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Relationship of femoral neck areal bone mineral density to volumetric bone mineral density, bone size, and femoral strength in men and women

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Abstract

Summary

Using combined dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography, we demonstrate that men matched with women for femoral neck (FN) areal bone mineral density (aBMD) have lower volumetric BMD (vBMD), higher bone cross-sectional area, and relatively similar values for finite element (FE)-derived bone strength.

Introduction

aBMD by DXA is widely used to identify patients at risk for osteoporotic fractures. aBMD is influenced by bone size (i.e., matched for vBMD, larger bones have higher aBMD), and increasing evidence indicates that absolute aBMD predicts a similar risk of fracture in men and women. Thus, we sought to define the relationships between FN aBMD (assessed by DXA) and vBMD, bone size, and FE-derived femoral strength obtained from quantitative computed tomography scans in men versus women.

Methods

We studied men and women aged 40 to 90 years and not on osteoporosis medications.

Results

In 114 men and 114 women matched for FN aBMD, FN total cross-sectional area was 38% higher (P < 0.0001) and vBMD was 16% lower (P < 0.0001) in the men. FE models constructed in a subset of 28 women and 28 men matched for FN aBMD showed relatively similar values for bone strength and the load-to-strength ratio in the two groups.

Conclusions

In this cohort of young and old men and women from Rochester, MN, USA who are matched by FN aBMD, because of the offsetting effects of bone size and vBMD, femoral strength and the load-to-strength ratio tended to be relatively similar across the sexes.

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Acknowledgments

We would like to thank Sara Achenbach for her help with the statistical analyses, Jim Peterson for his help with data management, and Margaret Holets for the DXA aBMD measurements and analysis of the QCT scans.

Conflicts of interest

B.S., S.A., E.J.A., J.C., R.A.R., B.L.R., L.J.M., and S.K. have nothing to disclose. D.L.K. is an employee of O. N. Diagnostics and T.M.K. has a financial interest in O. N. Diagnostics and both they and the company may benefit from the results of this research.

Author information

Authors and Affiliations

  1. Endocrine Research Unit, Mayo Clinic, Guggenheim 7, 200 First Street SW, Rochester, MN, 55905, USA

    B. Srinivasan, B. L. Riggs & S. Khosla

  2. O. N. Diagnostics, Berkeley, CA, USA

    D. L. Kopperdahl & T. M. Keaveny

  3. Division of Rheumatology, Mayo Clinic, Rochester, MN, USA

    S. Amin

  4. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

    S. Amin, E. J. Atkinson & L. J. Melton III

  5. Biomedical Imaging Resource, College of Medicine, Mayo Clinic, Rochester, MN, USA

    J. Camp & R. A. Robb

  6. Oregon Health Sciences University, Portland, OR, USA

    E. S. Orwoll

  7. University of California, Berkeley, CA, USA

    T. M. Keaveny

Authors
  1. B. Srinivasan
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  2. D. L. Kopperdahl
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  3. S. Amin
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  4. E. J. Atkinson
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  5. J. Camp
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  6. R. A. Robb
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  7. B. L. Riggs
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  8. E. S. Orwoll
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  9. L. J. Melton III
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  10. T. M. Keaveny
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  11. S. Khosla
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Corresponding author

Correspondence to S. Khosla.

Additional information

This study was supported by NIH grants R01 AR027065, R43 AR052234, and 1UL1RR024150.

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Srinivasan, B., Kopperdahl, D.L., Amin, S. et al. Relationship of femoral neck areal bone mineral density to volumetric bone mineral density, bone size, and femoral strength in men and women. Osteoporos Int 23, 155–162 (2012). https://doi.org/10.1007/s00198-011-1822-8

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  • DOI: https://doi.org/10.1007/s00198-011-1822-8

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