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Lekamwasam S, Rathnayake H. Age Related Trends in Structural Indices of Proximal Femur in Women Aged 20-70 in Southern Sri Lanka. J Clin Densitom 2022; 25:464-469. [PMID: 36096901 DOI: 10.1016/j.jocd.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/14/2022] [Indexed: 11/20/2022]
Abstract
Age related trends of the indices of hip structure help understanding how bone strength changes with age and the increased bone fragility in old age. Community-dwelling women aged 20-70years (n = 419) were selected by stratified random method and divided into age categories; 20-29years (n-69), 30-39years (n = 60), 40-49years (n = 69), 50-59years (n = 107) and 60-70years (n = 114). All subjects underwent dual energy x-ray absorptiometry (DXA) and hip structure analysis using Hologic Discovery scanner (Hologic Inc, Bedford, USA). Measured indices included hip axis length (HAL) and neck shaft angle (NSA) of the proximal femur. Cross sectional area (CSA), cross sectional moment of inertia (CSMI), section modulus (SM), cortical thickness (CT), buckling ration (BR) of three regions of interest; narrow neck, intertrochanteric region and femoral shaft, were also measured. Age related trends of all indices were studied with Locally Weighted Scatterplot Smoothing lines (LOESS) and ANOVA. Mean HAL and NSA values were not different between age categories. CSA, CSMI, SM and CT in three different regions showed curvilinear relationships with age. These indices gradually increased with age between 20-50 years and the maximum values were seen in the 40-49years age category and they declined afterwards. The decline of these indices was more rapid in the narrow neck and intertrochanter regions when compared with femoral shaft and the lowest mean CSA, CSMI, SM and CT in these two regions were seen in the 60-70 age category. BR showed a gradual decrease with age between 20-50 years and the lowest mean value was seen in the 40-49 age category. BR increased afterwards and the maximum mean value was seen in the 60-70 age category. This study demonstrates the dynamics of structural properties of proximal femur in the three selected cross sections of community-dwelling women aged 20-70 years and the increased bone fragility in old age.
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Affiliation(s)
- Sarath Lekamwasam
- Department of Medicine, Faculty of Medicine, University of Ruhuna, Sri Lanka
| | - Hasanga Rathnayake
- Department of Biochemistry, Faculty of Medicine, University of Ruhuna, Sri Lanka.
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The Association Between Femoral Neck-Shaft Angle and Aging and Its Influence on the Performance of Functional Activity: A Cross-Sectional Investigation. J Aging Phys Act 2020; 28:250-254. [PMID: 31743091 DOI: 10.1123/japa.2019-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 06/22/2019] [Accepted: 07/13/2019] [Indexed: 11/18/2022]
Abstract
The purposes of this study were first to examine the association between aging and both the magnitude and asymmetry in the femoral neck-shaft angle (NSA). The second purpose was to determine the effects of both the magnitude and NSA asymmetry on the performance of functional activities in healthy individuals. Fifty-one subjects participated in this study. The femoral NSA was measured on computed tomography scout images. The participants performed four performance tests. Four hierarchical regression models were constructed to explore the effect of each predictor on the outcomes. Aging was associated with NSA asymmetry, but not with the degree of NSA. Age contributed significantly to the variability of all functional performance tests except the 10-m walking speed. The degree of the NSA did not contribute to the prediction of the functional performance tests. However, asymmetry in the NSA added significantly to the prediction of all functional performance tests except the 10-m walking speed.
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Nishida A, Kim WC, Yoshida T, Oka Y, Yamada N, Nakase M, Ikoma K, Fujiwara H, Ishikawa N, Ikegaya H, Kubo T. A new method for the estimation of age at death by using electrical impedance: A preliminary study. Leg Med (Tokyo) 2015; 17:560-8. [PMID: 26162996 DOI: 10.1016/j.legalmed.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 07/04/2015] [Accepted: 07/05/2015] [Indexed: 11/16/2022]
Abstract
Estimation of age at death is an important part of physical and forensic anthropology. The aim of this study was to investigate whether bioelectrical impedance analysis (BIA) of long bones can be used in the field of forensic medicine as a method to estimate age at death. BIA is easy to use and allows repeat measurements to be taken over time, and the equipment is inexpensive and portable. Impedance values (Z values) in 378 long bones (humeri, radii, femora, tibiae) of 40 male (233 bones) and 26 female (145 bones) autopsy cadavers were measured using two wire electrodes (connected to an alternating current device and a measuring device) inserted into the metaphyses of long bones. Computed tomography of the greater trochanter of the femur was also analyzed to evaluate bone mineral density (BMD). The results showed that Z values could be used to estimate age in males, and with an age cut-off point of 50 years in females. When estimating age at death from femur and tibia in males by using BIA, it is not necessary to consider the length of subjects. And it was thought that Z values reflected BMD. Among the long bones, the tibia is the most suitable and easy to use for Z value measurement. Z value measurement is a useful method for quantitative evaluation of age at death that can be performed quickly with inexpensive, portable equipment.
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Affiliation(s)
- Atsushi Nishida
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. a-nishi-@koto.kpu-m.ac.jp
| | - Wook-Cheol Kim
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takashi Yoshida
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshinobu Oka
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Naotake Yamada
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Masashi Nakase
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Kazuya Ikoma
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hiroyoshi Fujiwara
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Noboru Ishikawa
- Department of Forensic Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hiroshi Ikegaya
- Department of Forensic Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Toshikazu Kubo
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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Zhang H, Hu YQ, Zhang ZL. Age trends for hip geometry in Chinese men and women and the association with femoral neck fracture. Osteoporos Int 2011; 22:2513-22. [PMID: 21210083 DOI: 10.1007/s00198-010-1479-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 10/25/2010] [Indexed: 11/29/2022]
Abstract
UNLABELLED Hip dual-energy X-ray absorptiometry (DXA) images were used to calculate hip bone mineral density (BMD) and hip geometry parameters of 18,502 healthy Chinese people (14,435 women and 4,067 men), 254 subjects sustained a femoral neck fracture and 254 age- and sex-matched controls. Our study showed that thinning of the cortical shell and deterioration of the strength index (SI) in femoral neck with aging in both Chinese men and women. SI may be a risk factor for hip fracture in Chinese women. INTRODUCTION The purpose of this study was to evaluate age-related trends in the hip geometry of healthy Chinese men and women and to examine whether changes in hip geometric parameters is one of the risk factors of hip fracture. METHODS We recruited 14,435 women and 4,067 men as the study population. There were 254 subjects (216 women, 38 men) who had sustained a femoral neck fracture; 254 age- and sex-matched healthy persons served as controls. Hip DXA images were used to calculate hip BMD and hip geometry parameters, including the hip axis length (HAL), cross-sectional moment of inertia (CSMI), cross-sectional area (CSA), neck-shaft angle (NSA) and femoral SI. RESULTS Hip BMD, CSMI, CSA and SI showed significantly negative correlations with age. However, after adjustment for height and weight, HAL increased with age, and there was no strong correlation between CSMI and age in either sex. In both genders, hip BMD and CSA were significant lower in fracture cases compared with controls. After adjustment for hip BMD, in women only smaller SI (odds ratio [OR] 1.53; 95% confidence interval [CI], 1.04-2.26) was predictive of hip fracture but in men, none of the geometry parameters was associated with hip fracture risk. CONCLUSIONS This study demonstrated thinning of the cortical shell and deterioration of the resistance to bending and SI with aging in femoral neck in Chinese men and women. SI may be a risk factor for hip fracture that is independent of BMD measurement in Chinese women.
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Affiliation(s)
- H Zhang
- Department of Osteoporosis and Bone Diseases, Metabolic Bone Disease and Genetic Research Unit, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
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Zhang F, Tan LJ, Lei SF, Deng HW. The differences of femoral neck geometric parameters: effects of age, gender and race. Osteoporos Int 2010; 21:1205-14. [PMID: 19802512 PMCID: PMC2921984 DOI: 10.1007/s00198-009-1057-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2009] [Accepted: 08/10/2009] [Indexed: 12/01/2022]
Abstract
UNLABELLED This study aims at investigating the effects of age, sex, and ethnicity on five femoral neck geometric parameters (FNGPs): femoral neck periosteal diameter, cross-sectional area, cortical thickness, sectional modulus, and buckling ratio and found that the three factors would influence the FNGPs. INTRODUCTION Bone geometry is one of the most important predictors of bone strength and osteoporotic fractures. This study aims at investigating the effects of age, sex, and ethnicity on five femoral neck geometric parameters (FNGPs): femoral neck periosteal diameter (W), cross-sectional area (CSA), cortical thickness (CT), sectional modulus (Z), and buckling ratio (BR). METHODS In the studied 861 Caucasian subjects and 3,021 Chinese individuals, CSA, CT, and Z displayed trends of decrease with age, but W and BR showed increasing trends with age in both Chinese and Caucasian females and males (p < 0.05). W, CSA, CT, and Z were significantly higher (p <or= 0.001) in Caucasians than in Chinese and higher in males than in females except for BR between Chinese males and Chinese females. CONCLUSION In conclusion, the differences of FNGPs according to gender and ethnicity provide important implications in the different prevalence of osteoporotic fracture among different gender and ethnic groups.
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Affiliation(s)
- F. Zhang
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan 410081, People’s Republic of China
| | - L.-J. Tan
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan 410081, People’s Republic of China
| | - S.-F. Lei
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan 410081, People’s Republic of China. Departments of Orthopedic Surgery and Basic Medical Sciences, University of Missouri-Kansas City, 2411 Holmes St., Room M3-C03, Kansas City, MO 64108-2792, USA
| | - H.-W. Deng
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan 410081, People’s Republic of China. Center of Systematic Biomedical Research, Shanghai University of Science and Technology, Shanghai, China. Departments of Orthopedic Surgery and Basic Medical Sciences, University of Missouri-Kansas City, 2411 Holmes St., Room M3-C03, Kansas City, MO 64108-2792, USA
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Gregory JS, Aspden RM. Femoral geometry as a risk factor for osteoporotic hip fracture in men and women. Med Eng Phys 2008; 30:1275-86. [PMID: 18976949 DOI: 10.1016/j.medengphy.2008.09.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 09/25/2008] [Accepted: 09/25/2008] [Indexed: 10/21/2022]
Abstract
Osteoporotic hip fracture is associated with high mortality and morbidity and often results in a loss of mobility and independence. Osteoporosis is diagnosed by measuring Bone Mineral Density (BMD), a measure of the amount of mineral in a bone. Although BMD continues to serve well it does not fully account for bone strength and only partially accounts for the risk of hip fracture. The shape and structure of the proximal femur also help to determine how forces act in the hip in a fall and their measurement can aid the prediction of hip fracture. This review examines the link between simple geometrical measures of the proximal femur and hip fracture, or bone strength. It will explore how they relate to each other and to anthropometric factors such as sex, height, weight and age. Limitations in these measures will be identified and new methods of analysis reviewed that encompass many different aspects of the shape of the femur. These new methods show great promise for improving the prediction of fracture risk in the future.
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Affiliation(s)
- Jennifer S Gregory
- Bone and Musculoskeletal Programme, Division of Applied Medicine, University of Aberdeen, UK.
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