Accelerated Bone Loss in Older Men: Effects on Bone Microarchitecture and Strength

for the Osteoporotic Fractures in Men (MrOS) Research Group, Jane A. Cauley, Andrew J. Burghardt, Stephanie L. Harrison, Peggy M. Cawthon, Ann V. Schwartz, Elizabeth Barrett Connor, Kristine E. Ensrud, Lisa Langsetmo, Sharmila Majumdar, Eric Orwoll

Research output: Contribution to journalArticle

Abstract

Accelerated bone loss (ABL) shown on routine dual-energy X-ray absorptiometry (DXA) may be accompanied by microarchitectural changes, increased cortical porosity, and lower bone strength. To test this hypothesis, we performed a cross-sectional study and used high-resolution peripheral quantitative computed tomography (HR-pQCT) scans (Scanco Medical AG, Brüttisellen, Switzerland) to measure estimated bone strength and microarchitecture in the distal radius and distal and diaphyseal tibia. We studied 1628 men who attended the year 14 exam of the Osteoporotic Fractures in Men (MrOS) study. We retrospectively characterized areal bone mineral density (aBMD) change from the year 7 to year 14 exam in three categories: “accelerated” loss, ≥10% loss at either the total hip or femoral neck (n = 299, 18.4%); “expected” loss, <10% (n = 1061, 65.2%), and “maintained” BMD, ≥0% (n = 268, 16.5%). The ABL cut-off was a safety alert established for MrOS. We used regression models to calculate adjusted mean HR-pQCT parameters in men with ABL, expected loss, or maintained BMD. Men who experienced ABL were older and had a lower body mass index and aBMD and experienced greater weight loss compared with other men. Total volumetric BMD and trabecular and cortical volumetric BMD were lower in men with ABL compared with the expected or maintained group. Men with ABL had significantly lower trabecular bone volume fraction (BV/TV), fewer trabeculae, and greater trabecular separation at both the distal radius and tibia than men with expected loss or who maintained aBMD, all p trend <0.001. Men with ABL had lower cortical thickness and lower estimated bone strength, but there was no difference in cortical porosity except at the tibia diaphyseal site. In summary, men with ABL have lower estimated bone strength, poorer trabecular microarchitecture, and thinner cortices than men without ABL but have similar cortical porosity. These impairments may lead to an increased risk of fracture.

LanguageEnglish (US)
Pages1859-1869
Number of pages11
JournalJournal of Bone and Mineral Research
Volume33
Issue number10
DOIs
StatePublished - Oct 1 2018

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Bone and Bones
Porosity
Tibia
Bone Density
Tomography
Osteoporotic Fractures
Femur Neck
Photon Absorptiometry
Switzerland
Hip
Weight Loss
Body Mass Index
Cross-Sectional Studies
Safety

Keywords

  • ACCELERATED BONE LOSS
  • BONE QCT
  • GENERAL POPULATION STUDIES
  • OSTEOPOROSIS

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine

Cite this

Accelerated Bone Loss in Older Men : Effects on Bone Microarchitecture and Strength. / for the Osteoporotic Fractures in Men (MrOS) Research Group.

In: Journal of Bone and Mineral Research, Vol. 33, No. 10, 01.10.2018, p. 1859-1869.

Research output: Contribution to journalArticle

for the Osteoporotic Fractures in Men (MrOS) Research Group 2018, 'Accelerated Bone Loss in Older Men: Effects on Bone Microarchitecture and Strength' Journal of Bone and Mineral Research, vol. 33, no. 10, pp. 1859-1869. https://doi.org/10.1002/jbmr.3468
for the Osteoporotic Fractures in Men (MrOS) Research Group. / Accelerated Bone Loss in Older Men : Effects on Bone Microarchitecture and Strength. In: Journal of Bone and Mineral Research. 2018 ; Vol. 33, No. 10. pp. 1859-1869.
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AU - Connor, Elizabeth Barrett

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