title: Age-related differences in volumetric bone mineral density, microarchitecture, and bone strength of distal radius and tibia in Chinese women: a high-resolution pQCT reference database study.
abstract: In a cohort of 393 Chinese women, by using high-resolution peripheral quantitative computed tomography (HR-pQCT), we found that significant cortical bone loss occurred after midlife. Prominent increase in cortical porosity began at the fifth decade but reached a plateau before the sixth decade. Trabecular bone loss was already evident in young adulthood and continued throughout life.
  
  
  BACKGROUND
  This study aimed to investigate age-related differences in volumetric bone mineral density (vBMD), microarchitecture, and estimated bone strength at peripheral skeleton in Chinese female population.
  
  
  METHODS
  In a cross-sectional cohort of 393 Chinese women aged 20-90 years, we obtained vBMD, microarchtecture, and micro-finite element-derived bone strength at distal radius and tibia using HR-pQCT.
  
  
  RESULTS
  The largest predictive age-related difference was found for cortical porosity (Ct.Po) which showed over four-fold and two-fold differences at distal radius and tibia, respectively, over the adulthood. At both sites, cortical bone area, vBMD, and thickness showed significant quadratic association with age with significant decrease beginning after midlife. Change of Ct.Po became more prominent between age of 50 and 57 (0.26 %/year at distal radius, 0.54 %/year at distal tibia, both p ≤ 0.001) but thereafter, reached a plateau (0.015 and 0.028 %/year, both p > 0.05). In contrast, trabecular vBMD and microarchitecture showed linear association with age with significant deterioration observed throughout adulthood. Estimated age of peak was around age of 20 for trabecular vBMD and microarchitecture and Ct.Po and age of 40 for cortical vBMD and microarchitecture. Estimated stiffness and failure load peaked at mid-30s at the distal radius and at age 20 at distal tibia.
  
  
  CONCLUSIONS
  Age-related differences in vBMD and microarchitecture in Chinese women differed by bone compartments. Significant cortical bone loss occurred after midlife. Prominent increase in Ct.Po began at the fifth decade but appeared to be arrested before the sixth decade. Loss of trabecular bone was already evident in young adulthood and continued throughout life.
authors: Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China.
authors: V W Y
authors: VW
authors: Hung
authors: Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China.
authors: T Y
authors: TY
authors: Zhu
authors: Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China.|Joint ACC-CUHK Space Medicine Center on Health Maintenance of Musculoskeletal System (Shenzhen Base of ACC-CUHK State Key Lab of Basic and Applied Space Medicine), The Chinese University Shenzhen Research Institute, Shenzhen, China.
authors: W-H
authors: WH
authors: Cheung
authors: Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China.
authors: T-N
authors: TN
authors: Fong
authors: Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China.
authors: F W P
authors: FW
authors: Yu
authors: Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China.
authors: L-K
authors: LK
authors: Hung
authors: Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China.|Joint ACC-CUHK Space Medicine Center on Health Maintenance of Musculoskeletal System (Shenzhen Base of ACC-CUHK State Key Lab of Basic and Applied Space Medicine), The Chinese University Shenzhen Research Institute, Shenzhen, China.
authors: K-S
authors: KS
authors: Leung
authors: Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China.|Joint ACC-CUHK Space Medicine Center on Health Maintenance of Musculoskeletal System (Shenzhen Base of ACC-CUHK State Key Lab of Basic and Applied Space Medicine), The Chinese University Shenzhen Research Institute, Shenzhen, China.
authors: J C Y
authors: JC
authors: Cheng
authors: Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China. tplam@ort.cuhk.edu.hk.
authors: T-P
authors: TP
authors: Lam
authors: Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China. lingqin@cuhk.edu.hk.|Translational Medicine Research and Development Center, Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China. lingqin@cuhk.edu.hk.
authors: L
authors: L
authors: Qin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000208:ethnology / Q000473:pathology / Q000502:physiology*; D000886:Anthropometry / Q000379:methods; D044466:Asian People / Q000706:statistics & numerical data; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008875:Middle Aged; D011884:Radius / Q000033:anatomy & histology / Q000502:physiology*; D012016:Reference Values; D013977:Tibia / Q000033:anatomy & histology / Q000502:physiology*; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
keywords: Ageing; Bone microarchitecture; Bone strength; High-resolution pQCT; Volumetric BMD
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