Sex-related variations in cortical and trabecular bone of the femoral neck in an elderly Chinese population

Quantitative computed tomography (QCT) was used to investigate sex-related variations in cortical and trabecular bone of the femoral neck. Cortical bone thickness of women in the superior quadrant was thinner than that of men, and the cortex in all four quadrants was negatively associated with age in women. Introduction This cross-sectional study aimed to investigate sex-related similarities and differences in femoral neck structure in an elderly Chinese population by QCT bone investigational toolkit (BIT) analysis. Methods This study included 207 male (67.9 +/- 7.7 years; range, 55-87 years) and 400 female subjects (68.0 +/- 8.7 years; range, 55-96 years). BIT module was used to measure cortical and trabecular bone in anatomic quadrants of the femoral neck. Measurements of cortical thickness (Ct. Th), cortical vBMD (Ct. vBMD), trabecular vBMD (Tb. vBMD), and integral vBMD(It. vBMD) at the femoral neck were determined in four anatomical sectors. Results The greatest difference between sexes, after adjusting for age, height, and weight, was in Ct. Th of Quadrant Superoanterior (SA), which was 27.4% lower in women (p< 0.001). Ct. Th of Quadrant Supero-posterior (SP) was 15.1% lower in women (p = 0.027). Ct. Th and Tb. vBMDin all four quadrants appeared to be negatively associated with age in females, whereas no significant relationship was observed in males, except Ct. Th of Quadrant SP. Conclusions The superior femoral neck geometry between males and females was significantly different, even after adjustment for body size and age, and the sub-regional cortical and trabecular bone negatively age-related changes in women indicated that women apparently have a more vulnerable geometrical outcome with age for fractures than men.