Bone mineral loss at the distal femur and proximal tibia following spinal cord injury in men and women

Courtney M. Mazur; W. Brent Edwards; Ifaz T. Haider; Ying Fang; Leslie R. Morse; Thomas J. Schnitzer; Narina Simonian; Karen L. Troy

doi:10.1016/j.jocd.2023.101380

Bone mineral loss at the distal femur and proximal tibia following spinal cord injury in men and women

Courtney M. Mazur, W. Brent Edwards, Ifaz T. Haider, Ying Fang, Leslie R. Morse, Thomas J. Schnitzer, Narina Simonian, Karen L. Troy^*

^*Corresponding author for this work

Physical Medicine and Rehabilitation

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Purpose: Spinal cord injury (SCI) causes rapid bone loss and increases risk of fragility fractures in the lower extremities. The majority of individuals with SCI are men, and few studies have investigated sex as a biological variable in SCI-induced osteoporosis. This cross-sectional study aimed to quantify sex-specific differences in bone mineral following SCI. Methods: Quantitative computed tomography (QCT) scans of the distal femur and proximal tibia were obtained at baseline of one of four clinical trials enrolling people who sustained SCI 1 month to 50 years prior to recruitment. Bone volume (BV), bone mineral content (BMC), bone mineral density (BMD), and bending strength index (BSI) were quantified in the integral, trabecular, and cortical bone in the epiphysis, metaphysis and diaphysis. Scans from 106 men and 31 women were analyzed to measure sex-specific effects on bone loss over time post-SCI. Results: BMC and BSI declined exponentially as a function of time post-SCI and were best described by separate decay curves for men and women. Women had BV, BMC, and BSI at 58-77% that of men in the acute and plateau phases, with both sexes showing similar rates of loss as a function of time post-SCI. Trabecular BMD was best described as an exponential decay versus time post-SCI, with no sex-specific differences. Conclusions: Due to consistently lower BV, BMC, and BSI, women may be more susceptible to fractures after SCI than men.

Original language	English (US)
Article number	101380
Journal	Journal of Clinical Densitometry
Volume	26
Issue number	3
DOIs	https://doi.org/10.1016/j.jocd.2023.101380
State	Published - Jul 1 2023

Funding

The data analyzed here were collected with support from Department of Defense U.S. Army Medical Research and Materiel Command (grant numbers SC130125 , SC090010 / contract W81XWH-10-1-0951 and grant SC130125 /contract W81XWH-14-2-0193 to TJS), Department of Defense W81XWH‐10‐1‐1043 and W81XWH-15-2-0078 to LRM and the National Institutes of Health HD056721 and R01AR064793 to LRM. REDCap is supported by the Northwestern University Clinical and Translational Science (NUCATS) Institute , which is funded in part by a Clinical and Translational Science Award (CTSA) grant UL1TR001422 from the National Institutes of Health (NIH) .

Keywords

Bone fracture
Computer assisted image analysis
Sex differences
Spinal cord injury

ASJC Scopus subject areas

Endocrinology, Diabetes and Metabolism
Orthopedics and Sports Medicine
Radiology Nuclear Medicine and imaging

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10.1016/j.jocd.2023.101380

Cite this

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title = "Bone mineral loss at the distal femur and proximal tibia following spinal cord injury in men and women",

abstract = "Purpose: Spinal cord injury (SCI) causes rapid bone loss and increases risk of fragility fractures in the lower extremities. The majority of individuals with SCI are men, and few studies have investigated sex as a biological variable in SCI-induced osteoporosis. This cross-sectional study aimed to quantify sex-specific differences in bone mineral following SCI. Methods: Quantitative computed tomography (QCT) scans of the distal femur and proximal tibia were obtained at baseline of one of four clinical trials enrolling people who sustained SCI 1 month to 50 years prior to recruitment. Bone volume (BV), bone mineral content (BMC), bone mineral density (BMD), and bending strength index (BSI) were quantified in the integral, trabecular, and cortical bone in the epiphysis, metaphysis and diaphysis. Scans from 106 men and 31 women were analyzed to measure sex-specific effects on bone loss over time post-SCI. Results: BMC and BSI declined exponentially as a function of time post-SCI and were best described by separate decay curves for men and women. Women had BV, BMC, and BSI at 58-77\% that of men in the acute and plateau phases, with both sexes showing similar rates of loss as a function of time post-SCI. Trabecular BMD was best described as an exponential decay versus time post-SCI, with no sex-specific differences. Conclusions: Due to consistently lower BV, BMC, and BSI, women may be more susceptible to fractures after SCI than men.",

keywords = "Bone fracture, Computer assisted image analysis, Sex differences, Spinal cord injury",

author = "Mazur, \{Courtney M.\} and Edwards, \{W. Brent\} and Haider, \{Ifaz T.\} and Ying Fang and Morse, \{Leslie R.\} and Schnitzer, \{Thomas J.\} and Narina Simonian and Troy, \{Karen L.\}",

note = "Publisher Copyright: {\textcopyright} 2023 The International Society for Clinical Densitometry",

year = "2023",

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day = "1",

doi = "10.1016/j.jocd.2023.101380",

language = "English (US)",

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T1 - Bone mineral loss at the distal femur and proximal tibia following spinal cord injury in men and women

AU - Mazur, Courtney M.

AU - Edwards, W. Brent

AU - Haider, Ifaz T.

AU - Fang, Ying

AU - Morse, Leslie R.

AU - Schnitzer, Thomas J.

AU - Simonian, Narina

AU - Troy, Karen L.

PY - 2023/7/1

Y1 - 2023/7/1

N2 - Purpose: Spinal cord injury (SCI) causes rapid bone loss and increases risk of fragility fractures in the lower extremities. The majority of individuals with SCI are men, and few studies have investigated sex as a biological variable in SCI-induced osteoporosis. This cross-sectional study aimed to quantify sex-specific differences in bone mineral following SCI. Methods: Quantitative computed tomography (QCT) scans of the distal femur and proximal tibia were obtained at baseline of one of four clinical trials enrolling people who sustained SCI 1 month to 50 years prior to recruitment. Bone volume (BV), bone mineral content (BMC), bone mineral density (BMD), and bending strength index (BSI) were quantified in the integral, trabecular, and cortical bone in the epiphysis, metaphysis and diaphysis. Scans from 106 men and 31 women were analyzed to measure sex-specific effects on bone loss over time post-SCI. Results: BMC and BSI declined exponentially as a function of time post-SCI and were best described by separate decay curves for men and women. Women had BV, BMC, and BSI at 58-77% that of men in the acute and plateau phases, with both sexes showing similar rates of loss as a function of time post-SCI. Trabecular BMD was best described as an exponential decay versus time post-SCI, with no sex-specific differences. Conclusions: Due to consistently lower BV, BMC, and BSI, women may be more susceptible to fractures after SCI than men.

AB - Purpose: Spinal cord injury (SCI) causes rapid bone loss and increases risk of fragility fractures in the lower extremities. The majority of individuals with SCI are men, and few studies have investigated sex as a biological variable in SCI-induced osteoporosis. This cross-sectional study aimed to quantify sex-specific differences in bone mineral following SCI. Methods: Quantitative computed tomography (QCT) scans of the distal femur and proximal tibia were obtained at baseline of one of four clinical trials enrolling people who sustained SCI 1 month to 50 years prior to recruitment. Bone volume (BV), bone mineral content (BMC), bone mineral density (BMD), and bending strength index (BSI) were quantified in the integral, trabecular, and cortical bone in the epiphysis, metaphysis and diaphysis. Scans from 106 men and 31 women were analyzed to measure sex-specific effects on bone loss over time post-SCI. Results: BMC and BSI declined exponentially as a function of time post-SCI and were best described by separate decay curves for men and women. Women had BV, BMC, and BSI at 58-77% that of men in the acute and plateau phases, with both sexes showing similar rates of loss as a function of time post-SCI. Trabecular BMD was best described as an exponential decay versus time post-SCI, with no sex-specific differences. Conclusions: Due to consistently lower BV, BMC, and BSI, women may be more susceptible to fractures after SCI than men.

KW - Bone fracture

KW - Computer assisted image analysis

KW - Sex differences

KW - Spinal cord injury

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Bone mineral loss at the distal femur and proximal tibia following spinal cord injury in men and women

Abstract

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Keywords

ASJC Scopus subject areas

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