Oct;70(10):1269-75. doi: 10.1093/gerona/glv052. Epub 2015 May 1.
Age- and sex-specific 3D bone structure patterns in human radii and tibiae were investigated with respect to individuals' osteodensitometric status to unravel associations with site-specific fracture occurrences and underlying loading patterns.
A sample of 385 patients (121 men and 264 women, age range: 23-91 years) were investigated. The patients were classified according to dual X-ray absorptiometry T-scores in three groups: control (n = 60), osteopenia (n = 160), and osteoporosis (n = 165). Bone architecture and geometry were assessed by high-resolution peripheral quantitative computed tomography of the cortical and trabecular compartments in distal radii and tibiae.
We found site-dependent age- and sex-related trends regarding bone architecture and geometry. Females displayed more pronounced age-related changes than males. Specifically, female radii showed both cortical and trabecular structural deterioration with aging, whereas the tibiae demonstrated exclusively cortical deterioration. The mean cortical perimeter revealed a significant age-related increase for both sexes even after adjusting for body height and weight, which suggests that periosteal expansion can be observed in both the tibia and also in the radius. Osteopenia and osteoporosis cases did not reveal higher cortical perimeters in comparison to controls.
The tomographic assessment of bone structure further clarifies the architectural basis for increased bone fragility at distal radii and tibiae with advanced age leading to fracture predilection in females. Our findings may represent a morphological link to epidemiological data on age-dependent fracture incidences. Our data support the presence of periosteal apposition at both skeletal sites despite different loading magnitudes, and challenges the view on periosteal expansion just as a compensatory mechanism to counterbalance bone loss.
本研究旨在探讨桡骨和胫骨的三维骨结构模式在年龄和性别方面的差异，以及这些差异与个体骨密度状态的关系，从而揭示与特定部位骨折发生和潜在载荷模式的关联。
研究对象为 385 名患者（男 121 名，女 264 名，年龄范围：23-91 岁）。根据双能 X 线吸收法 T 评分，将患者分为三组：对照组（n = 60）、骨量减少组（n = 160）和骨质疏松组（n = 165）。采用高分辨率外周定量计算机断层扫描技术对桡骨和胫骨远端的皮质和松质骨进行骨结构和几何形态评估。
我们发现骨结构和几何形态存在与部位相关的、年龄和性别相关的趋势。女性的年龄相关性变化比男性更为明显。具体来说，女性桡骨表现出皮质和松质结构随年龄的恶化，而胫骨仅表现出皮质的恶化。即使在调整了身高和体重后，男女双侧的平均皮质周径仍呈现出显著的年龄相关性增加，这表明在胫骨和桡骨都可以观察到骨皮质的外周扩张。与对照组相比，骨量减少和骨质疏松组的皮质周径并没有更高。
骨结构的断层评估进一步阐明了桡骨和胫骨远端随年龄增长导致骨折易感性增加的结构基础，这导致女性的骨折倾向增加。我们的发现可能代表了与年龄相关性骨折发生率的流行病学数据之间的形态学联系。我们的数据支持在两个骨骼部位都存在骨皮质外周形成的观点，尽管存在不同的加载量，这挑战了仅仅将骨皮质外周形成视为代偿性机制以抵消骨丢失的观点。
