Epidemiology of peak bone mass, structure and strength in males as assessed by high resolution peripheral quantitative CT (HR-pQCT). A cross-sectional study
K. Brixen & S. Hansen
In males, peak bone mass as evaluated by DXA is reached at the age of 2022 years and may be important for the risk of fracture later in life. DXA, however, only provides two-dimensional images and does not allow assessment of bone structure.
We used HR-pQCT to assess trabecular and cortical volumetric BMD (vBMD) and bone microarchitecture at the distal radius and tibia in a population based study including healthy male volunteers. Moreover, bone strength was estimated using finite element analysis. Subjects treated with drugs or diagnosed with conditions affecting bone metabolism were excluded. A total of 247 men aged 2080 years were included. DXA at the lumbar spine and total hip (Hologic Discovery, US) and HR-pQCT at the non-dominant distal radius and tibia (Scanco Medical, Switzerland) were performed.
Assessed by DXA, areal BMD at the lumbar spine was highest at the age of 35 and had peaked by the age of 20 years at the total hip. Trabecular vBMD in radius and tibia peaked around the age of 30 and 25 years, respectively. Trabecular number in radius had peaked by the age of 20 and peaked around the age of 30 years in tibia. Trabecular thickness in both radius and tibia had peaked by the age of 20 years. Cortical thickness in radius and tibia peaked before the age of 20 and around the age of 40 years, respectively. From the time of peak (or age 20) to the age of 80, pronounced changes in both radius and tibia were seen in trabecular thickness (−1.4 and −1.6 S.D., respectively) and cortical thickness (−0.6 and −0.9 S.D., respectively). Data on estimated bone strength will be presented.
In conclusion, bone mass, structure and strength peak at different ages. With age detrimental effects on microarchitecture were most pronounced for trabecular thickness and cortical thickness.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details are unavailable.