Bone structure assessed by HR-pQCT, TBS and DXL in adult patients with different types of osteogenesis imperfecta

• Published in: Osteoporosis international Vol. 26; no. 10; pp. 2431 - 2440
• Main Authors: Kocijan, R., Muschitz, C., Haschka, J., Hans, D., Nia, A., Geroldinger, A., Ardelt, M., Wakolbinger, R., Resch, H.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.10.2015; Springer Nature B.V
• Subjects: Absorptiometry, Photon - methods; Adult; Aged; Aged, 80 and over; Bone density; Bone Density - physiology; Bone diseases; Calcaneus - diagnostic imaging; Calcaneus - physiopathology; Case-Control Studies; Endocrinology; Female; Femur - physiopathology; Hip Joint - physiopathology; Humans; Lumbar Vertebrae - physiopathology; Male; Medical imaging; Medicine; Medicine & Public Health; Microstructure; Middle Aged; Original Article; Orthopedics; Osteogenesis Imperfecta - diagnostic imaging; Osteogenesis Imperfecta - pathology; Osteogenesis Imperfecta - physiopathology; Radius - diagnostic imaging; Radius - pathology; Rheumatology; Tibia - diagnostic imaging; Tibia - pathology; Tomography, X-Ray Computed - methods; Young Adult; Osteogenesis imperfecta; DXL; HR-pQCT; Bone microstructure; TBS; DXA
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-015-3156-4

Summary Bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT) was assessed in adult patients with mild, moderate, and severe osteogenesis imperfecta (OI). The trabecular bone score (TBS), bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), and dual X-ray and laser (DXL) at the calcaneus were likewise assessed in patients with OI. Trabecular microstructure and BMD in particular were severely altered in patients with OI. Introduction OI is characterized by high fracture risk but not necessarily by low BMD. The main purpose of this study was to assess bone microarchitecture and BMD at different skeletal sites in different types of OI. Methods HR-pQCT was performed in 30 patients with OI (mild OI-I, n  = 18 (41.8 [34.7, 55.7] years) and moderate to severe OI-III-IV, n  = 12 (47.6 [35.3, 58.4] years)) and 30 healthy age-matched controls. TBS, BMD by DXA at the lumbar spine and hip, as well as BMD by DXL at the calcaneus were likewise assessed in patients with OI only. Results At the radius, significantly lower trabecular parameters including BV/TV ( p  = 0.01 and p  < 0.0001, respectively) and trabecular number ( p  < 0.0001 and p  < 0.0001, respectively) as well as an increased inhomogeneity of the trabecular network ( p  < 0.0001 and p  < 0.0001, respectively) were observed in OI-I and OI-III-IV in comparison to the control group. Similar results for trabecular parameters were found at the tibia. Microstructural parameters were worse in OI-III-IV than in OI-I. No significant differences were found in cortical thickness and cortical porosity between the three subgroups at the radius. The cortical thickness of the tibia was thinner in OI-I ( p  < 0.001), but not OI-III-IV, when compared to controls. Conclusions Trabecular BMD and trabecular bone microstructure in particular are severely altered in patients with clinical OI-I and OI-III-IV. Low TBS and DXL and their significant associations to HR-pQCT parameters of trabecular bone support this conclusion.