J Bone Metab.  2024 Nov;31(4):279-289. 10.11005/jbm.24.765.

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

• Brance ML
• Saraví FD
• Henríquez MM
• Larroudé MS
• Jacobo JE
• Araujo SA
• Longobardi V
• Zanchetta MB
• Ulla MR
• Martos F
• Salerni H
• Oliveri B
• Bonanno MS
• Meneses NL
• Baclini PD
• Ramírez Stieben LA
• Gregorio SD
• Brun LR

• KMID: 2561864
• DOI: http://doi.org/10.11005/jbm.24.765

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.

Keyword

Bone and bones · Bone density · Cancellous bone · Cortical bone · 3D-DXA