Elderly men and women with similar areal bone density show significant differences in bone microstructure and fracture pattern.
4 affiliations
- 1Divisão de Endocrinologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
- 2Divisão de Reumatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
- 3Bone D Consultoria e Treinamento São Paulo SR Brasil Bone D Consultoria e Treinamento, São Paulo, SR Brasil.
- 4Instituto Nacional de Traumatologia e Ortopedia, Divisão de Pesquisa, Rio de Janeiro, RJ, Brasil.
Abstract
Objective
To compare bone microarchitecture and fracture patterns between elderly men and women with similar spine and hip bone mineral densities (BMDs).Subjects and methods
Twenty-eight men and 84 age-BMI-BMD-matched women aged 65 years and older with at least one major osteoporotic fracture underwent laboratory tests, dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and trabecular bone score (TBS).Results
There were no sex differences in biochemistry, BMD or lowest T-scores. TBS values were low in 67% of the cohort and significantly correlated with HR-pQCT parameters. At HR-pQCT evaluation, men had greater bones (total area and cortical perimeter at distal radius and tibia) and better trabecular vBMD and microstructure at distal radius, but similar values for cortical vBMD and cortical thickness. When compared with Brazilian age-sex-reference HR-pQCT data from healthy individuals, all parameters tested were numerically lower in the study group. These differences seemed more pronounced in men, particularly for cortical thickness at the distal tibia, where relative deficits reached -46.9% in men and -35.4% in women. There was no sex difference in vertebral fractures, but wrist and shoulder fractures were more common in women (p = 0.006), whereas hip fractures were more common in men (p = 0.03).Conclusion
To achieve similar DXA values, men appear to have greater relative bone deficits than women when compared to age-sex-matched healthy Brazilian population. This study highlights the importance of HR-pQCT to understand sex-specific differences in fracture pattern in the study population.
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BibTeX
@article{gama2026elderly,
title = {{Elderly men and women with similar areal bone density show significant differences in bone microstructure and fracture pattern.}},
author = {Eduardo Medeiros Ferreira da Gama and Leonardo Vieira and Francisco de Paula Paranhos-Neto and Laura Maria Carvalho Mendonça and Luiza Silva Machado de Andrade and Miguel Madeira and Guilherme Cardenaz de Souza and João Antonio Matheus Guimarães and Maria Eugênia Leite Duarte and Maria Lucia Fleiuss Farias},
journal = {Archives of endocrinology and metabolism},
year = {2026},
month = oct,
doi = {10.20945/2359-4292-2026-0126},
url = {https://europepmc.org/article/MED/42905601},
note = {CC BY},
}
RIS
TY - JOUR
TI - Elderly men and women with similar areal bone density show significant differences in bone microstructure and fracture pattern.
AU - Eduardo Medeiros Ferreira da Gama
AU - Leonardo Vieira
AU - Francisco de Paula Paranhos-Neto
AU - Laura Maria Carvalho Mendonça
AU - Luiza Silva Machado de Andrade
AU - Miguel Madeira
AU - Guilherme Cardenaz de Souza
AU - João Antonio Matheus Guimarães
AU - Maria Eugênia Leite Duarte
AU - Maria Lucia Fleiuss Farias
PY - 2026
DA - 2026/10/20
JO - Archives of endocrinology and metabolism
DO - 10.20945/2359-4292-2026-0126
UR - https://europepmc.org/article/MED/42905601
AB - Objective To compare bone microarchitecture and fracture patterns between elderly men and women with similar spine and hip bone mineral densities (BMDs).Subjects and methods Twenty-eight men and 84 age-BMI-BMD-matched women aged 65 years and older with at least one major osteoporotic fracture underwent laboratory tests, dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and trabecular bone score (TBS).Results There were no sex differences in biochemistry, BMD or lowest T-scores. TBS values were low in 67% of the cohort and significantly correlated with HR-pQCT parameters. At HR-pQCT evaluation, men had greater bones (total area and cortical perimeter at distal radius and tibia) and better trabecular vBMD and microstructure at distal radius, but similar values for cortical vBMD and cortical thickness. When compared with Brazilian age-sex-reference HR-pQCT data from healthy individuals, all parameters tested were numerically lower in the study group. These differences seemed more pronounced in men, particularly for cortical thickness at the distal tibia, where relative deficits reached -46.9% in men and -35.4% in women. There was no sex difference in vertebral fractures, but wrist and shoulder fractures were more common in women (p = 0.006), whereas hip fractures were more common in men (p = 0.03).Conclusion To achieve similar DXA values, men appear to have greater relative bone deficits than women when compared to age-sex-matched healthy Brazilian population. This study highlights the importance of HR-pQCT to understand sex-specific differences in fracture pattern in the study population.
SN - 2359-3997
SN - 2359-4292
ER -