Better skeletal microstructure confers greater mechanical advantages in Chinese-American women versus white women

Abstract

Despite lower areal bone mineral density (aBMD), Chinese-American women have fewer fractures than white women. We hypothesized that better skeletal microstructure in Chinese-American women in part could account for this paradox. Individual trabecula segmentation (ITS), a novel image-analysis technique, and micro–finite-element analysis (μFEA) were applied to high-resolution peripheral quantitative computed tomography (HR-pQCT) images to determine bone microarchitecture and strength in premenopausal Chinese-American and white women. Chinese-American women had 95% and 80% higher plate bone volume fraction at the distal radius and tibia, respectively, as well as 20% and 18% higher plate number density compared with white women (p < .001). With similar rodlike characteristics, the plate-to-rod ratio was twice as high in the Chinese-American than in white trabecular bone (p < .001). Plate-rod junction density, a parameter indicating trabecular network connections, was 37% and 29% greater at the distal radius and tibia, respectively, in Chinese-American women (p < .002). Moreover, the orientation of the trabecular bone network was more axially aligned in Chinese-American women because axial bone volume fraction was 51% and 32% higher at the distal radius and tibia, respectively, than in white women (p < .001). These striking differences in trabecular bone microstructure translated into 55% to 68% (distal radius, p < .001) and 29% to 43% (distal tibia, p < .01) greater trabecular bone strength, as assessed by Young’s moduli, in the Chinese-American versus the white group. The observation that Chinese-American women have a major microstructural advantage over white women may help to explain why their risk of fracture is lower despite their lower BMD.

MicroCT-based evaluation of the trabecular bone quality of different implant anchorage sites for masticatory rehabilitation of the maxilla

“…In a subsequent study, Kato et al (2005) confirmed, for edentulous specimens, a higher trabecular bone quality (higher bone volume fraction with thicker and more plate-like structured trabeculae) in the Jugale region, which also represents the apical anchorage site of zygomatic implants. Possible differences due to ethnicity (Nkenke et al, 2003;Liu et al, 2011;Kim et al, 2013b;Putman et al, 2013) and/or body height (Uchida et al, 2001) suggested the present microCT-based analysis in a Caucasian population. Compared with previous studies on edentulous specimens (micro-CT (Kato et al, 2005) and histomorphometric (Nkenke et al, 2003) analyses), a slightly higher bone volume fraction associated with a higher trabecular thickness was detected for the zygomatic bone.…”

“…For zygomatic bone, studies on its quantity are available (Uchida et al, 2001;Nkenke et al, 2003;Van Steenberghe et al, 2003;Corvello et al, 2011;Balshi et al, 2012), but data on its quality are still scarce and, except for one histological study by Nkenke et al (2003), are restricted to Japanese populations (Kato et al, 2004(Kato et al, , 2005Yoshino et al, 2007). Possible differences due to ethnicity (Uchida et al, 2001;Nkenke et al, 2003;Liu et al, 2011;Kim et al, 2013b;Putman et al, 2013) and the technique applied for bone analysis (histomorphometry vs. micro-computed tomography (microCT)) (Chappard et al, 2005;Bonnet et al, 2009), and the lack of an intraindividual comparison with the maxilla, triggered the present microCT-based study to assess the trabecular bone quality of the zygomatic bone and compare it with the anterior and posterior maxilla.…”

Trabecular Plate Loss and Deteriorating Elastic Modulus of Femoral Trabecular Bone in Intertrochanteric Hip Fractures

“…It has been discovered that Chinese-American women earned greater bone strength than Caucasian-American women from vast advantages of more plate-like trabecular microstructure and much better aligned trabecular orientation, i.e. twice as high pBV/TV, 50% higher aBV/TV (20). Echoing the study of Chinese vs. Caucasian bone quality, results in the present study proved that loss of trabecular plates and axially aligned trabeculae in the intertrochanteric region significantly diminished the resistance of femur to mechanical impact from various directions and likely led to fragility fractures at the hip.…”

“…We have shown that trabecular plates and rods of different orientations had distinct roles in mechanical properties and failure mechanisms of trabecular bone (17)(18)(19). Also, ITS analysis has revealed the key differences between Caucasian American and Chinese American skeleton, demonstrating that higher plate/rod ratio accounted for reduced fracture risk in Chinese Americans in spite of similar aBMD (20). In addition, ITS and micro finite element (µFE) analyses were able to distinguish postmenopausal women with and without fragility fractures independent of aBMD (12).…”

Musculoskeletal phenotype through the life course: the role of nutrition

“…Trabeculae thicken and change orientation during growth and development. As trabecular bone is lost during aging, the most supporting trabeculae to the direction of load are maintained to prevent fracture for as long as possible, for example, trabeculae in the vertebrae, radius or tibia (14,15) . Loading conditions: Increases or decreases in muscle strength will drive a modification of bone by the mechanostat.…”