High-resolution pQCT analysis at the distal radius and tibia discriminates patients with recent wrist and femoral neck fractures.
We depict a fragility bone state in two primitive osteoporosis populations using 3D high-resolution peripheral in vivo QCT (HR-pQCT). Postmenopausal women (C, controls, n = 54; WF, wrist, n = 50; HF, hip, n = 62 recent fractured patients) were analyzed for lumbar and hip DXA areal BMD (aBMD), cancellous and cortical volumetric BMD (vBMD), and microstructural and geometric parameters on tibia and radius by HR-pQCT. Principal component analysis (PCA) allowed extracting factors that best represent bone variables. Comparison between groups was made by analysis of covariance (ANCOVA). Two factors (>80% of the entire variability) are extracted by PCA: at the radius, the first is a combination of trabecular parameters and the second of cortical parameters. At the tibia, we found the reverse. Femoral neck aBMD is decreased in WF (8.6%) and in HF (18%) groups (no lumbar difference). WF showed a approximately 20% reduction in radius trabecular vBMD and number. Radius cortical vBMD and thickness decrease by 6% and 14%, respectively. At the tibia, only the cortical compartment is affected, with approximately 20% reduction in bone area, thickness, and section modulus and 6% reduction in vBMD. HF showed same radius trabecular alterations than WF, but radius cortical parameters are more severely affected than WF with reduced bone area (25%), thickness (28.5%), and vBMD (11%). At the tibia, trabecular vBMD and number decrease by 26% and 17.5%, respectively. Tibia cortical bone area, thickness, and section modulus showed a >30% decrease, whereas vBMD reduction reached 13%. Geometry parameters at the tibia displayed the greatest differences between healthy and fractured patients and between wrist and hip fractures.
Vico
Laurence
L
INSERM U890 IFR143, University of St-Etienne, St-Etienne, France. vico@univ-st-etienne.fr
Zouch
Mohamed
M
Amirouche
Adel
A
Frère
Delphine
D
Laroche
Norbert
N
Koller
Bruno
B
Laib
Andres
A
Thomas
Thierry
T
Alexandre
Christian
C
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D001835:Body Weight; D015519:Bone Density; D016022:Case-Control Studies; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006620:Hip Fractures / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011884:Radius / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013977:Tibia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014954:Wrist Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology