Bone Microarchitecture in Men and Women with Diabetes: The Importance of Cortical Porosity

Abstract Objectives Previous studies reported that dairy foods are associated with higher areal bone mineral density (BMD) in older adults. However, data on bone strength and bone microarchitecture are lacking. The objective of this study was to determine the association of milk, yogurt, cheese, cream, milk + yogurt and milk + yogurt + cheese intakes with high resolution peripheral quantitative computed tomography (HR-pQCT) measures of bone in older adults from the Framingham Offspring study. Methods This cross-sectional study included 532 men and 694 women (aged 32–81y, mean 64y) with measures of dairy food intake (servings/wk.) from a food frequency questionnaire. Cortical and trabecular BMD and microarchitecture at the distal tibia and radius were measured using HR-pQCT. We focused on five bone parameters: 1) Bone strength assessed via failure load from micro–finite element analysis, 2) Two cortical bone measures: cortical BMD and cortical thickness; and 3) Two trabecular bone measures: trabecular bone density and trabecular number. Sex-combined and sex-specific multivariable linear regression was used to estimate the association of dairy food intake (energy adjusted) with each bone measure adjusting for covariates (sex, age, height, weight, current smoking, energy intake, calcium supplement use, vitamin D supplement use, physical activity and multivitamin use). Results Over 90% of the participants consumed the recommended ≥ 3 servings of dairy per day. Mean milk intake ± SD was 5.5 servings/week in both men and women. In sex combined analyses, only cheese intake was associated with cortical BMD at the radius and tibia (Table). None of the other dairy foods were significantly associated with any of the bone measures. In sex-stratified analysis higher cheese intake was associated with lower cortical BMD at the radius and tibia in women alone (radius: β = −9.61 ± 2.73, P = 0.001, tibia: β = −9.41 ± 3.10, P = 0.001). In men, higher cream intake was associated with higher trabecular number (radius: β = 0.021 ± 0.011, P = 0.02, tibia: β = 0.024 ± 0.012, P = 0.05). Higher yogurt intake was also associated with higher trabecular volumetric BMD at the tibia in men alone (tibia: β = 4.86 ± 2.00, P = 0.02). Conclusions In this cohort of primarily healthy older men and women with high dairy food consumption, specific dairy foods seem to be more beneficial in men than women. Negative associations for cheese intake and cortical BMD in women should be further confirmed in longitudinal studies. Funding Sources NIH AR # 053205; FHS N01-HC-25195 R01 AR/AG 41398 and unrestricted institutional research grant from Dairy Management Inc. Supporting Tables, Images and/or Graphs

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Sex- and Age-Related Differences in Bone Microarchitecture in Men Relative to Women Assessed by High-Resolution Peripheral Quantitative Computed Tomography

Journal of Osteoporosis ◽

10.1155/2012/129760 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 15

Author(s):

Shreyasee Amin ◽

Sundeep Khosla

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Bone Strength ◽

Bone Biopsy ◽

Bone Microarchitecture ◽

Quantitative Computed Tomography ◽

Older Men ◽

Peripheral Quantitative Computed Tomography ◽

Men And Women ◽

Age Related

The trabecular and cortical compartments of bone each contributes to bone strength. Until recently, assessment of trabecular and cortical microstructure has required a bone biopsy. Now, trabecular and cortical microstructure of peripheral bone sites can be determined noninvasively using high-resolution peripheral quantitative computed tomography (HR-pQCT). Studies that have used HR-pQCT to evaluate cohorts of both men and women have provided novel insights into the changes in bone microarchitecture that occur with age between the sexes, which may help to explain the lower fracture incidence in older men relative to women. This review will highlight observations from these studies on both the sex- and age-related differences in trabecular and cortical microstructure that may underlie the differences in bone strength, and thereby fracture risk, between men and women.

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Impaired bone microarchitecture in premenopausal women with acromegaly: the possible role of Wnt signaling

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab260 ◽

2021 ◽

Author(s):

Paula P B Silva ◽

Rosa M R Pereira ◽

Liliam Takayama ◽

Clarissa G Borba ◽

Felipe H Duarte ◽

...

Keyword(s):

Vertebral Fractures ◽

Bone Microarchitecture ◽

Premenopausal Women ◽

Control Group ◽

Cortical Porosity ◽

Cross Sectional ◽

Pituitary Deficiency ◽

The Impact ◽

Wnt Inhibitors

Abstract Context Acromegaly can impair bone integrity, increasing the risk of vertebral fractures (VF). Objective To evaluate the impact of isolated GH/IGF-I hypersecretion on bone turnover markers,Wnt inhibitors, BMD, microarchitecture, bone strength and vertebral fractures in female patients with acromegaly (Acro), compared to healthy control group (HC). Design, setting, and patients Cross-sectional study including 83 premenopausal women without any pituitary deficiency:18 acromegaly in remission (AcroR), 12 in group with active acromegaly (AcroA) and 53 HC. Serum P1NP, β-CTX, osteocalcin, sclerostin and DKK1 were measured in blood samples. DXA, HR-pQCT and vertebral fractures evaluation were also assessed simultaneously. Main outcome and Results AcroA showed significantly lower sclerostin and higher DKK1 as compared to HC. On HR-pQCT of tibia and radius, Acro showed impairment of trabecular (area and trabecular number), increased cortical porosity and increased cortical area and cortical thickness compared to HC. The only significant correlation found with HR-pQCT parameters was a positive correlation between cortical porosity and serum DKK1 (R=0.45, P=0.044). Mild VF were present in approximately thirty percent of patients. Conclusions Eugonadal women with acromegaly without any pituitary deficiency showed increased cortical BMD, impairment of trabecular bone microstructure and increased VF. Sclerostin was not correlated with any HR-pQCT parameters, however DKK1 was correlated with cortical porosity in tibia (P=0.027). Additional studies are needed to clarify, the role of Wnt inhibitors on bone microarchitecture impairment in acromegaly.

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Improved biomechanics in experimental chronic rotator cuff repair after shockwaves is not reflected by bone microarchitecture

PLoS ONE ◽

10.1371/journal.pone.0262294 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262294

Author(s):

Xaver Feichtinger ◽

Patrick Heimel ◽

Stefan Tangl ◽

Claudia Keibl ◽

Sylvia Nürnberger ◽

...

Keyword(s):

Rotator Cuff ◽

Transition Zone ◽

Rotator Cuff Repair ◽

Bone Microarchitecture ◽

Study Groups ◽

Bone Microstructure ◽

Cortical Porosity ◽

Sprague Dawley ◽

Double Row ◽

Cuff Repair

Purpose The aim of this study was to investigate the effect of extracorporeal shockwave therapy (ESWT) on bone microstructure as well as the bone-tendon-interface and the musculo-tendinous transition zone to explain the previously shown improved biomechanics in a degenerative rotator cuff tear animal model. This study hypothesized that biomechanical improvements related to ESWT are a result of improved bone microstructure and muscle tendon properties. Methods In this controlled laboratory study unilateral supraspinatus (SSP) tendon detachment was performed in 48 male Sprague-Dawley rats. After a degeneration period of three weeks, SSP tendon was reconstructed transosseously. Rats were randomly assigned into three groups (n = 16 per group): control (noSW); intraoperative shockwave treatment (IntraSW); intra- and postoperative shockwave treatment (IntraPostSW). Eight weeks after SSP repair, all rats were sacrificed and underwent bone microstructure analysis as well as histological and immunohistochemical analyses. Results With exception of cortical porosity at the tendon area, bone microstructure analyses revealed no significant differences between the three study groups regarding cortical and trabecular bone parameters. Cortical Porosity at the Tendon Area was lowest in the IntraPostSW (p≤0.05) group. Histological analyses showed well-regenerated muscle and tendon structures in all groups. Immunohistochemistry detected augmented angiogenesis at the musculo-tendinous transition zone in both shockwave groups indicated by CD31 positive stained blood vessels. Conclusion In conclusion, bone microarchitecture changes are not responsible for previously described improved biomechanical results after shockwave treatment in rotator cuff repair in rodents. Immunohistochemical analysis showed neovascularization at the musculo-tendinous transition zone within ESWT-treated animals. Further studies focusing on neovascularization at the musculo-tendinous transition zone are necessary to explain the enhanced biomechanical and functional properties observed previously. Clinical relevance In patients treated with a double-row SSP tendon repair, an improvement in healing through ESWT, especially in this area, could prevent a failure of the medial row, which is considered a constantly observed tear pattern.

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