Abstract
Quantitative computed tomography (QCT) can estimate volumetric bone mineral density (vBMD) and distinguish trabecular from cortical bone. Few comprehensive studies have examined correlates of vBMD in older men. This study evaluated the impact of demographic, anthropometric, lifestyle, and medical factors on vBMD in 1172 men aged 69 to 97 years and enrolled in the Osteoporotic Fractures in Men Study (MrOS). Peripheral quantitative computed tomography (pQCT) was used to measure vBMD of the radius and tibia. The multivariable linear regression models explained up to 10% of the variance in trabecular vBMD and up to 9% of the variance in cortical vBMD. Age was not correlated with radial trabecular vBMD. Correlates associated with both cortical and trabecular vBMD were age (−), caffeine intake (−), total calcium intake (+), nontrauma fracture (−), and hypertension (+). Higher body weight was related to greater trabecular vBMD and lower cortical vBMD. Height (−), education (+), diabetes with thiazolidinedione (TZD) use (+), rheumatoid arthritis (+), using arms to stand from a chair (−), and antiandrogen use (−) were associated only with trabecular vBMD. Factors associated only with cortical vBMD included clinic site (−), androgen use (+), grip strength (+), past smoker (−), and time to complete five chair stands (−). Certain correlates of trabecular and cortical vBMD differed among older men. An ascertainment of potential risk factors associated with trabecular and cortical vBMD may lead to better understanding and preventive efforts for osteoporosis in men. © 2010 American Society for Bone and Mineral Research.
Highlights
There is growing recognition that osteoporosis and fractures in older men are significant public health problems that contribute to disability and premature death.[1]
Our study results suggest that some correlates of trabecular volumetric bone mineral density (vBMD) may differ from those of cortical vBMD
Age was not associated with lower trabecular vBMD of the radius, consistent with the findings of a previous study by Dalzell and colleagues[20] but contrary to the findings of Riggs and colleagues,(21,22) Reduction in trabecular vBMD has been shown to occur before midlife in men and women and to continue unabated through life.[21,22,23] The mechanism for this early onset of trabecular vBMD loss remains unknown
Summary
There is growing recognition that osteoporosis and fractures in older men are significant public health problems that contribute to disability and premature death.[1]. Men over the age of 50 have a 13% estimated risk of developing an osteoporotic fracture.[3]. A major limitation of dual-energy X-ray absorptiometry (DXA) is its inability to distinguish cortical and trabecular bone. Bones tend to differ in their composition of trabecular and cortical bone. The spine is primarily trabecular bone.[4] identifying correlates of trabecular bone can lead to a better understanding of what factors might be associated with spine fracture. DXA provides a measurement in only two dimensions and reports an areal BMD (aBMD). Bones of larger width and length tend to have greater depth (eg, in men compared with women), and since bone depth is not accounted for in DXA scanning, reliance on aBMD inherently
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