title: Microarchitectural abnormalities are more severe in postmenopausal women with vertebral compared to nonvertebral fractures.
abstract: BACKGROUND
  Abnormal bone microarchitecture predisposes postmenopausal women to fragility fractures. Whether women with vertebral fractures have worse microarchitecture than those with nonvertebral fractures is unknown.
  
  
  METHODS
  Postmenopausal women with a history of low trauma vertebral fracture (n=30) and nonvertebral fracture (n=73) and controls (n=120) had areal bone mineral density of lumbar spine, total hip, femoral neck, 1/3 radius, and ultradistal radius measured by dual-energy x-ray absorptiometry. Trabecular and cortical volumetric bone mineral density and microarchitecture were measured by high-resolution peripheral quantitative computed tomography of the distal radius and tibia. Finite element analysis estimated whole bone stiffness.
  
  
  RESULTS
  Mean age of subjects was 68±7 yr. Groups were similar with respect to age, race, and body mass index. Mean T-scores did not differ from controls at any site except the ultradistal radius (vertebral fracture, 0.6 sd lower; nonvertebral fracture, 0.4 sd lower). Compared to controls, women with vertebral fractures had lower total, cortical, and trabecular volumetric density, lower cortical thickness, trabecular number and thickness, greater trabecular separation and network heterogeneity, and lower stiffness at both radius and tibia. Differences between women with nonvertebral fractures and controls were similar but less pronounced. Compared to women with nonvertebral fractures, women with vertebral fractures had lower total and trabecular density, lower cortical thickness and trabecular number, and greater trabecular separation and heterogeneity at the tibia. Whole bone stiffness tended to be lower (P=0.06). Differences between fracture groups at the radius were not statistically significant.
  
  
  CONCLUSIONS
  Women with vertebral fractures have more severe trabecular and cortical microarchitectural deterioration than those with nonvertebral fractures, particularly at the tibia.
authors: Department of Medicine, Columbia University College of Physicians and Surgeons, 630 West 168th Street, PH8 West 864, New York, New York 10032, USA.
authors: Emily M
authors: EM
authors: Stein
authors: X Sherry
authors: XS
authors: Liu
authors: Thomas L
authors: TL
authors: Nickolas
authors: Adi
authors: A
authors: Cohen
authors: Donald J
authors: DJ
authors: McMahon
authors: Bin
authors: B
authors: Zhou
authors: Chiyuan
authors: C
authors: Zhang
authors: Mafo
authors: M
authors: Kamanda-Kosseh
authors: Felicia
authors: F
authors: Cosman
authors: Jeri
authors: J
authors: Nieves
authors: X Edward
authors: XE
authors: Guo
authors: Elizabeth
authors: E
authors: Shane
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density / Q000502:physiology; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D017698:Postmenopause / Q000502:physiology*; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed