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Aging and disease    2018, Vol. 9 Issue (6) : 976-987     DOI: 10.14336/AD.2018.0124
Orginal Article |
Age-Related Changes in Femoral Head Trabecular Microarchitecture
Greenwood Charlene1,*, Clement John2, Dicken Anthony3, Evans Paul3, Lyburn Iain4, Martin Richard M.5, Stone Nick6, Zioupos Peter1, Rogers Keith1
1Cranfield Forensic Institute, Cranfield University, Shrivenham, UK.
2Melbourne Dental School, University of Melbourne, Melbourne, Australia.
3The Imaging Science Group, Nottingham Trent University, Nottingham, UK.
4Cobalt Health, Cheltenham, UK.
5Social and Community Medicine, Bristol University, Bristol, UK.
6Physics and Astronomy, Exeter University, Exeter, UK.
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Abstract  

Osteoporosis is a prevalent bone condition, characterised by low bone mineral density and increased fracture risk. Currently, the gold standard for identifying osteoporosis and increased fracture risk is through quantification of bone mineral density using dual energy X-ray absorption. However, many studies have shown that bone strength, and consequently the probability of fracture, is a combination of both bone mass and bone ‘quality’ (architecture and material chemistry). Although the microarchitecture of both non-fracture and osteoporotic bone has been previously investigated, many of the osteoporotic studies are constrained by factors such as limited sample number, use of ovariectomised animal models, and lack of male and female discrimination. This study reports significant differences in bone quality with respect to the microarchitecture between fractured and non-fractured human femur specimens. Micro-computed tomography was utilised to investigate the microarchitecture of femoral head trabecular bone from a relatively large cohort of non-fracture and fracture human donors. Various microarchitectural parameters have been determined for both groups, providing an understanding of the differences between fracture and non -fracture material. The microarchitecture of non-fracture and fracture bone tissue is shown to be significantly different for many parameters. Differences between sexes also exist, suggesting differences in remodelling between males and females in the fracture group. The results from this study will, in the future, be applied to develop a fracture model which encompasses bone density, architecture and material chemical properties for both female and male tissues.

Keywords micro computed tomography (μ-CT)      osteoporosis      aging      microarchitecture      trabecular bone      femoral head     
Corresponding Authors: Greenwood Charlene   
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These authors contributed equally to this work

Issue Date: 11 October 2017
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Greenwood Charlene
Clement John
Dicken Anthony
Evans Paul
Lyburn Iain
Martin Richard M.
Stone Nick
Zioupos Peter
Rogers Keith
Cite this article:   
Greenwood Charlene,Clement John,Dicken Anthony, et al. Age-Related Changes in Femoral Head Trabecular Microarchitecture[J]. Aging and disease, 2018, 9(6): 976-987.
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http://www.aginganddisease.org/EN/10.14336/AD.2018.0124     OR     http://www.aginganddisease.org/EN/Y2018/V9/I6/976
Fracture
Non - Fracture
MaleFemaleMaleFemale
Donors7304439
Number of Specimens23584439
Age Range (yrs)74 - 8459 - 9121 - 9320 - 90
Age Mean (yrs)76.90 ± 2.7282.47 ± 6.4364.75 ± 19.0066.18 ± 17.92
Weight Range (kg)70 - 8341 - 7953 - 10640 - 121
Weight Mean (kg)76.36 ± 7.3561.28 ± 8.9578.59 ± 15.3266.79 ± 19.77
Height Range (cm)178 - 179155 - 173157 - 192145 - 169
Height Mean (cm)178.13 ± 0.65163.91 ± 5.23173.91 ± 8.53159.63 ± 6.76
Table 1  Population characteristics for fracture and non-fracture groups, differentiated according to sex.
Fracture
Non - Fracture
FemalesMalesFemalesMales
BV/TV0.18 ± 0.010.18 ± 0.010.30 ± 0.010.32 ± 0.01
BS/BV (mm-1)16.06 ± 0.4017.84 ± 0.5310.83 ± 0.2410.10 ± 0.22
TbTh (mm)0.13 ± 0.0040.11 ± 0.0030.19 ± 0.0040.20 ± 0.005
TbN (mm-1)1.42 ± 0.031.60 ± 0.051.60 ± 0.021.57 ± 0.03
TbSp (mm)0.60 ± 0.020.52 ± 0.020.44 ± 0.010.45 ± 0.01
SMI1.81 ± 0.061.85 ± 0.071.14 ± 0.051.15 ± 0.06
BMD (g cm-3)0.30 ± 0.010.31 ± 0.020.50 ± 0.020.52 ± 0.02
TMD (g HA cm-3)1.61 ± 0.011.65 ± 0.011.64 ± 0.011.62 ± 0.01
Table 2  Average values (in bold) and the associated errors (SEM) for the microarchitectural parameters for fracture and non-fracture groups.
Figure 1.  Micro-CT (µ-CT) three-dimensional rendered images from non-fracture (left) and fracture (right) female specimens of the same age (84 yrs).
Figure 2.  Relationship between BMD values and age, comparing fracture and non-fracture groups, female specimens (left) and male specimens (right). With age, a significant correlation was observed for both non-fracture males and females. The linear trend correlation coefficients for non-fracture males and females were p < 0.01, R2 = 0.19 and p < 0.05, R2 = 0.14 respectively. Errors have been excluded from the graphs for clarity. For the non-fracture group, each data point represents one donor. For the fracture group each data point represents an individual specimen several of which may arise from a single donor.
ANOVA
Non - Fracture vs Fracture (Age Matched)
Male
n = 21 (NF); n = 21 (F)
Female
n = 22 (NF); n = 47 (F)

p - valueMean differencep - valueMean difference
BV/TV< 0.010.10 ± 0.02< 0.010.10 ± 0.01
BS/BV (mm-1)< 0.01-7.15 ± 0.63< 0.01-4.81 ±0.51
TbTh (mm)< 0.010.07 ± 0.01< 0.010.05 ± 0.01
TbN (mm-1)*-0.12 ± 0.06< 0.05-0.15 ± 0.05
TbSp (mm)*0.03 ± 0.03< 0.01-0.14 ± 0.03
SMI< 0.01-0.60 ± 0.12< 0.01-0.60 ± 0.10
BMD (g cm-3)<0.010.15 ± 0.03< 0.010.18 ± 0.02
TMD (g HA cm-3)*-0.04 ± 0.02< 0.050.05 ± 0.01
Table 3  P-values for age matched ANOVA analysis of fracture (F) and non-fracture (NF) groups differentiated according to sex, for each microarchitectural parameter.
Linear Regression Analysis
Non - Fracture Correlations with Age
MaleFemale

p -valueR2Δ (per 5 yrs)p -valueR2Δ (per 5 yrs)
BV/TV< 0.010.19-0.007 ± 0.002< 0.010.22-0.007 ± 0.002
BS/BV (mm-1)*0.04*< 0.050.110.136 ± 0.065
TbTh (mm)*0.01*< 0.050.13-0.003 ± 0.001
TbN (mm-1)< 0.010.31-0.028 ± 0.006< 0.050.15-0.016 ± 0.006
TbSp (mm)< 0.010.290.012 ± 0.002< 0.010.230.009 ± 0.003
SMI*0.01**0.09*
BMD (g cm-3)< 0.010.19-0.012 ± 0.004< 0.050.14-0.010 ± 0.004
TMD (g HA cm-3)*0.02**0.01*
Table 4  P-values and R2 calculated from linear regression statistical analysis when comparing the various microarchitecture parameters and age for non-fracture males and females.
Figure 3.  Relationship between TbTh values and age, comparing fracture and non-fracture groups, female specimens (left) and male specimens (right). There was no significant correlation with age for non-fracture males, whereas a significant correlation for non-fracture females was observed. The linear trend correlation coefficients for non-fracture females were p < 0.05, R2 = 0.13. Errors have been excluded from the graphs for clarity. For the non-fracture group, each data point represents one donor. For the fracture group each data point represents an individual specimen several of which may arise from a single donor.
Figure 4.  Relationship between TbN values and age, comparing fracture and non-fracture groups, female specimens (left) and male specimens (right). With age, a significant correlation was observed for both non-fracture males and females. The linear trend correlation coefficients for non-fracture males and females were p < 0.01, R2 = 0.19 and p < 0.05, R2 = 0.15 respectively. Errors have been excluded from the graphs for clarity. For the non-fracture group, each data point represents one donor. For the fracture group each data point represents an individual specimen several of which may arise from a single donor.
Figure 5.  Relationship between TMD values and age, comparing fracture and non-fracture groups, female specimens (left) and male specimens (right). With age, no significant correlation was observed for non-fracture males and females (p > 0.05). Errors have been excluded from the graphs for clarity. For the non-fracture group, each data point represents one donor. For the fracture group each data point represents an individual specimen several of which may arise from a single donor.
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