Skeletal Structure in Postmenopausal Women with Osteopenia and Fractures is Characterized by Abnormal Trabecular Plates and Cortical Thinning

摘要: The majority of fragility fractures occur in women with osteopenia rather than osteoporosis by dual energy x-ray absorptiometry (DXA). However, it is difficult to identify which are at greatest risk. We performed this study determine whether osteopenic and without fracture had differences trabecular morphology biomechanical properties bone. hypothesized that would have fewer plates, less connectivity lower stiffness. enrolled 117 postmenopausal DXA (mean age 66 years; 58 59 non-fractured controls). All areal bone mineral density DXA. Trabecular cortical volumetric BMD (vBMD), microarchitecture, porosity were measured high resolution peripheral computed tomography (HR-pQCT) the distal radius tibia. HR-pQCT scans subjected finite element analysis estimate whole stiffness individual trabecula segmentation (ITS) evaluate type (as plate or rod), orientation connectivity. Groups similar age, race, BMI, mean T-scores. Fracture subjects vBMD, thinner cortices, more widely separated trabeculae. By ITS, axially aligned trabeculae Whole was fractures. Cortical did not differ. Differences found both sites, whereas pronounced radius. In summary, thinner, rod-like structure, compared controls, despite aBMD Our results suggest addition loss, changes rod structure may be important mechanisms osteopenia.