학술논문
Differences in Trabecular Plate and Rod Structure in Premenopausal Women Across the Weight Spectrum
CLINICAL RESEARCH ARTICLE
CLINICAL RESEARCH ARTICLE
Document Type
Academic Journal
Author
Source
Journal of Clinical Endocrinology & Metabolism. October 2019, Vol. 104 Issue 10, p4501, 10 p.
Subject
Language
English
ISSN
0021-972X
Abstract
Trabecular bone is important in skeletal loading because it carries most of the load in a vertebral body and transfers the load from the joint surface to cortical bone in [...]
Context: Premenopausal women with anorexia nervosa (AN) and obesity (OB) have elevated fracture risk. More plate-like and axially aligned trabecular bone, assessed by individual trabeculae segmentation (ITS), is associated with higher estimated bone strength. Trabecular plate and rod structure has not been reported across the weight spectrum. Objective: To investigate trabecular plate and rod structure in premenopausal women. Design: Cross-sectional study. Setting: Clinical research center. Participants: Atotal of 105 women age 21 to 46 years: (i) women with AN (n = 46), (ii) eumenorrheic lean healthy controls (HCs) (n = 29), and (iii) eumenorrheic women with OB (n = 30). Measures: Trabecular microarchitecture by ITS. Results: Mean age ([+ or -]SD) was similar (28.9 [+ or -] 6.3 years) and body mass index differed (16.7 [+ or -] 1.8 vs 22.6 [+ or -] 1.4 vs 35.1 [+ or -] 3.3 kg/[m.sup.2]; P < 0.0001) across groups. Bone was less plate-like and axially aligned in AN (P [less than or equal to] 0.01) and did not differ between OB and HC. After controlling for weight, plate and axial bone volume fraction and plate number density were lower in OB vs HC; some were lower in OB than AN (P < 0.05). The relationship between weight and plate variables was quadratic (R = 0.39 to 0.70; P [less than or equal to] 0.0006) (i.e., positive associations were attenuated at high weight). Appendicular lean mass and IGF-1 levels were positively associated with plate variables (R = 0.27 to 0.67; P < 0.05). Amenorrhea was associated with lower radial plate variables than eumenorrhea in AN (P < 0.05). Conclusions: In women with AN, trabecular bone is less plate-like. In women with OB, trabecular plates do not adapt to high weight. This is relevant because trabecular plates are associated with greater estimated bone strength. Higher muscle mass and IGF-1 levels may mitigate some of the adverse effects of low weight or excess adiposity on bone. (J Clin Endocrinol Metab 104: 4501-4510, 2019)
Context: Premenopausal women with anorexia nervosa (AN) and obesity (OB) have elevated fracture risk. More plate-like and axially aligned trabecular bone, assessed by individual trabeculae segmentation (ITS), is associated with higher estimated bone strength. Trabecular plate and rod structure has not been reported across the weight spectrum. Objective: To investigate trabecular plate and rod structure in premenopausal women. Design: Cross-sectional study. Setting: Clinical research center. Participants: Atotal of 105 women age 21 to 46 years: (i) women with AN (n = 46), (ii) eumenorrheic lean healthy controls (HCs) (n = 29), and (iii) eumenorrheic women with OB (n = 30). Measures: Trabecular microarchitecture by ITS. Results: Mean age ([+ or -]SD) was similar (28.9 [+ or -] 6.3 years) and body mass index differed (16.7 [+ or -] 1.8 vs 22.6 [+ or -] 1.4 vs 35.1 [+ or -] 3.3 kg/[m.sup.2]; P < 0.0001) across groups. Bone was less plate-like and axially aligned in AN (P [less than or equal to] 0.01) and did not differ between OB and HC. After controlling for weight, plate and axial bone volume fraction and plate number density were lower in OB vs HC; some were lower in OB than AN (P < 0.05). The relationship between weight and plate variables was quadratic (R = 0.39 to 0.70; P [less than or equal to] 0.0006) (i.e., positive associations were attenuated at high weight). Appendicular lean mass and IGF-1 levels were positively associated with plate variables (R = 0.27 to 0.67; P < 0.05). Amenorrhea was associated with lower radial plate variables than eumenorrhea in AN (P < 0.05). Conclusions: In women with AN, trabecular bone is less plate-like. In women with OB, trabecular plates do not adapt to high weight. This is relevant because trabecular plates are associated with greater estimated bone strength. Higher muscle mass and IGF-1 levels may mitigate some of the adverse effects of low weight or excess adiposity on bone. (J Clin Endocrinol Metab 104: 4501-4510, 2019)