Differing patterns of age-related cortical and trabecular bone loss between Chinese men and women: A population-based HR-pQCT study
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We hypothesize that gender-difference in fracture risk has its origin in differences of age-related changes in bone density and microarchitecture. A population-based study is conducted to describe gender differences in age-related changes in bone density, and cortical and trabecular miarochitecture in a large cohort of Chinese men and women.

Seven hundred and twenty-two Chinese (272 men and 450 women) aged between 20 to 90 years were recruited from local community of Hong Kong. All subjects were carefully screened to rule out disorders and/or medications that affect bone metabolism. Bone geometry, volumetric bone mineral density (vBMD) and bone microarchitecture were assessed using high resolution peripheral quantitative computed tomography (HR-pQCT) at distal radius and tibia.

Young men (20-29 years old) achieved a significantly larger bone (26-30%), with a larger cortical area (28-29%) and larger medullary cavity (25-31%), as well as denser (25- 26%) and thicker (Tb.Th 6-12%) trabeculae at both distalradius and tibia than young women (all p<0.0001). At distal tibia, young men also had significantly more (Tb.N, 19%, p<0.0001) and better connected (Tb.Sp, -19%, p<0.0001) trabeculae. Young women, however, had denser (by 4%) and less porous cortices (Ct.Po, by 64-107%) than young men. In men, during ageing, there was no significant changes in cortical thickness (Ct.Th) and Tb.N at distal radius or in geometry at distal tibia. Except for cortical vBMD at distal radius, age-related bone loss in men exhibited a linear pattern. In contrast, women experienced significant trabecular bone loss in a linear pattern and cortical bone loss in a quadratic pattern. In women, cortical bone loss, manifested as decreased cortical vBMD and Ct.Th and increased Ct.Po, became more rapid after mid-life. From the second to the seventh decade of life, at distal radius, men lost significantly fewer cortical bone (vBMD decreased by -5.2%, Ct.Th by -2.6%, and Ct.Po increased by 3 folds) than women (-13.5%, -25.5%, 8 folds, respectively, all p<0.0005). Similar amount of trabecular bone was lost in both genders. But men experienced mostly thinning of trabeculae (Tb.Th by -6.4%), whilst women loss of trabeculae (Tb.N by 20%), leaving a significantly better
connected trabecular network in men than in women. Similar differences were found at distal tibia.

Our findings highlight the important gender differences in patterns of age-related bone loss. The significantly greater loss of cortical bone and trabecular network integrity during ageing in women may underpin gender differences in fracture risk.
著者T. Y. Zhu, V. W. Y. Hung, C. W. Y. Choy, C. K. L. Cheng, J. C. Y. Cheng, L. Qin
會議名稱8th International Conference on Osteoporosis and Bone Research

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