alexa Bone Strength, Skeletal Muscle Area, and Biochemical Ma
ISSN: 2329-9509

Journal of Osteoporosis and Physical Activity
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Research Article

Bone Strength, Skeletal Muscle Area, and Biochemical Markers Associated with Bone Metabolism in Patients with Fragility Distal Radius Fracture

Shigeharu Uchiyama1*, Shota Ikegami1, Mikio Kamimura2, Hideki Moriya3, Tsutomu Akahane4, Kiichi Nonaka5, Toshihiko Imaeda6 and Hiroyuki Kato1
1Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
2Kamimura Clinic, Matsumoto, Japan
3Department of Orthopaedic Surgery, Ina Chuo Municipal Hospital, Ina, Japan
4Department of Orthopaedic Surgery, Shinshu Ueda Medical Center, Ueda, Japan
5Canon Lifecare Solutions Inc. Tokyo, Japan
6Department of Food and Nutritional Environment, Kinjo Gakuin University, Nagoya, Japan
Corresponding Author : Shigeharu Uchiyama
Associate Professor, Department of Orthopaedic Surgery
Shinshu University School of Medicine, Asahi 3-1-1
Matsumoto 390-8621, Japan
Tel: 81-263-37-3095
E-mail: [email protected]
Received October 16, 2015; Accepted January 20, 2016; Published January 24, 2016
Citation: Uchiyama S, Ikegami S, Kamimura M, Moriya H, Akahane T, Nonaka K, et al. (2016) Bone Strength, Skeletal Muscle Area, and Biochemical Markers Associated with Bone Metabolism in Patients with Fragility Distal Radius Fracture. J Osteopor Phys Act 4:167. doi:10.4172/2329-9509.1000167
Copyright: © 2016 Uchiyama S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Distal radius fracture (DRF) is often the first fragility fracture that occurs in postmenopausal women and exhibits the high risk of future fragility fractures at the other skeletal sites. So far, the other factors rather than bone mineral density have not been well investigated. Our aim was to determine the characteristics of the patients with previous fragility DRFs. We enrolled 48 postmenopausal women with a history of fragility DRF (fracture group) and age-matched 96 healthy postmenopausal women volunteers (control group). Hip BMD of all the participants was obtained using DXA. Geometrical parameters and biomechanical indices of the femoral neck were obtained using quantitative CT. Using CT images, the cross-sectional area of the skeletal muscle and fat inside the fascia was calculated at the proximal thigh. Twelve biochemical markers and hormones associated with bone metabolism were also measured. Each parameter was compared between the patients and controls by analysis of variance (ANOVA), followed by ANCOVA adjusting for femoral neck areal BMD. BMD of the femoral neck was significantly lower in the fracture group than the control, while skeletal muscle area was not. Femoral neck cortical thickness was significantly smaller and buckling ratio was significantly greater in the fracture group; however, after adjusting for BMD, the differences were no longer significant. Further, 25(OH)D, Urinary deoxypyridinoline (DPD), and serum and urinary pentosidine levels were significantly higher in the fracture group than in the control group; those differences remained significant after adjusting for BMD. The patients with previous DRFs exhibited lower BMD, which was not accompanied by lower skeletal muscle area or muscle strength. Further, bone metabolism alterations such as low 25(OH)D, high DPD, and high serum and urinary pentosidine levels were also observed in such patients, independent of the areal BMD determined by DXA. Level of Evidence: Prognotic Study.


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