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. 2024 Nov;31(4):279-289.
doi: 10.11005/jbm.24.765. Epub 2024 Nov 30.

Age- and Sex-Related Volumetric Density Differences in Trabecular and Cortical Bone of the Proximal Femur in Healthy Population

María Lorena Brance  1   2   3 , Fernando Daniel Saraví  4 , Muriel M Henríquez  4 , María Silvia Larroudé  5 , Jorge E Jacobo  6 , Sebastian Abalo Araujo  7 , Vanesa Longobardi  8 , María Bélen Zanchetta  8 , María Rosa Ulla  9 , Florencia Martos  9 , Helena Salerni  10 , Beatriz Oliveri  3   11   12 , Marina Soledad Bonanno  12 , Naraline Luna Meneses  1 , Pilar Diaz Baclini  2 , Luis A Ramírez Stieben  1   2 , Silvana Di Gregorio  13 , Lucas R Brun  2   3
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Age- and Sex-Related Volumetric Density Differences in Trabecular and Cortical Bone of the Proximal Femur in Healthy Population

María Lorena Brance et al. J Bone Metab. 2024 Nov.

Abstract

Background: There are age- and sex-related increases in the prevalence of osteoporosis. Bone densitometry based on dual energy X-ray absorptiometry (DXA) is the gold standard for the assessment of bone mineral density (BMD). Three-dimensional (3D) analysis of the proximal femur (3D-DXA) allows discrimination between cortical and trabecular compartments, and it has shown a good correlation with computed tomography. We aimed to assess age- and sex-related volumetric density differences in trabecular and cortical bone using 3D-DXA and determine the reference intervals for integral volumetric (v)BMD within the Argentine population.

Methods: Healthy female and male adult subjects (N=1,354) from Argentina were included. Hip BMD was measured using DXA, and 3D analysis was performed using 3D-Shaper software. The integral vBMD, cortical surface BMD, and trabecular vBMD (trab vBMD) were measured.

Results: The study population included 73.9% women (N=1,001) and 26.13% men (N=353). We found a significant decrease in integral vBMD between 20 and 90 years in both sexes (women, -23.1%; men, -16.6%). Bone loss indicated in the integral vBMD results was mainly due to a decrease in trabecular bone in both sexes (women, -33.4%; men, -27.7%). The age-related loss of cortical bone density was less and was limited to the female population, without no age-related differences in men. Moreover, 3D-DXA allowed us to propose reference intervals for integral vBMD.

Conclusions: We found age- and sex-related bone loss between 20 and 90 years in an Argentine cohort via integral vBMD measurements using 3D-DXA, mainly due to decreases in trabecular bone in both sexes. The age-related loss of cortical bone density was less and was limited to the female population.

Keywords: 3D-DXA; Bone and bones; Bone density; Cancellous bone; Cortical bone.

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Conflict of interest statement

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Locally weighted regression smoothing curves between age and 3-dimensional dual energy X-ray absorptiometry parameters, stratified by sex. Data are shown as mean values and 95% confidence intervals. vBMD, volumetric bone mineral density; Cortical sBMD, cortical surface bone mineral density.
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