2006
DOI: 10.1359/jbmr.051022
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Abstract: In an age-and sex-stratified population sample (n = 700), we estimated fall-related loads and bone strength indices at the UDR and FN. These load/strength ratios more closely simulated patterns of wrist and hip fractures occurring in the same population than did measurement of vBMD.Introduction: Areal BMD measurements, although associated with fracture risk, incompletely explain patterns of fragility fractures. Moreover, population-based assessments relating applied loads and whole bone strength to fracture pa… Show more

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Cited by 107 publications
(77 citation statements)
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“…This result is consistent with prior studies that have reported that fracture rates are similar for 50-year old men and women but diverge with increasing age with a much higher fracture rate in older women [27,28]. Many factors may contribute to the increased differences between sexes in fracture rates with ageing, including differences in bone strength [29,30], propensity to fall [26], and the load placed on the bone [31]. The gradient of fracture risk by age varies not only by sex, but also by skeletal site [28,32].…”
Section: Discussionsupporting
confidence: 91%
“…This result is consistent with prior studies that have reported that fracture rates are similar for 50-year old men and women but diverge with increasing age with a much higher fracture rate in older women [27,28]. Many factors may contribute to the increased differences between sexes in fracture rates with ageing, including differences in bone strength [29,30], propensity to fall [26], and the load placed on the bone [31]. The gradient of fracture risk by age varies not only by sex, but also by skeletal site [28,32].…”
Section: Discussionsupporting
confidence: 91%
“…As increasing bone size increases crosssectional moment of inertia (CSMI) and resistance to bending, 32 the increased odds for fracture with increasing bone turnover suggests that the positive effect of larger bone size on bone strength does not offset the negative impact of higher porosity and thinning of cortices produced by increased bone remodeling. 24,31,[33][34][35] This first evidence of association of in vivo measurements of proximal femur cortical porosity from clinical CT images with bone remodeling activity as reflected by PINP and CTX 31 confirm a previously reported association between distal tibia cortical porosity with PINP and CTX. 36 Cortical bone loss is the result of unbalanced and accelerated intracortical remodeling on the surfaces formed by the many canals traversing cortical bone.…”
Section: Bone Turnover Markers Cortical Porosity and Fracturesupporting
confidence: 84%
“…(42,48) This apparent sex difference in macrostructural changes with aging may partially explain the higher incidence of Colles' fractures in women than in men. (34) Despite a larger bone size, thicker cortices, and greater volume of trabecular bone in young-adult men, our estimate of sizeadjusted bone strength (ultimate stress) was not significantly different between young-adult men and women. Also, the predicted decline in size-adjusted bone strength was similar in magnitude in both sexes despite sex differences in the pattern of age-related bone loss in the trabecular and cortical compartments.…”
Section: Discussioncontrasting
confidence: 53%
“…Consistent with previous population-based studies of adults in the United States (13) and the United Kingdom, (14) our results suggest that patterns of age-related bone loss differ between women and men and also between the cortical and trabecular compartments at the distal radius and distal tibia. The predicted macro-and microstructural changes with aging in our cohort may help to explain the significantly greater incidence of forearm fractures in women than in men, (34) as well as how age-related structural changes differ between weight-bearing and non-weight-bearing sites. Before discussing our findings in detail, we acknowledge that in this cross-sectional study we cannot determine true agerelated changes in HR-pQCT outcomes in women and men.…”
Section: Discussionmentioning
confidence: 85%
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