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Skeletal changes through the lifespan--from growth to senescence
Joshua N Farr1, Sundeep Khosla1
1Endocrine Research Unit and Kogod Center on Aging, Mayo Clinic, Guggenheim 7-11, 200 First Street SW, Rochester, MN 55905, USA.
Nature Reviews. Endocrinology
|June 3, 2015
Summary
Age-related fragility fractures are a major health issue. High-resolution imaging reveals that changes in cortical bone, like thinning and porosity, significantly impact fracture risk throughout life.
Area of Science:
- Bone biology and biomechanics
- Gerontology and public health
- Medical imaging and diagnostics
Background:
- Age-related fragility fractures represent a significant global health burden.
- Bone mass acquisition during growth and age-related bone loss influence late-life fracture risk.
- High-resolution peripheral quantitative computed tomography (HRpQCT) allows in vivo assessment of bone microarchitecture.
Purpose of the Study:
- To investigate the role of bone microarchitecture, particularly cortical bone changes, in age-related fragility fractures.
- To examine how bone structure alterations during adolescence and aging affect fracture risk.
- To identify potential biomarkers for increased fracture risk.
Main Methods:
- Utilized high-resolution peripheral quantitative computed tomography (HRpQCT) for in vivo bone microarchitecture assessment.
- Analyzed cortical bone parameters (thinning, porosity) and trabecular bone structure (trabecular thinning, number reduction).
- Correlated bone microarchitecture with fracture history and age-related bone loss patterns in men and women.
Main Results:
- Adolescent distal forearm fractures are linked to cortical bone alterations (thinning, porosity) and reduced peak bone mass.
- Elderly men with childhood fractures show increased osteoporotic fracture risk.
- Age-related bone loss differs between sexes: men show trabecular thinning, women show trabecular number reduction.
- Increased cortical porosity is increasingly recognized as a significant factor in age-related fragility fractures.
Conclusions:
- Cortical bone microarchitecture, especially porosity, plays a critical role in age-related fragility fractures, potentially more than previously understood.
- HRpQCT provides valuable insights into bone changes across the lifespan, aiding in fracture risk assessment.
- Understanding sex-specific bone loss mechanisms and the impact of cortical porosity is crucial for developing targeted interventions.
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