A case-control study of fractures in men with idiopathic osteoporosis: Fractures are associated with older age and low cortical bone density

作者：Ostertag Agnes; Collet Corinne; Chappard Christine; Fernandez Sylvie; Vicaut Eric; Cohen Solal Martine; de Vernejoul Marie Christine^*

来源：Bone, 2013, 52(1): 48-55.

DOI：10.1016/j.bone.2012.09.020

• Idiopathic osteoporosis
• Fracture
• Men
• Bone biochemical factors
• Bone micro-architectural parameters

Objectives: To determine biochemical, radiological and micro-architectural bone factors related to fragility fractures in idiopathic male osteoporosis (IMO) patients. IMO is a rare disorder characterized by low areal bone mineral density (aBMD) (Z-score%26lt;-2) occurring in men after excluding secondary causes of low BMD. %26lt;br%26gt;Methods: We conducted a case-control study in 31 patients with fragility fracture (IMO F+) that had occurred after the age of 40 years and 37 without fracture (IMO F-). We first compared IMO group to 40 age-matched disease-free men. We measured aBMD and bone micro-architectural indices at distal radius and tibia sites with a HR-pQCT scan (XtremeCT) using standard and extended cortical analysis. Urine and blood samples were collected in order to determine the levels of bone-turnover markers and the potential determinant of bone fragility. Models of analysis of covariance, including age, height and weight as adjustment factors, were used to compare the groups. %26lt;br%26gt;Results: Compared to their controls. IMO patients showed marked disturbance of their micro-architectural parameters at tibia and radius affecting both trabecular and cortical parameters. IMO F+ subjects were significantly older than IMO F- subjects (58 8 +/- vs. 53 9 +/- yrs, p = 0.01). BMD Z-score at the total-hip was significantly lower in IMO F+ (-1.3 +/- 0.5 vs. 0.9 +/- 0.8 g/cm(2), p = 0.01). After adjustment, trabecular micro-architectural parameters, biochemical markers and hormonal parameters were not different: in the 2 groups. At distal tibia, cortical v-BMD was significantly lower in IMO F+ patients (799 +/- 73 vs. 858 +/- 60 mg/cm(3), p = 0.03), while cortical thickness was not different. %26lt;br%26gt;Conclusion: Our results show that patients with IMO display a marked disturbance of trabecular and cortical bone micro-architecture, and that age and low cortical density are determinants of the fracture occurrence.

• 出版日期2013-1