SEX-DIFFERENCES IN GEOMETRY OF THE FEMORAL-NECK WITH AGING - A STRUCTURAL-ANALYSIS OF BONE-MINERAL DATA

被引:165
作者
BECK, TJ
RUFF, CB
SCOTT, WW
PLATO, CC
TOBIN, JD
QUAN, CA
机构
[1] JOHNS HOPKINS MED INST, DEPT CELL BIOL & ANAT, BALTIMORE, MD 21205 USA
[2] JOHNS HOPKINS MED INST, DEPT ORTHOPAED SURG, BALTIMORE, MD 21205 USA
[3] JOHNS HOPKINS MED INST, DEPT BIOMED ENGN, BALTIMORE, MD 21205 USA
[4] FRANCIS SCOTT KEY MED CTR, NIA, GERONTOL RES CTR, APPL PHYSIOL SECT, BALTIMORE, MD 21224 USA
关键词
BONE MINERAL ANALYSIS; HIP STRENGTH ANALYSIS; AGE; FEMORAL NECK STRESS;
D O I
10.1007/BF00297293
中图分类号
R5 [内科学];
学科分类号
1002 [临床医学]; 100201 [内科学];
摘要
The greater hip fracture rate among elderly women is generally ascribed to differences in femoral neck strength between the sexes. Strength of a given bone is a function of both its material properties and the magnitudes of mechanical stresses within it. This study examined the hypothesis that these apparent strength differences between the sexes are due to dissimilarities in the restructuring of the femoral neck with age, which result in higher stresses in elderly women. Using Hip Strength Analysis, a computer program developed by the authors, femoral neck cross-sectional geometric properties for stress analyses were derived from bone mineral image data of 409 community living, white subjects ranging from 19 to 93 years of age. Though both sexes show declines in femoral neck bone mineral density (BMD) and cross-sectional area with age, only females show a decline in the cross-sectional moment of inertia (CSMI, a geometric index of bone rigidity). The lack of decline in male CSMI appears to be a result of a small but significant increase in femoral neck girth. Similar age-related changes have been observed in the femoral shaft by others. The net effect of these observed changes is that mechanical stresses in the femoral neck of females appear to increase at three times the rate per decade of those of males. These results lend support to the hypothesis that the higher fracture rate in elderly women is due, at least in part, to elevated levels of mechanical stress, resulting from a combination of greater bone loss and less compensatory geometric restructuring with age.
引用
收藏
页码:24 / 29
页数:6
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