Microstructure of the trabecula and cortex of iliac bone in primary hyperparathyroidism patients determined using histomorphometry and node-strut analysis

Uchiyama, Toru; Tanizawa, Tatsuhiko; Ito, Akihiro; Endo, Naoto; Takahashi, Hideaki

doi:10.1007/s007740050096

Cited by 32 publications

(27 citation statements)

References 20 publications

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“…(3,4,6,8) The changes in the cortical compartment of the radius, with reduced Ct.Th seen in our study, are in line with some (4,26) but not other (2) histomorphometric findings in biopsies from the iliac crest. In contrast to the histomophometric findings in biopsies from the iliac crest, (2,7) we did not observe an increase in Ct.Po in the radius. The inability to demonstrate a difference in Ct.Po could be due to a lack of power given the relatively small number of subjects evaluated because we did observe a 19% difference in Ct.Po in PHPT patients compared with controls (2.10% AE 1.08% in PHPT, 1.71% AE 0.97% in controls).…”

Section: Discussioncontrasting

confidence: 99%

“…(2)(3)(4) Most histomorphometric studies on iliac crest bone biopsies have found preservation in cancellous bone microarchitecture but increased cortical porosity (Ct.Po) and/or reduced cortical width. (2)(3)(4)(5)(6)(7)(8) Several epidemiologic studies have found an increased fracture risk in PHPT patients, suggesting a reduced bone biomechanical competence as a consequence of the high turnover state per se or owing to the subsequent bone loss. (9)(10)(11)(12) The access to parameters of bone quality synonymous with bone characteristics besides BMD (13) has improved in recent…”

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confidence: 99%

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Effects on bone geometry, density, and microarchitecture in the distal radius but not the tibia in women with primary hyperparathyroidism: A case-control study using HR-pQCT

Hansen

Jensen

Rasmussen

et al. 2010

Journal of Bone and Mineral Research

110

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Patients with primary hyperparathyroidism (PHPT) have continuously elevated parathyroid hormone (PTH) and consequently increased bone turnover with negative effects on cortical (Ct) bone with preservation of trabecular (Tb) bone. High-resolution peripheral quantitative computed tomography (HR-pQCT) is a new technique for in vivo assessment of geometry, volumetric density, and microarchitecture at the radius and tibia. In this study we aimed to evaluate bone status in women with PHPT compared with controls using HR-pQCT. The distal radius and tibia of 54 women-27 patients with PHPT (median age 60, range 44-75 years) and 27 randomly recruited age-matched healthy controls (median age 60, range 44-76 years)-were imaged using HR-pQCT along with areal bone mineral density (aBMD) by dual-energy X-ray absorptiomentry (DXA) of the ultradistal forearm, femoral neck, and spine (L1-L4). Groups were comparable regarding age, height, and weight. In the radius, patients had reduced Ct area (Ct.Ar) ( p ¼ .008), Ct thickness (Ct.th) ( p ¼ .01) along with reduced total ( p ¼ .002), Ct ( p ¼ .02), and Tb ( p ¼ .02) volumetric density and reduced Tb number (Tb.N) ( p ¼ .04) and increased Tb spacing (Tb.sp) ( p ¼ .05). Ct porosity did not differ. In the tibia, no differences in HR-pQCT parameters were found. Moreover, patients had lower ultradistal forearm ( p ¼ .005), spine ( p ¼ .04), and femoral neck ( p ¼ 0.04) aBMD compared with controls. In conclusion, a negative bone effect of continuously elevated PTH with alteration of HR-pQCT assessed geometry, volumetric density, and both trabecular and cortical microarchitecture in radius but not tibia was found along with reduced aBMD by DXA at all sites in female patients with PHPT. ß

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Section: Discussioncontrasting

confidence: 99%

mentioning

confidence: 99%

Effects on bone geometry, density, and microarchitecture in the distal radius but not the tibia in women with primary hyperparathyroidism: A case-control study using HR-pQCT

Hansen

Jensen

Rasmussen

et al. 2010

Journal of Bone and Mineral Research

110

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“…Filling of the endocortical remodeling space as a result of the decline in bone turnover, however, seems the most likely mode of action. In contrast to previous findings in iliac bone, (2,8,9) we did not observe statistically significant differences in cortical porosity in patients compared to controls at baseline; neither did we find significant decreases in cortical porosity in response to surgery. This is most likely caused by the inability of HR-pQCT system to capture small cortical pores adequately.…”

Section: Journal Of Bone and Mineral Researchcontrasting

confidence: 99%

“…(1)(2)(3)(4)6,7) In iliac cortical bone, endocortical and intracortical remodeling seem preferentially ORIGINAL ARTICLE J JBMR increased over periosteal remodeling, causing reduced cortical width and/or increased cortical porosity. (2,5,(7)(8)(9) At peripheral sites, alterations of cortical bone geometry have been found consistent with periosteal bone apposition and endocortical bone resorption. (10)(11)(12)(13) Overall, effects appear detrimental to bone integrity as patients with PHPT have been found to have an increased risk of fracture.…”

Section: Introductionmentioning

confidence: 70%

Parathyroidectomy improves bone geometry and microarchitecture in female patients with primary hyperparathyroidism: A one-year prospective controlled study using high-resolution peripheral quantitative computed tomography

Hansen

Hauge

Rasmussen

et al. 2012

Journal of Bone and Mineral Research

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Following parathyroidectomy (PTX), bone mineral density (BMD) increases in patients with primary hyperparathyroidism (PHPT), yet information is scarce concerning changes in bone structure and strength following normalization of parathyroid hormone levels postsurgery. In this 1-year prospective controlled study, high-resolution peripheral quantitative computed tomography (HR-pQCT) was used to evaluate changes in bone geometry, volumetric BMD (vBMD), microarchitecture, and estimated strength in female patients with PHPT before and 1 year after PTX, compared to healthy controls. Twenty-seven women successfully treated with PTX (median age 62 years; range, 44-75 years) and 31 controls (median age 63 years; range, 40-76 years) recruited by random sampling from the general population were studied using HR-pQCT of the distal radius and tibia as well as with dual-energy X-ray absorptiometry (DXA) of the forearm, spine, and hip. The two groups were comparable with respect to age, height, weight, and menopausal status. In both radius and tibia, cortical (Ct.) vBMD and Ct. thickness increased or were maintained in patients and decreased in controls (p < 0.01). Radius cancellous bone architecture was improved in patients through increased trabecular number and decreased trabecular spacing compared with changes in controls (p < 0.05). No significant cancellous bone changes were observed in tibia. Estimated bone failure load by finite element modeling increased in patients in radius but declined in controls (p < 0.001). Similar, albeit borderline significant changes in estimated failure load were found in tibia (p ¼ 0.06). This study showed that females with PHPT had improvements in cortical bone geometry and increases in cortical and trabecular vBMD in both radius and tibia along with improvements in cancellous bone architecture and estimated strength in radius 1 year after PTX, reversing or attenuating age-related changes observed in controls. ß

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“…Node-strut analysis is an established histomorphometric method that is recognized as being most suitable for the evaluation of bone structure [17, 18, 20, 21]. The results of node-strut analysis obtained from conventional microscopic histomorphometry and from high-resolution CT have been shown to be in good agreement with each other [22].…”

Section: Discussionsupporting

confidence: 60%

Microfocus Computed Tomography Analysis of Early Changes in Bone Microstructure in Rats with Chronic Renal Failure

Kazama

Iwasaki²,

Yamato³

et al. 2004

Nephron Exp Nephrol

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Background/Aims: Little is known about the microstructural changes in bone tissue in the early phase of chronic renal failure (CRF). In this study, we analyzed the bone tissue in a rat model of early CRF using a high-resolution X-ray tomographic system, i.e. microfocus computed tomography (MXCT), which is capable of detecting microscopic structural changes in bone tissue. Methods: CRF rats were created by 7/8 nephrectomy by ligation of the renal artery branches, and were sacrificed 24 weeks after surgery. MXCT and bone mineral densitometry by single-energy X-ray absorptiometry (SXA) were performed using extracted bone samples. Images obtained by MXCT were further analyzed by node-strut morphometry. Results: Biochemical analysis confirmed that CRF was induced in 7/8-renal artery-ligated rats. MXCT demonstrated a significant decrease in trabecular bone in uremic rats, whereas SXA was unable to detect the difference. The node-strut method revealed decreased trabecular connectivity, with little change in the thickness of the trabecular bone in uremic rats. Conclusion: MXCT was able to detect significant changes in trabecular bone at an early stage of renal failure. The observed structural changes differed from those found in long-term dialysis patients. MXCT is a practical and promising device used for the non-invasive evaluation of early bone changes in uremic patients.

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Microstructure of the trabecula and cortex of iliac bone in primary hyperparathyroidism patients determined using histomorphometry and node-strut analysis

Cited by 32 publications

References 20 publications

Effects on bone geometry, density, and microarchitecture in the distal radius but not the tibia in women with primary hyperparathyroidism: A case-control study using HR-pQCT

Effects on bone geometry, density, and microarchitecture in the distal radius but not the tibia in women with primary hyperparathyroidism: A case-control study using HR-pQCT

Parathyroidectomy improves bone geometry and microarchitecture in female patients with primary hyperparathyroidism: A one-year prospective controlled study using high-resolution peripheral quantitative computed tomography

Microfocus Computed Tomography Analysis of Early Changes in Bone Microstructure in Rats with Chronic Renal Failure

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