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  3. Reference values and clinical predictors of bone strength for HR-pQCT-based distal radius and tibia strength assessments in women and men.

Reference values and clinical predictors of bone strength for HR-pQCT-based distal radius and tibia strength assessments in women and men.

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DOI
10.7892/boris.144454
Publisher DOI
10.1007/s00198-020-05405-0
PubMed ID
32451557
Abstract
Reference values for radius and tibia strength using multiple-stack high-resolution peripheral quantitative computed tomography (HR-pQCT) with homogenized finite element analysis are presented in order to derive critical values improving risk prediction models of osteoporosis. Gender and femoral neck areal bone mineral density (aBMD) were independent predictors of bone strength.

INTRODUCTION

The purpose was to obtain reference values for radius and tibia bone strength computed by using the homogenized finite element analysis (hFE) using multiple stacks with a HR-pQCT.

METHODS

Male and female healthy participants aged 20-39 years were recruited at the University Hospital of Bern. They underwent interview and clinical examination including hand grip, gait speed and DXA of the hip. The nondominant forearm and tibia were scanned with a double and a triple-stack protocol, respectively, using HR-pQCT (XCT II, SCANCO Medical AG). Bone strength was estimated by using the hFE analysis, and reference values were calculated using quantile regression. Multivariable analyses were performed to identify clinical predictors of bone strength.

RESULTS

Overall, 46 women and 41 men were recruited with mean ages of 25.1 (sd 5.0) and 26.2 (sd 5.2) years. Sex-specific reference values for bone strength were established. Men had significantly higher strength for radius (mean (sd) 6640 (1800) N vs. 4110 (1200) N; p < 0.001) and tibia (18,200 (4220) N vs. 11,970 (3150) N; p < 0.001) than women. In the two multivariable regression models with and without total hip aBMD, the addition of neck hip aBMD significantly improved the model (p < 0.001). No clinical predictors of bone strength other than gender and aBMD were identified.

CONCLUSION

Reference values for radius and tibia strength using multiple HR-pQCT stacks with hFE analysis are presented and provide the basis to help refining accurate risk prediction models. Femoral neck aBMD and gender were significant predictors of bone strength.
Date Issued
2020-10
Publication Type
Article
Subject(s)
600 Technology > 610 Medicine & health
Subjects
Bone strength Clinical predictors Failure load Finite element analysis HR-pQCT Multiple stacks Reference values
Language(s)
en
Author(s)
Stuck, Andreas  
Geriatric Clinic - Partial Clinic Inselspital  
Schenk, Denis Elia  
ARTORG Center - Biomechanics  
Zysset, Philippe  orcid-logo
ARTORG Center - Biomechanics  
Bütikofer, Lukas  
Clinical Trials Unit Bern (CTU)  
Mathis, Andrea Maria  
ARTORG Center - Biomechanics  
Lippuner, Kurt  
Universitätspoliklinik für Osteoporose  
Additional Credits
ARTORG Center - Biomechanics  
Clinical Trials Unit Bern (CTU)  
Universitätspoliklinik für Osteoporose  
Geriatric Clinic - Partial Clinic Inselspital  
Journal
Osteoporosis international
Publisher
Springer-Verlag
ISSN
0937-941X
Access(Rights)
open.access
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