TY - JOUR
T1 - Bone mineral loss at the distal femur and proximal tibia following spinal cord injury in men and women
AU - Mazur, Courtney M.
AU - Edwards, W. Brent
AU - Haider, Ifaz T.
AU - Fang, Ying
AU - Morse, Leslie R.
AU - Schnitzer, Thomas J.
AU - Simonian, Narina
AU - Troy, Karen L.
N1 - Publisher Copyright:
© 2023 The International Society for Clinical Densitometry
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Purpose: Spinal cord injury (SCI) causes rapid bone loss and increases risk of fragility fractures in the lower extremities. The majority of individuals with SCI are men, and few studies have investigated sex as a biological variable in SCI-induced osteoporosis. This cross-sectional study aimed to quantify sex-specific differences in bone mineral following SCI. Methods: Quantitative computed tomography (QCT) scans of the distal femur and proximal tibia were obtained at baseline of one of four clinical trials enrolling people who sustained SCI 1 month to 50 years prior to recruitment. Bone volume (BV), bone mineral content (BMC), bone mineral density (BMD), and bending strength index (BSI) were quantified in the integral, trabecular, and cortical bone in the epiphysis, metaphysis and diaphysis. Scans from 106 men and 31 women were analyzed to measure sex-specific effects on bone loss over time post-SCI. Results: BMC and BSI declined exponentially as a function of time post-SCI and were best described by separate decay curves for men and women. Women had BV, BMC, and BSI at 58-77% that of men in the acute and plateau phases, with both sexes showing similar rates of loss as a function of time post-SCI. Trabecular BMD was best described as an exponential decay versus time post-SCI, with no sex-specific differences. Conclusions: Due to consistently lower BV, BMC, and BSI, women may be more susceptible to fractures after SCI than men.
AB - Purpose: Spinal cord injury (SCI) causes rapid bone loss and increases risk of fragility fractures in the lower extremities. The majority of individuals with SCI are men, and few studies have investigated sex as a biological variable in SCI-induced osteoporosis. This cross-sectional study aimed to quantify sex-specific differences in bone mineral following SCI. Methods: Quantitative computed tomography (QCT) scans of the distal femur and proximal tibia were obtained at baseline of one of four clinical trials enrolling people who sustained SCI 1 month to 50 years prior to recruitment. Bone volume (BV), bone mineral content (BMC), bone mineral density (BMD), and bending strength index (BSI) were quantified in the integral, trabecular, and cortical bone in the epiphysis, metaphysis and diaphysis. Scans from 106 men and 31 women were analyzed to measure sex-specific effects on bone loss over time post-SCI. Results: BMC and BSI declined exponentially as a function of time post-SCI and were best described by separate decay curves for men and women. Women had BV, BMC, and BSI at 58-77% that of men in the acute and plateau phases, with both sexes showing similar rates of loss as a function of time post-SCI. Trabecular BMD was best described as an exponential decay versus time post-SCI, with no sex-specific differences. Conclusions: Due to consistently lower BV, BMC, and BSI, women may be more susceptible to fractures after SCI than men.
KW - Bone fracture
KW - Computer assisted image analysis
KW - Sex differences
KW - Spinal cord injury
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U2 - 10.1016/j.jocd.2023.101380
DO - 10.1016/j.jocd.2023.101380
M3 - Article
C2 - 37201436
AN - SCOPUS:85159446380
SN - 1094-6950
VL - 26
JO - Journal of Clinical Densitometry
JF - Journal of Clinical Densitometry
IS - 3
M1 - 101380
ER -