Peripheral Quantitative Computed Tomography (pQCT) Measures Contribute to the Understanding of Bone Fragility in Older Patients With Low-trauma Fracture

Jiang, Hongyuan; Yates, Christopher J; Gorelik, Alexandra; Kale, Ashwini; Song, Qichun; Wark, John D.

doi:10.1016/j.jocd.2017.02.003

Cited by 16 publications

(21 citation statements)

References 23 publications

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“…Each participant was allocated 7 min for one scout and two research scans of his/her non-dominant lower leg (tibia), classified as the leg preferentially used to kick a ball. The research assistant identified by palpation and marked with pen the superior edge of the medial malleolus and the medial edge of the tibial plateau 25. The length of the tibia was taken to be the distance between these two points as measured using a standard measuring tape.…”

Section: Methodsmentioning

confidence: 99%

“…The 4% site corresponds to the distal shaft of the tibia, which contains mostly trabecular bone with a thin cortex; bone turnover in trabecular bone is higher than that of cortical bone 37. The 66% site corresponds to the tibial diaphysis, comprised mainly of cortical bone which is a major determinant of the intrinsic stiffness or elastic modulus of bone22 37; this site features in existing clinical reference ranges 25. One tomographic image was taken at each of these sites, at a scan speed of 20 mm/s, slice thickness of 2.4 mm and voxel size of 0.4 mm.…”

Section: Methodsmentioning

confidence: 99%

“…Extracted measures were chosen to support comparisons with other published analyses25 and in collaboration with Stratec scientists and a Senior Scientist at The Children’s Hospital in Westmead, New South Wales, Australia. From the 4% site, trabecular BMD (mg/cm 3 ) and total cross-sectional area (mm 2 ) were calculated using the threshold 169.0 and peel and contour modes ‘1’ with a trabecular area of 45% 23 25 38.…”

Section: Methodsmentioning

confidence: 99%

“…For the 66% site the peel and cortical modes were changed to ‘2’ and a density threshold of 710 g/cm 3 was applied to separate the cortical bone from other tissues. Metrics from the 66% site were cortical BMD (mg/cm 3 ), total cross-sectional area (mm 2 ) and endosteal circumference, periosteal circumference and cortical thickness (all mm) 25 39. We used the circular ring model to determine the circumference and thickness.…”

Section: Methodsmentioning

confidence: 99%

“…However, population-based and age-based reference data are needed to define osteoporosis using pQCT 24. The importance of robust reference data can be inferred from small existing reference populations such as a white American convenience sample of 416 children aged 5-18 years with tibial pQCT parameters, where older children had larger, thicker cortical bones than younger children within the same height interval 25. In adults, cross-sectional data from the Italian InCHIANTI ageing study of just over 1000 participants aged from their 20s to their 80s indicated a linear trend of decline in trabecular BMD, starting in early adulthood in both men (−0.94+0.11 mg/cm 3 per year) and women (−1.23+0.09 mg/cm 3 per year) 23…”

Section: Introductionmentioning

confidence: 99%

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pQCT bone geometry and strength: population epidemiology and concordance in Australian children aged 11–12 years and their parents

et al. 2019

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ObjectivesTo describe the epidemiology and concordance of bone health in a population-based sample of Australian parent-child dyads at child age 11–12 years.DesignPopulation-based cross-sectional study (the Child Health CheckPoint) nested between waves 6 and 7 of the Longitudinal Study of Australian Children (LSAC).SettingAssessment centres in seven cities around Australia, February 2015–March 2016.Participants: of all participating CheckPoint families (n=1874), bone data were available for 1222 dyads (1271 children, 50% girls; 1250 parents, 86% mothers).Outcome measuresPeripheral quantitative CT (pQCT) of the non-dominant leg scanned at the 4% (distal) and 66% (mid-calf) tibial sites. Stratec XCT 2000 software generated estimates of bone density, geometry and polar stress-strain index.Parent-child concordance were assessed using Pearson’s correlation coefficients and multivariable linear regression models. Percentiles were determined using survey weights. Survey weights and methods accounted for LSAC’s complex sampling, stratification and clustering within postcodes.ResultsConcordances were greater for the geometric pQCT parameters (periosteal circumference 0.38, 95% CI 0.33 to 0.43; endosteal circumference 0.42, 95% CI 0.37 to 0.47; total cross-sectional area 0.37, 95% CI 0.32 to 0.42) than density (cortical density 0.25, 95% CI 0.19 to 0.30). Mother-child and father-child values were similar. Relationships attenuated only slightly on adjustment for age, sex and body mass index. Percentiles and concordance are presented for the whole sample and by sex.ConclusionsThere is strong parent-child concordance in bone geometry and, to a lesser extent, density even before the period of peak adolescent bone deposition. This geometrical concordance suggests that future intergenerational bone studies could consider using pQCT rather than the more commonly used dual X-ray absorptiometry (DXA).

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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pQCT bone geometry and strength: population epidemiology and concordance in Australian children aged 11–12 years and their parents

et al. 2019

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Longitudinal association between muscle and bone loss: Results of US and Japanese cohort studies

Osawa,

An,

Nishita

et al. 2024

J cachexia sarcopenia muscle

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BackgroundMuscle and bone are physiologically interconnected, but joint changes of muscle and bone with aging, and whether the muscle‐bone changes are different by sex and by country has been little studied. We examined longitudinal associations of bone mineral density (BMD) and muscle mass or muscle strength in community‐dwelling 65 years or older in the United States and Japan.MethodsThe present analytic sample included 1129 women and men from the Baltimore Longitudinal Study of Aging (BLSA) (mean age, 74.5 ± 7.5 years; women, 49.8%) and 1998 women and men from the National Institute for Longevity Sciences‐Longitudinal Study of Aging (NILS‐LSA) (mean age, 70.0 ± 4.5 years; women, 51.4%). Median follow‐up was 4.6 (min‐max, 0–15.4) years in the BLSA and 4.0 (min‐max, 0–13.4) years in the NILS‐LSA. We selected visits at which participants had BMD (whole body, pelvic, femoral neck, trochanter, and Ward's triangle BMDs) and muscle mass [appendicular lean mass, (ALM)] measured by DXA scan. In each bone site, we ran cohort‐specific bivariate linear mixed‐effects models adjusted for baseline age, sex, body height, body weight, fat mass, education year, and smoking status. Race was an additional adjustment in the BLSA. Additionally, we performed sex‐specific analyses.ResultsIn the BLSA, the rate of change in ALM positively correlated with the rate of change in the whole body (rho = 0.30, P < 0.0001) and pelvic BMD (rho = 0.24, P < 0.0001), but not in trochanter, femoral neck, or Ward's triangle BMD (P > 0.05). In the NILS‐LSA, ALM positively correlated with the rate of change in all bone sites (rho ranged from 0.20 to 0.71, P < 0.01). In women, ALM positively correlated with the rate of change in all bone sites in both cohorts (in the NILS‐LSA, rho ranged from 0.35 to 0.91, P < 0.01; in the BLSA, rho ranged from 0.26 to 0.56, P < 0.05) except for femoral neck BMD in the BLSA. In men, ALM positively correlated with pelvic, trochanter, and Ward's triangle BMD in the NILS‐LSA (rho ranged from 0.45 to 0.68, P < 0.0001), and whole body and trochanter BMD in the BLSA (both, rho = 0.20, P < 0.05).ConclusionsMuscle loss co‐occurred with bone loss in both cohorts, but the association in the NILS‐LSA tended to be stronger than in the BLSA, and the association was higher in women than in men, implying that the association may differ by sex and country.

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Bone health in long‐term survivors of pediatric acute lymphoblastic leukemia. An assessment by peripheral quantitative computed tomography

Barr

Inglis

Athale

et al. 2021

Pediatric Blood & Cancer

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Background: Loss of bone mineral is a common concomitant of the treatment of acute lymphoblastic leukemia (ALL) due mainly to chemotherapy, especially with corticosteroids. Osteopenia/osteoporosis may be encountered long into survivorship. Measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry is limited to two-dimensionality and cannot distinguish trabecular from cortical bone.Methods: A sample of 74 subjects, ages 13.5-38.3 years more than 10 years from diagnosis, underwent peripheral quantitative computed tomography (pQCT) at metaphyseal (trabecular bone) and diaphyseal (cortical bone) sites in the radius and tibia. pQCT provides three-dimensional assessment of bone geometry, density, and architecture.Results: Average values in multiple metrics were similar to those in healthy individuals, but deficits in both trabecular and cortical bones were revealed by lower Z scores using an ethnically comparable sample of healthy individuals. Connectivity, a measure of bone architecture and a surrogate measure of bone strength, was lower in females than males. Survivors of standard-risk ALL had greater connectivity in and more compact trabecular bone than high-risk survivors who had received more intensive osteotoxic chemotherapy. There were no statistically significant differences in any of the metrics at any of the sites between subjects who had or had not a history of fracture, cranial irradiation, or use of a bisphosphonate.Conclusions: These long-term survivors of ALL have somewhat compromised bone health, but data in comparable healthy populations are limited. Longitudinal studies in larger and more ethnically diverse cohorts will provide greater insight into bone health in this vulnerable population.

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Peripheral Quantitative Computed Tomography (pQCT) Measures Contribute to the Understanding of Bone Fragility in Older Patients With Low-trauma Fracture

Cited by 16 publications

References 23 publications

pQCT bone geometry and strength: population epidemiology and concordance in Australian children aged 11–12 years and their parents

pQCT bone geometry and strength: population epidemiology and concordance in Australian children aged 11–12 years and their parents

Longitudinal association between muscle and bone loss: Results of US and Japanese cohort studies

Bone health in long‐term survivors of pediatric acute lymphoblastic leukemia. An assessment by peripheral quantitative computed tomography

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