Cortical Fractal Analysis and Collagen Crosslinks Content in Femoral Neck After Osteoporotic Fracture in Postmenopausal Women: Comparison with Osteoarthritis
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The femoral neck (FN) has been previously characterized by thinner cortices in osteoporotic fracture (HF) when compared to hip osteoarthritis (HOA). The purposes of this study were to complete the previous investigations on FNs from HF and HOA by analyzing the complexity of the cortical structure and to approach the intrinsic properties of cortical bone by assessing the collagen crosslink contents. FN samples were obtained during arthroplasty in 35 postmenopausal women (HF; n = 17; mean age 79 ± 2 years; HOA; n = 18; mean age 66 ± 2 years). The cortical fractal dimension (Ct.FD) and lacunarity (Ct.Lac) derived from high-resolution peripheral quantitative tomography (isotropic voxel size: 82 μm) images of FN by using Ctan software and Fraclac running in ImageJ were analyzed. The collagen crosslinks content [pyridinoline, deoxypyridinoline, pentosidine (PEN)] were assessed in cortical bone. Ct.FD was significantly lower (p < 0.0001) in HF than HOA reflecting a decreased complexity and was correlated to the age and BMD. In two sub-groups, BMD- and age-matched, respectively, Ct.FD remained significantly lower in HF than HOA (p < 0.001). Ct.Lac was not different between HF and HOA. PEN content was two times higher in HF than HOA (p < 0.0001) independently of age. In conclusion, FN with HF was characterized by a less complex cortical texture and higher PEN content than HOA. In addition to the decreased bone mass and BMD previously reported, these modifications contribute to the lower bone quality in HF than HOA in postmenopausal women.
KeywordsCortical bone Osteoporosis Femoral neck Lacunarity Fractal dimension
The author Gustavo Davi Rabelo thanks the “Ciência sem Fronteiras - Conselho Nacional de Desenvolvimento Científico e Tecnológico/Brasil” (Processo número 245336/2012-5) for the Post-doc scholarship.
GDR and PC designed the study and were evolved in all phases of the study and in writing the manuscript. JPR, NPM, and EG contributed to the experimental work and drafting the results. GDR, JPR, and PC were responsible for statistical analysis of the data. RC was responsible for the discussion of the results and supervision. All authors revised the paper critically for intellectual content and approved the final version. All authors agree to be accountable for the work and to ensure that any questions relating to the accuracy and integrity of the paper are investigated and properly resolved.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 4.Chavassieux P, Seeman E, Delmas PD (2007) Insights into material and structural basis of bone fragility from diseases associated with fractures: how determinants of the biomechanical properties of bone are compromised by disease. Endocr Rev 28:151–164. https://doi.org/10.1210/er.2006-0029 CrossRefPubMedGoogle Scholar
- 5.World Health Organisation (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. Tech Rep Ser 843:1–129Google Scholar
- 15.Bauer JS, Kohlmann S, Eckstein F et al (2006) Structural analysis of trabecular bone of the proximal femur using multislice computed tomography: a comparison with dual X-ray absorptiometry for predicting biomechanical strength in vitro. Calcif Tissue Int 78:78–89. https://doi.org/10.1007/s00223-005-0070-3 CrossRefPubMedGoogle Scholar
- 20.De Laet C, Reeve J (2001) Epidemiology of osteoporotic fractures in Europe. In: Marcus R, Feldman D, Kelsey J (eds) Osteoporosis, vol 1, 2nd edn. Academic Press, San Diego, pp 585–597Google Scholar
- 25.Viguet-Carrin S, Gineyts E, Bertholon C, Delmas PD (2009) Simple and sensitive method for quantification of fluorescent enzymatic mature and senescent crosslinks of collagen in bone hydrolysate using single-column high performance liquid chromatography. J Chromatogr B Analyt Technol Biomed Life Sci 877:1–7. https://doi.org/10.1016/j.jchromb.2008.10.043 CrossRefPubMedGoogle Scholar
- 30.Bernhard A, Milovanovic P, Zimmermann EA et al (2013) Micro-morphological properties of osteons reveal changes in cortical bone stability during aging, osteoporosis, and bisphosphonate treatment in women. Osteoporos Int 24:2671–2680. https://doi.org/10.1007/s00198-013-2374-x CrossRefPubMedGoogle Scholar
- 31.Saito M, Fujii K, Soshi S, Tanaka T (2006) Reductions in degree of mineralization and enzymatic collagen cross-links and increases in glycation-induced pentosidine in the femoral neck cortex in cases of femoral neck fracture. Osteoporos Int 17:986–995. https://doi.org/10.1007/s00198-006-0087-0 CrossRefPubMedGoogle Scholar
- 36.Issever AS, Link TM, Kentenich M et al (2009) Trabecular bone structure analysis in the osteoporotic spine using a clinical in vivo setup for 64-slice MDCT imaging: comparison to microCT imaging and microFE modeling. J Bone Miner Res 24:1628–1637. https://doi.org/10.1359/JBMR.090311 CrossRefPubMedGoogle Scholar
- 37.Berteau JP, Gineyts E, Pithioux M et al (2015) Ratio between mature and immature enzymatic cross-links correlates with post-yield cortical bone behavior: an insight into greenstick fractures of the child fibula. Bone 79:190–195. https://doi.org/10.1016/j.bone.2015.05.045 CrossRefPubMedGoogle Scholar