Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites.
B. Lawrence Riggs,L. Joseph Melton,Richard A. Robb,Jon J. Camp,Elizabeth J. Atkinson,James M. Peterson,Peggy A Rouleau,Cynthia H. McCollough,Mary L. Bouxsein,Sundeep Khosla +9 more
TLDR
Over life, the cross‐sectional area of the vertebrae and proximal femur increased by ∼15% in both sexes, whereas vBMD at these sites decreased by 39–55% and 34–46%, respectively, with greater decreases in women than in men.Abstract:
UNLABELLED In a population-based, cross-sectional study, we assessed age- and sex-specific changes in bone structure by QCT. Over life, the cross-sectional area of the vertebrae and proximal femur increased by approximately 15% in both sexes, whereas vBMD at these sites decreased by 39-55% and 34-46%, respectively, with greater decreases in women than in men. INTRODUCTION The changes in bone structure and density with aging that lead to fragility fractures are still unclear. MATERIALS AND METHODS In an age- and sex-stratified population sample of 373 women and 323 men (age, 20-97 years), we assessed bone geometry and volumetric BMD (vBMD) by QCT at the lumbar spine, femoral neck, distal radius, and distal tibia. RESULTS In young adulthood, men had 35-42% larger bone areas than women (p < 0.001), consistent with their larger body size. Bone area increased equally over life in both sexes by approximately 15% (p < 0.001) at central sites and by approximately 16% and slightly more in men at peripheral sites. Decreases in trabecular vBMD began before midlife and continued throughout life (p < 0.001), whereas cortical vBMD decreases began in midlife. Average decreases in trabecular vBMD were greater in women (-55%) than in men (-46%, p < 0.001) at central sites, but were similar (-24% and -26%, respectively) at peripheral sites. With aging, cortical area decreased slightly, and the cortex was displaced outwardly by periosteal and endocortical bone remodeling. Cortical vBMD decreased over life more in women ( approximately 25%) than in men (approximately 18%, p < 0.001), consistent with menopausal-induced increases in bone turnover and bone porosity. CONCLUSIONS Age-related changes in bone are complex. Some are beneficial to bone strength, such as periosteal apposition with outward cortical displacement. Others are deleterious, such as increased subendocortical resorption, increased cortical porosity, and, especially, large decreases in trabecular vBMD that may be the most important cause of increased skeletal fragility in the elderly. Our findings further suggest that the greater age-related decreases in trabecular and cortical vBMD and perhaps also their smaller bone size may explain, in large part, why fragility fractures are more common in elderly women than in elderly men.read more
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Secular Trends in Incidence of Atrial Fibrillation in Olmsted County, Minnesota, 1980 to 2000, and Implications on the Projections for Future Prevalence
Yoko Miyasaka,Marion E. Barnes,Bernard J. Gersh,Stephen S. Cha,Kent R. Bailey,Walter P. Abhayaratna,James B. Seward,Teresa S.M. Tsang +7 more
TL;DR: The age-adjusted incidence of AF increased significantly in Olmsted County during 1980 to 2000 and the projected number of persons with AF for the United States will exceed 10 million by 2050, underscoring the urgent need for primary prevention strategies against AF development.
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Bone Quality — The Material and Structural Basis of Bone Strength and Fragility
Ego Seeman,Pierre D. Delmas +1 more
TL;DR: In this article, a review discusses advances in knowledge regarding the composition and structure of bone, the modeling and remodeling of bone and the formation of bone during growth and its reconstruction in adults.
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In Vivo Assessment of Trabecular Bone Microarchitecture by High-Resolution Peripheral Quantitative Computed Tomography."
TL;DR: HR-pQCT appears promising to assess bone density and microarchitecture at peripheral sites in terms of reproducibility and ability to detect age- and disease-related changes.
Journal ArticleDOI
Effects of Sex and Age on Bone Microstructure at the Ultradistal Radius: A Population-Based Noninvasive In Vivo Assessment
Sundeep Khosla,B. Lawrence Riggs,Elizabeth J. Atkinson,Ann L. Oberg,Lisa J McDaniel,Margaret F. Holets,James M. Peterson,L. Joseph Melton +7 more
TL;DR: Compared with women, men had thicker trabeculae in young adulthood and had less microstructural damage with aging, which may contribute to the virtual immunity of men to age‐related increases in wrist fractures.
Journal ArticleDOI
Age‐Related Changes in Trabecular Architecture Differ in Female and Male C57BL/6J Mice
TL;DR: Deterioration in vertebral and femoral trabecular microarchitecture begins early, continues throughout life, is more pronounced at the femoral metaphysis than in the vertebrae, and is greater in females than males.
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