Reference curves of bone parameters obtained by high resolution peripheral quantitative computed tomography (HR-pQCT) in healthy men

Author(s)

Jackeline Couto Alvarenga

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
• Defense date: 2019-06-26

Examining board members

Rosa Maria Rodrigues Pereira; Charles Heldan de Moura Castro; Luciana Parente Costa Seguro

• Advisor: Rosa Maria Rodrigues Pereira

Abstract

INTRODUCTION: The availability of high resolution peripheral quantitative computed tomography (HR-pQCT) has made it possible to measure volumetric bone mineral density (BMD) and three-dimensional bone microarchitecture in vivo, as well as to evaluate bone strength through finite element (FE) analysis. As there is no database for Brazilian male population, the main objective of this cross-sectional study was to establish reference values for the bone parameters obtained by HR-pQCT in men, categorized for decades and adjusted for weight and height, of the distal radius and tibia. As a secondary objective, to correlate the bone strength parameter - stiffness (S) and other parameters measured by HR-pQCT and parameters obtained by dual-energy X-ray absorptiometry (DXA), including trabecular bone score (TBS). METHODS: Healthy Brazilian men (n = 340) including ages of 20 to 92 years were included in this study. The non-dominant forearm and left leg were immobilized, and standard and advanced segmentation methods were performed for the distal radius and tibia analyzes by HR-pQCT. From HR-pQCT images, volumetric BMD and bone microstructure of trabecular and cortical were evaluated, and bone strength was estimated using FE analysis. Measurements of the lumbar spine and femur by DXA were also performed to obtain BMD and TBS values. The data were described as median and quartiles (IQR). Multiple linear regression models according to age, weight and height were developed and illustrated by dispersion diagrams with 95% normality intervals. Pearson correlations were calculated between some parameters of interest. RESULTS: Parameters of volumetric BMD, structure and bone strength, at distal radius and tibia, showed a significant association with age (p < 0.05). The correlations between S with the other parameters of volumetric BMD and microarchitecture, as well as with areal BMD and TBS, were stronger in the tibia except for trabecular thickness, which was better in the distal radius. The correlations between TBS and density parameters (trabecular and cortical), number and trabecular thickness, and cortical thickness in the peripheral sites were significant (p < 0.05), except with cortical thickness in the tibia. When TBS was evaluated according to risk category, and correlated with S in the distal radius and tibia, and lumbar spine BMD, only the low risk group (TBS ³ 1.310) had significant correlations (p < 0.05). CONCLUSION: This work developed reference values for the bone parameters obtained by HR-pQCT, based on a healthy population for males. Correlations between the parameters support to understand the role of each variable and the relationship with fracture risk. Researchers and clinicians can use these data as an additional tool to assess male bone health and changes in bone quality (AU)

• FAPESP's process: 15/14698-5 - Reference curves of bone parameters obtained by high resolution peripheral quantitative computed tomography (HR-PQCT) in healthy men
• Grantee: Jackeline Couto Alvarenga Amaral
• Support Opportunities: Scholarships in Brazil - Doctorate