Department of Biomedical Engineering, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada.
Department of Biomedical Engineering, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada.
Bone. 2023 Aug;173:116803. doi: 10.1016/j.bone.2023.116803. Epub 2023 May 16.
Females are up to four times more likely to sustain a stress fracture than males. Our previous work, using statistical appearance modeling in combination with the finite element method, suggested that sex-related differences in tibial geometry may increase bone strain in females. The purpose of this study was to cross-validate these findings, by quantifying sex-related differences in tibia-fibula bone geometry, density, and finite element-predicted bone strain in a new cohort of young physically active adults. CT scans of the lower leg were collected for fifteen males (23.3 ± 4.3 years, 1.77 ± 0.09 m, 75.6 ± 10.0 kg) and fifteen females (22.9 ± 3.0 years, 1.67 ± 0.07 m, 60.9 ± 6.7 kg). A statistical appearance model was fit to each participant's tibia and fibula. The average female and male tibia-fibula complex, controlled for isotropic scaling, were then calculated. Bone geometry, density, and finite element-predicted bone strains in running were compared between the average female and male. The new cohort illustrated the same patterns as the cohort from the previous study: the tibial diaphysis of the average female was narrower and had greater cortical bone density. Peak strain and the volume of bone experiencing ≥4000 με were 10 % and 80 % greater, respectively, in the average female when compared to the average male, which was driven by a narrower diaphysis. The sex-related disparities in tibial geometry, density, and bone strain described by our previous model were also observed in this entirely new cohort. Disparities in tibial diaphysis geometry likely contribute to the elevated stress fracture risk observed in females.
女性发生应力性骨折的可能性比男性高 4 倍。我们之前的工作使用统计外观建模结合有限元方法，表明胫骨几何形状的性别差异可能会增加女性的骨骼应变。本研究的目的是通过量化新的年轻活跃成年人队列中胫骨-腓骨骨骼几何形状、密度和有限元预测的骨骼应变的性别差异，对这些发现进行交叉验证。对 15 名男性（23.3±4.3 岁，1.77±0.09 米，75.6±10.0 公斤）和 15 名女性（22.9±3.0 岁，1.67±0.07 米，60.9±6.7 公斤）的小腿进行 CT 扫描。为每位参与者的胫骨和腓骨拟合统计外观模型。然后计算控制各向同性缩放的平均女性和男性胫骨-腓骨复合体。比较平均女性和男性在跑步时的骨骼几何形状、密度和有限元预测的骨骼应变。新队列显示出与之前研究队列相同的模式：女性的胫骨骨干更窄，皮质骨密度更高。与男性相比，女性的峰值应变和经历≥4000με的骨骼体积分别增加了 10%和 80%，这主要是由于骨干更窄。我们之前的模型描述的胫骨几何形状、密度和骨骼应变的性别差异在这个全新的队列中也观察到了。胫骨骨干几何形状的差异可能导致女性观察到的应力性骨折风险增加。
