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Increased Heterogeneity of Bone Matrix Mineralization in Pediatric Patients Prone to Fractures: A Biopsy Study

Tamminen, Inari S.; Misof, Barbara M.; Roschger, Paul; Mayranpaa, Mervi K.; Turunen, Mikael J.; Isaksson, Hanna LU ; Kroger, Heikki; Makitie, Outi and Klaushofer, Klaus (2014) In Journal of Bone and Mineral Research 29(5). p.1110-1117
Abstract
Idiopathic osteoporosis (IOP) in children is characterized by fragility fractures and/or low bone mineral density in otherwise healthy individuals. The aim of the present work was to measure bone mineralization density distribution (BMDD) based on quantitative backscattered electron imaging (qBEI) in children with suspected IOP. Entire cross-sectional areas of transiliac bone biopsy samples from children (n=24, 17 boys; aged 6.7-16.6 years) with a history of fractures (n=14 with at least one vertebral fracture) were analyzed for cancellous (Cn) and cortical (Ct) BMDD. Outcomes were compared with normal reference BMDD data and correlated with the patients' clinical characteristics and bone histomorphometry findings. The subjects had similar... (More)
Idiopathic osteoporosis (IOP) in children is characterized by fragility fractures and/or low bone mineral density in otherwise healthy individuals. The aim of the present work was to measure bone mineralization density distribution (BMDD) based on quantitative backscattered electron imaging (qBEI) in children with suspected IOP. Entire cross-sectional areas of transiliac bone biopsy samples from children (n=24, 17 boys; aged 6.7-16.6 years) with a history of fractures (n=14 with at least one vertebral fracture) were analyzed for cancellous (Cn) and cortical (Ct) BMDD. Outcomes were compared with normal reference BMDD data and correlated with the patients' clinical characteristics and bone histomorphometry findings. The subjects had similar average degree but significantly higher heterogeneity of mineralization in both Cn and Ct bone (Cn.CaWidth +23%, Ct.CaWidth +15%, p<0.001 and p=0.002, respectively), together with higher percentages of low mineralized cancellous (Cn.CaLow +35%, p<0.001) and highly mineralized cortical bone areas (Ct.CaHigh +82%, p=0.032). Ct.CaWidth and Ct.CaLow were positively correlated with mineralizing surface per bone surface (MS/BS; a primary histomorphometric determinant of bone formation) and with serum bone turnover markers (all p<0.05). The correlations of the mineralization heterogeneity with histomorphometric and serum bone turnover indices suggest that an enhanced variation in bone turnover/formation contributes to the increased heterogeneity of mineralization. However, it remains unclear whether the latter is cause for, or the response to the increased bone fragility in these children with suspected IOP. (c) 2014 American Society for Bone and Mineral Research. (Less)
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published
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keywords
QUANTITATIVE BACKSCATTERED ELECTRON IMAGING, QBEI, BONE MINERALIZATION, DENSITY DISTRIBUTION, BMDD, IDIOPATHIC OSTEOPOROSIS, CHILDREN, HISTOMORPHOMETRY, VERTEBRAL FRACTURE
in
Journal of Bone and Mineral Research
volume
29
issue
5
pages
1110 - 1117
publisher
AMBMR
external identifiers
  • wos:000334658700012
  • scopus:84899122128
ISSN
1523-4681
DOI
10.1002/jbmr.2124
language
English
LU publication?
yes
id
1724063b-5611-4622-8ac5-04f0dce36a9a (old id 4488215)
date added to LUP
2014-06-23 14:18:30
date last changed
2017-05-14 03:12:18
@article{1724063b-5611-4622-8ac5-04f0dce36a9a,
  abstract     = {Idiopathic osteoporosis (IOP) in children is characterized by fragility fractures and/or low bone mineral density in otherwise healthy individuals. The aim of the present work was to measure bone mineralization density distribution (BMDD) based on quantitative backscattered electron imaging (qBEI) in children with suspected IOP. Entire cross-sectional areas of transiliac bone biopsy samples from children (n=24, 17 boys; aged 6.7-16.6 years) with a history of fractures (n=14 with at least one vertebral fracture) were analyzed for cancellous (Cn) and cortical (Ct) BMDD. Outcomes were compared with normal reference BMDD data and correlated with the patients' clinical characteristics and bone histomorphometry findings. The subjects had similar average degree but significantly higher heterogeneity of mineralization in both Cn and Ct bone (Cn.CaWidth +23%, Ct.CaWidth +15%, p&lt;0.001 and p=0.002, respectively), together with higher percentages of low mineralized cancellous (Cn.CaLow +35%, p&lt;0.001) and highly mineralized cortical bone areas (Ct.CaHigh +82%, p=0.032). Ct.CaWidth and Ct.CaLow were positively correlated with mineralizing surface per bone surface (MS/BS; a primary histomorphometric determinant of bone formation) and with serum bone turnover markers (all p&lt;0.05). The correlations of the mineralization heterogeneity with histomorphometric and serum bone turnover indices suggest that an enhanced variation in bone turnover/formation contributes to the increased heterogeneity of mineralization. However, it remains unclear whether the latter is cause for, or the response to the increased bone fragility in these children with suspected IOP. (c) 2014 American Society for Bone and Mineral Research.},
  author       = {Tamminen, Inari S. and Misof, Barbara M. and Roschger, Paul and Mayranpaa, Mervi K. and Turunen, Mikael J. and Isaksson, Hanna and Kroger, Heikki and Makitie, Outi and Klaushofer, Klaus},
  issn         = {1523-4681},
  keyword      = {QUANTITATIVE BACKSCATTERED ELECTRON IMAGING,QBEI,BONE MINERALIZATION,DENSITY DISTRIBUTION,BMDD,IDIOPATHIC OSTEOPOROSIS,CHILDREN,HISTOMORPHOMETRY,VERTEBRAL FRACTURE},
  language     = {eng},
  number       = {5},
  pages        = {1110--1117},
  publisher    = {AMBMR},
  series       = {Journal of Bone and Mineral Research},
  title        = {Increased Heterogeneity of Bone Matrix Mineralization in Pediatric Patients Prone to Fractures: A Biopsy Study},
  url          = {http://dx.doi.org/10.1002/jbmr.2124},
  volume       = {29},
  year         = {2014},
}