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Journal of Bone and Mineral Metabolism

, Volume 31, Issue 2, pp 144–152 | Cite as

Dissimilarity of femur aging in men and women from a Nationwide Survey in Korea (KNHANES IV)

  • Kyoung Min Kim
  • Jung Soo Lim
  • Kwang Joon Kim
  • Han Seok Choi
  • Yumie Rhee
  • Han Jin Oh
  • Hoon Choi
  • Woong Hwan Choi
  • Jung Gu Kim
  • Sung-Kil LimEmail author
Original article

Abstract

In light of the differences in hip fracture rates between men and women of different ages, age-related changes in bone structure that lead to bone fragility might differ depending on both age and gender. To investigate age-related bone loss and geometric deterioration of the femur, hip scans of 1,504 men and 2,076 women aged 19–92 years acquired during the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV) using dual-energy X-ray absorptiometry (DXA) were analyzed with a structural analysis program. Cross-sectional area and cortical thickness with bone mineral density in men started to decline from the third decade and continued to decline at a constant rate. However, in women, these parameters remained nearly constant until the fifth decade and then declined at a more rapid rate than that seen in men. Consequently, changes in the buckling ratio, earlier onset, and continuation of increase over the lifetime were observed in men. A relatively later onset with a greater acceleration with aging was observed in women. Taken together, there were obvious gender and age differences in structural trends with age. Bone aging, i.e., bone loss and geometric deterioration, actually begins at a young age, especially in men, and osteoporosis prevention strategies should target not only the elderly but also younger individuals.

Keywords

Aging Bone mineral density Fracture Osteoporosis 

Notes

Acknowledgments

This work was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korea government (MEST) (No. 20110001024). We also express our heartfelt thanks to the Korean Osteoporosis Society.

Conflict of interest

The authors disclose that they have no conflicting interests in this work.

References

  1. 1.
    Seeman E, Delmas PD (2006) Bone quality–the material and structural basis of bone strength and fragility. N Engl J Med 354:2250–2261PubMedCrossRefGoogle Scholar
  2. 2.
    Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767PubMedCrossRefGoogle Scholar
  3. 3.
    Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882PubMedCrossRefGoogle Scholar
  4. 4.
    Klibanski A, Adams-Campbell L, Bassford T, Blair SN, Boden SD, Dickersin K, Gifford DR, Glasse L, Goldring SR, Hruska K, Johnson SR, McCauley LK, Russell WE (2001) Osteoporosis prevention, diagnosis, and therapy. J Am Med Assoc 285:785–795CrossRefGoogle Scholar
  5. 5.
    Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC Jr, Lindsay RL (1995) Proximal femur bone mineral levels of US adults. Osteoporos Int 5:389–409PubMedCrossRefGoogle Scholar
  6. 6.
    Wu XP, Liao EY, Huang G, Dai RC, Zhang H (2003) A comparison study of the reference curves of bone mineral density at different skeletal sites in native Chinese, Japanese, and American Caucasian women. Calcif Tissue Int 73:122–132PubMedCrossRefGoogle Scholar
  7. 7.
    Riggs BL, Melton LJ 3rd, Robb RA, Camp JJ, Atkinson EJ, Oberg AL, Rouleau PA, McCollough CH, Khosla S, Bouxsein ML (2006) Population-based analysis of the relationship of whole bone strength indices and fall-related loads to age- and sex-specific patterns of hip and wrist fractures. J Bone Miner Res 21:315–323PubMedCrossRefGoogle Scholar
  8. 8.
    Seeman E (2002) Pathogenesis of bone fragility in women and men. Lancet 359:1841–1850PubMedCrossRefGoogle Scholar
  9. 9.
    Riggs BL, Melton LJ, Robb RA, Camp JJ, Atkinson EJ, McDaniel L, Amin S, Rouleau PA, Khosla S (2008) A population-based assessment of rates of bone loss at multiple skeletal sites: evidence for substantial trabecular bone loss in young adult women and men. J Bone Miner Res 23:205–214PubMedCrossRefGoogle Scholar
  10. 10.
    Orwoll ES, Oviatt SK, McClung MR, Deftos LJ, Sexton G (1990) The rate of bone mineral loss in normal men and the effects of calcium and cholecalciferol supplementation. Ann Intern Med 112:29–34PubMedGoogle Scholar
  11. 11.
    Uusi-Rasi K, Semanick LM, Zanchetta JR, Bogado CE, Eriksen EF, Sato M, Beck TJ (2005) Effects of teriparatide [rhPTH (1-34)] treatment on structural geometry of the proximal femur in elderly osteoporotic women. Bone (NY) 36:948–958CrossRefGoogle Scholar
  12. 12.
    Beck TJ, Looker AC, Ruff CB, Sievanen H, Wahner HW (2000) Structural trends in the aging femoral neck and proximal shaft: analysis of the Third National Health and Nutrition Examination Survey dual-energy X-ray absorptiometry data. J Bone Miner Res 15:2297–2304PubMedCrossRefGoogle Scholar
  13. 13.
    Iki M, DongMei N, Tamaki J, Sato Y, Kagamimori S, Kagawa Y, Yoneshima H (2011) Age-specific reference values of hip geometric indices from a representative sample of the Japanese female population: Japanese Population-based Osteoporosis (JPOS) Study. Osteoporos Int 22:1987–1996PubMedCrossRefGoogle Scholar
  14. 14.
    Khoo BC, Beck TJ, Qiao QH, Parakh P, Semanick L, Prince RL, Singer KP, Price RI (2005) In vivo short-term precision of hip structure analysis variables in comparison with bone mineral density using paired dual-energy X-ray absorptiometry scans from multi-center clinical trials. Bone (NY) 37:112–121CrossRefGoogle Scholar
  15. 15.
    Hong S, Oh HJ, Choi H, Kim JG, Lim SK, Kim EK, Pyo EY, Oh K, Kim YT, Wilson K, Choi WH (2011) Characteristics of body fat, body fat percentage and other body composition for Koreans from KNHANES IV. J Korean Med Sci 26:1599–1605PubMedCrossRefGoogle Scholar
  16. 16.
    Riggs BL, Melton LJ III, Robb RA, Camp JJ, Atkinson EJ, Peterson JM, Rouleau PA, McCollough CH, Bouxsein ML, Khosla S (2004) Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. J Bone Miner Res 19:1945–1954PubMedCrossRefGoogle Scholar
  17. 17.
    Khosla S, Melton LJ, Atkinson EJ, O’Fallon WM, Klee GG, Riggs BL (1998) Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: a key role for bioavailable estrogen. J Clin Endocrinol Metab 83:2266–2274PubMedCrossRefGoogle Scholar
  18. 18.
    Leifke E, Gorenoi V, Wichers C, Von Zur MA, Von Buren E, Brabant G (2000) Age-related changes of serum sex hormones, insulin-like growth factor-1 and sex-hormone binding globulin levels in men: cross-sectional data from a healthy male cohort. Clin Endocrinol (Oxf) 53:689–695CrossRefGoogle Scholar
  19. 19.
    Rivadeneira F, Styrkarsdottir U, Estrada K, Halldorsson BV, Hsu YH et al (2009) Twenty bone-mineral-density loci identified by large-scale meta-analysis of genome-wide association studies. Nat Genet 41:1199–1206PubMedCrossRefGoogle Scholar
  20. 20.
    Ahlborg HG, Johnell O, Turner CH, Rannevik G, Karlsson MK (2003) Bone loss and bone size after menopause. N Engl J Med 349:327–334PubMedCrossRefGoogle Scholar
  21. 21.
    Szulc P, Seeman E, Duboeuf F, Sornay-Rendu E, Delmas PD (2006) Bone fragility: failure of periosteal apposition to compensate for increased endocortical resorption in postmenopausal women. J Bone Miner Res 21:1856–1863PubMedCrossRefGoogle Scholar
  22. 22.
    Anderson JY, Trinkaus E (1998) Patterns of sexual, bilateral and interpopulational variation in human femoral neck-shaft angles. J Anat 192:279–285PubMedCrossRefGoogle Scholar
  23. 23.
    Zebaze RM, Ghasem-Zadeh A, Bohte A, Iuliano-Burns S, Mirams M, Price RI, Mackie EJ, Seeman E (2010) Intracortical remodelling and porosity in the distal radius and post-mortem femurs of women: a cross-sectional study. Lancet 375:1729–1736PubMedCrossRefGoogle Scholar
  24. 24.
    Kim KM, Brown JK, Kim KJ, Choi HS, Kim HN, Rhee Y, Lim SK (2011) Differences in femoral neck geometry associated with age and ethnicity. Osteoporos Int 22:2165–2174PubMedCrossRefGoogle Scholar
  25. 25.
    De Laet C, Kanis JA, Oden A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV, Mellstrom D, Melton LJ 3rd, Meunier PJ, Pols HA, Reeve J, Silman A, Tenenhouse A (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338PubMedCrossRefGoogle Scholar
  26. 26.
    Nguyen TV, Sambrook PN, Eisman JA (1998) Bone loss, physical activity, and weight change in elderly women: the Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res 13:1458–1467PubMedCrossRefGoogle Scholar
  27. 27.
    Parhami F, Jackson SM, Tintut Y, Le V, Balucan JP, Territo M, Demer LL (1999) Atherogenic diet and minimally oxidized low density lipoprotein inhibit osteogenic and promote adipogenic differentiation of marrow stromal cells. J Bone Miner Res 14:2067–2078PubMedCrossRefGoogle Scholar
  28. 28.
    Almeida M, Ambrogini E, Han L, Manolagas SC, Jilka RL (2009) Increased lipid oxidation causes oxidative stress, increased peroxisome proliferator-activated receptor-gamma expression, and diminished pro-osteogenic Wnt signaling in the skeleton. J Biol Chem 284:27438–27448PubMedCrossRefGoogle Scholar
  29. 29.
    Takada I, Kouzmenko AP, Kato S (2009) Wnt and PPARgamma signaling in osteoblastogenesis and adipogenesis. Nat Rev Rheumatol 5:442–447PubMedCrossRefGoogle Scholar
  30. 30.
    Lanyon LE, Rubin CT (1984) Static vs dynamic loads as an influence on bone remodelling. J Biomech 17:897–905PubMedCrossRefGoogle Scholar
  31. 31.
    Khoo BC, Brown K, Zhu K, Pollock M, Wilson KE, Price RI, Prince RL (2012) Differences in structural geometrical outcomes at the neck of the proximal femur using two-dimensional DXA-derived projection (APEX) and three-dimensional QCT-derived (BIT QCT) techniques. Osteoporos Int 23:1393–1398PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2012

Authors and Affiliations

  • Kyoung Min Kim
    • 1
  • Jung Soo Lim
    • 1
  • Kwang Joon Kim
    • 1
  • Han Seok Choi
    • 2
  • Yumie Rhee
    • 1
  • Han Jin Oh
    • 3
  • Hoon Choi
    • 4
  • Woong Hwan Choi
    • 5
  • Jung Gu Kim
    • 6
  • Sung-Kil Lim
    • 1
    Email author
  1. 1.Division of Endocrinology, Department of Internal Medicine, Institute of Endocrine ResearchYonsei University College of MedicineSeoulKorea
  2. 2.Division of Endocrinology and Metabolism, Department of Internal MedicineDongguk University Ilsan HospitalGoyangKorea
  3. 3.Department of Family Medicine, College of MedicineKwandong UniversityGangneungKorea
  4. 4.Department of Obstetrics and Gynecology, College of MedicineInje University Sanggye Paik HospitalSeoulKorea
  5. 5.Division of Endocrinology and Metabolism, Department of Internal MedicineHanyang University College of MedicineSeoulKorea
  6. 6.Department of Obstetrics and Gynecology, College of MedicineSeoul National UniversitySeoulKorea

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