Abstract
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.
Highlights
High-resolution peripheral quantitative computed tomography (HR-pQCT) is a novel imaging modality that noninvasively assesses trabecular and cortical bone microstructure at the distal radius and tibia [1, 2]
Areal bone mineral density, as assessed by dual-energy Xray absorptiometry (DXA), remains an important predictor of fractures, DXA technology is limited in its inability to measure the trabecular and cortical bone compartments separately, each of which contributes to bone strength [3]
In a study involving almost 300 adolescent boys and girls between the ages of 15–20 years who had their distal tibia imaged by HR-pQCT, sex-related differences were more apparent by the age of 17–20 years, with boys in this age range having greater bone size, bone volume/total volume (BV/TV) and CtTh relative to girls [16]
Summary
High-resolution peripheral quantitative computed tomography (HR-pQCT) is a novel imaging modality that noninvasively assesses trabecular and cortical bone microstructure at the distal radius and tibia [1, 2]. With the development and subsequent validation of HR-pQCT [1, 4,5,6,7], trabecular and cortical microstructure of peripheral bone sites can be determined noninvasively and is more amenable for clinical study. There are a growing number of studies that have used HR-pQCT to evaluate relatively large cohorts of men and women. The findings from these studies have provided important advances to our understanding of the age-related changes in bone microarchitecture that occur, which may in turn help to explain the lower fracture incidence observed in aging men relative to aging women
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