Cortical Bone Microarchitecture in Dialysis Patients

2020 ◽  
Vol 51 (10) ◽  
pp. 833-838 ◽  
Author(s):  
Eva Benillouche ◽  
Agnes Ostertag ◽  
Caroline Marty ◽  
Pablo Ureña Torres ◽  
Martine Cohen-Solal
Keyword(s):  
Cortical Bone ◽  
Bone Microarchitecture ◽  
Quantitative Computed Tomography ◽  
Peripheral Quantitative Computed Tomography ◽  
Microcomputed Tomography ◽  
Bone Fragility ◽  
Bone Volume ◽  
Dialysis Patients ◽  
Dialysis Therapy ◽  
Bone Biopsies

<b><i>Background:</i></b> The incidence of skeletal fractures is high in dialysis patients. Current available tools are insufficient to predict bone fragility. We analyzed the microarchitecture in patients on dialysis therapy using bone biopsies and peripheral microcomputed tomography. <b><i>Methods:</i></b> We analyzed 12 trans-iliac bone biopsies of patients with recent fractures. Bone microarchitecture was assessed in the bone cores by histology (2D-), microcomputed tomography (3D-µCT), and high-resolution peripheral quantitative computed tomography (HR-pQCT) at the tibia. <b><i>Results:</i></b> Trabecular bone volume/tissue volume was similar in 2D histology and 3D-µCT (<i>p</i> = 0.40), while lower in HR-pQCT (<i>p</i> &#x3c; 0.01). There was no correlation in trabecular microarchitectural indices between 2-histology and 3D-µCT, or HR-pQCT. The 3D-µCT cortical thickness (Ct.Th) were positively correlated with 2D (<i>p</i> &#x3c; 0.05), but with HR-pQCT (<i>p</i> = 0.33). Ct.Th was lower in patients with ≥2 vertebral fractures than with one fracture. <b><i>Conclusions:</i></b> 3D-µCT is a reliable method for the measurement of cortical bone in bone biopsies. Prospective studies are awaited to address its value in discriminating fracture risk.

Bone Microarchitecture Assessment by High-Resolution Peripheral Quantitative Computed Tomography in Patients with Systemic Lupus Erythematosus Taking Corticosteroids

2010 ◽  
Vol 37 (7) ◽  
pp. 1473-1479 ◽  
Author(s):  
EDMUND K. LI ◽  
TRACY Y. ZHU ◽  
LAI-SHAN TAM ◽  
VIVIAN W. HUNG ◽  
JAMES F. GRIFFITH ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Bone Density ◽  
Cortical Bone ◽  
Vertebral Fractures ◽  
Lupus Erythematosus ◽  
Bone Microarchitecture ◽  
Quantitative Computed Tomography ◽  
Peripheral Quantitative Computed Tomography ◽  
Cortical Bone Density ◽  
Chronic Corticosteroid

Objective.We assessed the relationship between vertebral fracture and bone microarchitecture in patients with systemic lupus erythematosus (SLE) on chronic corticosteroid therapy using high-resolution peripheral quantitative computed tomography (HR-pQCT).Methods.Fifty-nine Chinese women with SLE taking corticosteroid were selected to participate in a cross-sectional study. Vertebral fracture was confirmed semiquantitatively by lateral radiographs of the thoracic and lumbar spine. Density and microarchitecture at the distal radius were measured with HR-pQCT. Areal bone mineral density (aBMD) at hip and lumbar spine was measured by dual-energy x-ray absorptiometry (DEXA).Results.Twelve patients had vertebral fractures. The aBMD of spine or hip did not differ between those with and without vertebral fractures. Measures by HR-pQCT revealed that patients with vertebral fractures had significantly lower level of average bone density (p = 0.007), cortical bone density (p = 0.029), trabecular bone density (p = 0.024), trabecular bone volume to tissue volume (p = 0.023), and trabecular thickness (p = 0.011) than those without vertebral fractures. Independent explanatory variables associated with higher risk of vertebral fractures were older age (p = 0.013) and lower average cortical bone density (p = 0.029).Conclusion.Vertebral fracture in patients with SLE on chronic corticosteroid treatment was associated with alterations of bone density and microarchitectures measured by HR-pQCT and DEXA. However, alterations were more pronounced in measurements by HR-pQCT. Low cortical bone density and old age were significant predictors of vertebral fracture risk.

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