title: Vertebral size, bone density, and strength in men and women matched for age and areal spine BMD.
abstract: To explore the possible mechanisms underlying sex-specific differences in skeletal fragility that may be obscured by two-dimensional areal bone mineral density (aBMD) measures, we compared quantitative computed tomography (QCT)-based vertebral bone measures among pairs of men and women from the Framingham Heart Study Multidetector Computed Tomography Study who were matched for age and spine aBMD. Measurements included vertebral body cross-sectional area (CSA, cm(2) ), trabecular volumetric BMD (Tb.vBMD, g/cm(3) ), integral volumetric BMD (Int.vBMD, g/cm(3) ), estimated vertebral compressive loading and strength (Newtons) at L3 , the factor-of-risk (load-to-strength ratio), and vertebral fracture prevalence. We identified 981 male-female pairs (1:1 matching) matched on age (± 1 year) and QCT-derived aBMD of L3 (± 1%), with an average age of 51 years (range 34 to 81 years). Matched for aBMD and age, men had 20% larger vertebral CSA, lower Int.vBMD (-8%) and Tb.vBMD (-9%), 10% greater vertebral compressive strength, 24% greater vertebral compressive loading, and 12% greater factor-of-risk than women (p < 0.0001 for all), as well as higher prevalence of vertebral fracture. After adjusting for height and weight, the differences in CSA and volumetric bone mineral density (vBMD) between men and women were attenuated but remained significant, whereas compressive strength was no longer different. In conclusion, vertebral size, morphology, and density differ significantly between men and women matched for age and spine aBMD, suggesting that men and women attain the same aBMD by different mechanisms. These results provide novel information regarding sex-specific differences in mechanisms that underlie vertebral fragility.
authors: Harvard-MIT Health Sciences and Technology Program, Cambridge, MA, USA; Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors: Alexander G
authors: AG
authors: Bruno
authors: Kerry E
authors: KE
authors: Broe
authors: Xiaochun
authors: X
authors: Zhang
authors: Elizabeth J
authors: EJ
authors: Samelson
authors: Ching-An
authors: CA
authors: Meng
authors: Rajaram
authors: R
authors: Manoharan
authors: John
authors: J
authors: D'Agostino
authors: L Adrienne
authors: LA
authors: Cupples
authors: Douglas P
authors: DP
authors: Kiel
authors: Mary L
authors: ML
authors: Bouxsein
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013131:Spine / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
keywords: AGING; BIOMECHANICS; BONE MINERAL DENSITY; OSTEOPOROSIS; POPULATION STUDIES; VERTEBRAL FRACTURE
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