title: Region-specific sex-dependent pattern of age-related changes of proximal femoral cancellous bone and its implications on differential bone fragility.
abstract: Despite evident interest in age-related bone changes, data on regional differences within the proximal femur are scarce. To date, there has been no comprehensive study on site-specific age-related changes in the trabecular architecture of three biomechanically important femoral subregions (medial neck, lateral neck, and intertrochanteric region) for both genders. In this study we investigated age-related deterioration in the trabecular architecture of those three subregions of the femoral neck for both genders. The research sample included 52 proximal femora (26 males, 26 females; age range, 26-96 years) from Forensic Department at University of Belgrade. Bone sections from the three regions of interest were scanned by micro-CT at University of Hamburg. The study revealed that proximal femoral microarchitecture cannot be perceived as homogeneous and, more importantly, that the aging process is not uniform. Besides the initial intersite differences, microarchitecture changed differently with increasing age, maintaining significant differences between the regions. In addition, we observed a different aging pattern between genders: deterioration was most significant in the intertrochanteric region in women, while the lateral neck was most affected in men. This finding supports epidemiological data about the differential occurrence of cervical vs. trochanteric fractures in aging males and females. In conclusion, the aging process in the proximal femur cannot be regarded as a simple function of quantitative bone loss but, rather, as an alteration of specific architecture that may degrade bone strength.
authors.affiliation: Laboratory for Anthropology, Department of Anatomy, School of Medicine, University of Belgrade, 4/2 Dr Subotica, 11000 Belgrade, Serbia. marijadjuric5@gmail.com
authors.forename: Marija
authors.initials: M
authors.lastname: Djuric
authors.forename: Danijela
authors.initials: D
authors.lastname: Djonic
authors.forename: Petar
authors.initials: P
authors.lastname: Milovanovic
authors.forename: Slobodan
authors.initials: S
authors.lastname: Nikolic
authors.forename: Robert
authors.initials: R
authors.lastname: Marshall
authors.forename: Jelena
authors.initials: J
authors.lastname: Marinkovic
authors.forename: Michael
authors.initials: M
authors.lastname: Hahn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology* / Q000502:physiology; D015984:Causality; D018450:Disease Progression; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012727:Sex Characteristics; D055114:X-Ray Microtomography