Are DXA/aBMD and QCT/FEA Stiffness and Strength Estimates Sensitive to Sex and Age?
Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element...
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| Published in: | Annals of biomedical engineering Vol. 45; no. 12; pp. 2847 - 2856 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
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New York
Springer US
01.12.2017
Springer Nature B.V |
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| ISSN: | 0090-6964, 1573-9686, 1573-9686 |
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| Abstract | Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element analysis (QCT/FEA) estimates fracture strength using 3D bone mineral distribution and geometry. By using experimentally-measured femoral stiffness and strength from a one hundred sample cadaveric cohort that included variations in sex and age, we wanted to determine if QCT/FEA estimates were able to better predict the experimental variations than DXA/aBMD. For each femur, DXA/aBMD was assessed and a QCT/FEA model was developed to estimate femoral stiffness and strength. Then, the femur was mechanically tested to fracture in a sideways fall on the hip position to measure stiffness and strength. DXA/aBMD and QCT/FEA estimates were compared for their sensitivity to sex and age with multivariate statistical analyses. When comparing the measured data with DXA/aBMD predictions, both age and sex were significant (
p
≤ 0.0398) for both femoral stiffness and strength. However, QCT/FEA predictions of stiffness and strength showed sex was insignificant (
p
≥ 0.23). Age was still significant (
p
≤ 0.0072). These results indicate that QCT/FEA, unlike DXA/aBMD, accounted for bone differences due to sex. |
|---|---|
| AbstractList | Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element analysis (QCT/FEA) estimates fracture strength using 3D bone mineral distribution and geometry. By using experimentally-measured femoral stiffness and strength from a one hundred sample cadaveric cohort that included variations in sex and age, we wanted to determine if QCT/FEA estimates were able to better predict the experimental variations than DXA/aBMD. For each femur, DXA/aBMD was assessed and a QCT/FEA model was developed to estimate femoral stiffness and strength. Then, the femur was mechanically tested to fracture in a sideways fall on the hip position to measure stiffness and strength. DXA/aBMD and QCT/FEA estimates were compared for their sensitivity to sex and age with multivariate statistical analyses. When comparing the measured data with DXA/aBMD predictions, both age and sex were significant (p ≤ 0.0398) for both femoral stiffness and strength. However, QCT/FEA predictions of stiffness and strength showed sex was insignificant (p ≥ 0.23). Age was still significant (p ≤ 0.0072). These results indicate that QCT/FEA, unlike DXA/aBMD, accounted for bone differences due to sex. Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element analysis (QCT/FEA) estimates fracture strength using 3D bone mineral distribution and geometry. By using experimentally-measured femoral stiffness and strength from a one hundred sample cadaveric cohort that included variations in sex and age, we wanted to determine if QCT/FEA estimates were able to better predict the experimental variations than DXA/aBMD. For each femur, DXA/aBMD was assessed and a QCT/FEA model was developed to estimate femoral stiffness and strength. Then, the femur was mechanically tested to fracture in a sideways fall on the hip position to measure stiffness and strength. DXA/aBMD and QCT/FEA estimates were compared for their sensitivity to sex and age with multivariate statistical analyses. When comparing the measured data with DXA/aBMD predictions, both age and sex were significant (p ≤ 0.0398) for both femoral stiffness and strength. However, QCT/FEA predictions of stiffness and strength showed sex was insignificant (p ≥ 0.23). Age was still significant (p ≤ 0.0072). These results indicate that QCT/FEA, unlike DXA/aBMD, accounted for bone differences due to sex.Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element analysis (QCT/FEA) estimates fracture strength using 3D bone mineral distribution and geometry. By using experimentally-measured femoral stiffness and strength from a one hundred sample cadaveric cohort that included variations in sex and age, we wanted to determine if QCT/FEA estimates were able to better predict the experimental variations than DXA/aBMD. For each femur, DXA/aBMD was assessed and a QCT/FEA model was developed to estimate femoral stiffness and strength. Then, the femur was mechanically tested to fracture in a sideways fall on the hip position to measure stiffness and strength. DXA/aBMD and QCT/FEA estimates were compared for their sensitivity to sex and age with multivariate statistical analyses. When comparing the measured data with DXA/aBMD predictions, both age and sex were significant (p ≤ 0.0398) for both femoral stiffness and strength. However, QCT/FEA predictions of stiffness and strength showed sex was insignificant (p ≥ 0.23). Age was still significant (p ≤ 0.0072). These results indicate that QCT/FEA, unlike DXA/aBMD, accounted for bone differences due to sex. Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element analysis (QCT/FEA) estimates fracture strength using 3D bone mineral distribution and geometry. By using experimentally-measured femoral stiffness and strength from a one hundred sample cadaveric cohort that included variations in sex and age, we wanted to determine if QCT/FEA estimates were able to better predict the experimental variations than DXA/aBMD. For each femur, DXA/aBMD was assessed and a QCT/FEA model was developed to estimate femoral stiffness and strength. Then, the femur was mechanically tested to fracture in a sideways fall on the hip position to measure stiffness and strength. DXA/aBMD and QCT/FEA estimates were compared for their sensitivity to sex and age with multivariate statistical analyses. When comparing the measured data with DXA/aBMD predictions, both age and sex were significant (P≤0.0398) for both femoral stiffness and strength. However, QCT/FEA predictions of stiffness and strength showed sex was insignificant (P≥0.23). Age was still significant (P≤0.0072). These results indicate that QCT/FEA, unlike DXA/aBMD, accounted for bone differences due to sex. Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element analysis (QCT/FEA) estimates fracture strength using 3D bone mineral distribution and geometry. By using experimentally-measured femoral stiffness and strength from a one hundred sample cadaveric cohort that included variations in sex and age, we wanted to determine if QCT/FEA estimates were able to better predict the experimental variations than DXA/aBMD. For each femur, DXA/aBMD was assessed and a QCT/FEA model was developed to estimate femoral stiffness and strength. Then, the femur was mechanically tested to fracture in a sideways fall on the hip position to measure stiffness and strength. DXA/aBMD and QCT/FEA estimates were compared for their sensitivity to sex and age with multivariate statistical analyses. When comparing the measured data with DXA/aBMD predictions, both age and sex were significant ( p ≤ 0.0398) for both femoral stiffness and strength. However, QCT/FEA predictions of stiffness and strength showed sex was insignificant ( p ≥ 0.23). Age was still significant ( p ≤ 0.0072). These results indicate that QCT/FEA, unlike DXA/aBMD, accounted for bone differences due to sex. Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element analysis (QCT/FEA) estimates fracture strength using 3D bone mineral distribution and geometry. By using experimentally-measured femoral stiffness and strength from a one hundred sample cadaveric cohort that included variations in sex and age, we wanted to determine if QCT/FEA estimates were able to better predict the experimental variations than DXA/aBMD. For each femur, DXA/aBMD was assessed and a QCT/FEA model was developed to estimate femoral stiffness and strength. Then, the femur was mechanically tested to fracture in a sideways fall on the hip position to measure stiffness and strength. DXA/aBMD and QCT/FEA estimates were compared for their sensitivity to sex and age with multivariate statistical analyses. When comparing the measured data with DXA/aBMD predictions, both age and sex were significant (p ≤ 0.0398) for both femoral stiffness and strength. However, QCT/FEA predictions of stiffness and strength showed sex was insignificant (p ≥ 0.23). Age was still significant (p ≤ 0.0072). These results indicate that QCT/FEA, unlike DXA/aBMD, accounted for bone differences due to sex. |
| Author | Giambini, Hugo Yaszemski, Michael J. Rezaei, Asghar Rossman, Timothy Carlson, Kent D. Dragomir-Daescu, Dan Lu, Lichun |
| AuthorAffiliation | 3 Division of Engineering, Mayo Clinic, Rochester, MN, USA 2 Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA 1 Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA |
| AuthorAffiliation_xml | – name: 1 Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA – name: 2 Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA – name: 3 Division of Engineering, Mayo Clinic, Rochester, MN, USA |
| Author_xml | – sequence: 1 givenname: Asghar surname: Rezaei fullname: Rezaei, Asghar organization: Department of Physiology and Biomedical Engineering, Mayo Clinic – sequence: 2 givenname: Hugo surname: Giambini fullname: Giambini, Hugo organization: Department of Orthopedic Surgery, Mayo Clinic – sequence: 3 givenname: Timothy surname: Rossman fullname: Rossman, Timothy organization: Division of Engineering, Mayo Clinic – sequence: 4 givenname: Kent D. surname: Carlson fullname: Carlson, Kent D. organization: Department of Physiology and Biomedical Engineering, Mayo Clinic – sequence: 5 givenname: Michael J. surname: Yaszemski fullname: Yaszemski, Michael J. organization: Department of Orthopedic Surgery, Mayo Clinic – sequence: 6 givenname: Lichun surname: Lu fullname: Lu, Lichun organization: Department of Physiology and Biomedical Engineering, Mayo Clinic – sequence: 7 givenname: Dan surname: Dragomir-Daescu fullname: Dragomir-Daescu, Dan email: dragomirdaescu.dan@mayo.edu organization: Department of Physiology and Biomedical Engineering, Mayo Clinic |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28940110$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_bonr_2022_101638 crossref_primary_10_1016_j_jmbbm_2025_107158 crossref_primary_10_1016_j_clinbiomech_2021_105365 crossref_primary_10_1007_s11657_020_0696_9 crossref_primary_10_2147_JPR_S516682 crossref_primary_10_1016_j_recot_2018_05_006 crossref_primary_10_1155_2020_8898888 crossref_primary_10_1007_s10439_019_02238_9 crossref_primary_10_1007_s11914_020_00584_5 crossref_primary_10_1007_s11657_022_01194_7 crossref_primary_10_1186_s12891_024_07903_2 crossref_primary_10_1038_s41598_021_94998_5 crossref_primary_10_3389_fmech_2021_691171 crossref_primary_10_1002_cnm_70081 crossref_primary_10_1080_10255842_2020_1754808 crossref_primary_10_1016_j_recote_2018_05_004 |
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| Copyright | Biomedical Engineering Society 2017 Annals of Biomedical Engineering is a copyright of Springer, (2017). All Rights Reserved. |
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| Keywords | Aging Sex differences Hip fracture Finite element analysis Bone biomechanics |
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