Vilayphiou Nicolas, Boutroy Stephanie, Sornay-Rendu Elisabeth, Van Rietbergen Bert, Chapurlat Roland
INSERM Research Unit 1033, Université de Lyon, Lyon, France; Scanco Medical AG, Bruttisellen, Switzerland.
INSERM Research Unit 1033, Université de Lyon, Lyon, France.
Bone. 2016 Feb;83:233-240. doi: 10.1016/j.bone.2015.10.012. Epub 2015 Oct 23.
The high resolution peripheral computed tomography (HR-pQCT) technique has seen recent developments with regard to the assessment of cortical porosity. In this study, we investigated the role of cortical porosity on bone strength in a large cohort of women. The distal radius and distal tibia were scanned by HR-pQCT. We assessed bone strength by estimating the failure load by microfinite element analysis (μFEA), with isotropic and homogeneous material properties. We built a multivariate model to predict it, using a few microarchitecture variables including cortical porosity. Among 857 Caucasian women analyzed with μFEA, we found that cortical and trabecular properties, along with the failure load, impaired slightly with advancing age in premenopausal women, the correlations with age being modest, with |rage| ranging from 0.14 to 0.38. After the onset of the menopause, those relationships with age were stronger for most parameters at both sites, with |rage| ranging from 0.10 to 0.64, notably for cortical porosity and failure load, which were markedly deteriorated with increasing age. Our multivariate model using microarchitecture parameters revealed that cortical porosity played a significant role in bone strength prediction, with semipartial r(2)=0.22 only at the tibia in postmenopausal women. In conclusion, in our large cohort of women, we observed a small decline of bone strength at the tibia before the onset of menopause. We also found an age-related increase of cortical porosity at both scanned sites in premenopausal women. In postmenopausal women, the relatively high increase of cortical porosity accounted for the decline in bone strength only at the tibia.
高分辨率外周计算机断层扫描（HR-pQCT）技术在评估皮质骨孔隙率方面有了新进展。在本研究中，我们调查了一大群女性中皮质骨孔隙率对骨强度的作用。通过HR-pQCT扫描桡骨远端和胫骨远端。我们通过微有限元分析（μFEA）估计破坏载荷来评估骨强度，采用各向同性和均匀的材料特性。我们建立了一个多变量模型来预测它，使用包括皮质骨孔隙率在内的一些微观结构变量。在857名接受μFEA分析的白种女性中，我们发现绝经前女性的皮质骨和小梁骨特性以及破坏载荷随年龄增长略有受损，与年龄的相关性适中，|r age|范围为0.14至0.38。绝经后，两个部位大多数参数与年龄的关系更强，|r age|范围为0.10至0.64，特别是皮质骨孔隙率和破坏载荷，随年龄增长明显恶化。我们使用微观结构参数的多变量模型显示，皮质骨孔隙率在骨强度预测中起重要作用，仅在绝经后女性的胫骨处半偏r(2)=0.22。总之，在我们的一大群女性中，我们观察到绝经前胫骨骨强度略有下降。我们还发现绝经前女性两个扫描部位的皮质骨孔隙率随年龄增加。在绝经后女性中，皮质骨孔隙率相对较高的增加仅导致胫骨骨强度下降。
