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S Boonen

Publications and source records attributed to S Boonen.

At least 55 records · Page 3Linked to original sources
PubMed1998

Do quantitative ultrasound measurements reflect structure independently of density in human vertebral cancellous bone?

Ultrasonic measurements were made in three orthogonal directions on 70 vertebral bone cubes. Apparent density (rho) was determined, and microcomputed tomography was used to derive a range of microstructural parameters. Qualitatively different ultrasonic behavior was observed in the craniocaudal (CC) axis, in which two distinct waves propagated. In this direction, only attenuation correlated strongly with rho (r2 = 80%), whereas, in the anteroposterior (AP) and mediolateral (ML) axes, there were significant correlations between all ultrasonic parameters and rho (r2 = 57%-79%). Microstructural parameters were, in general, correlated with ultrasonic properties, but when adjusted for rho, few significant relationships remained and the additional variance explained by individual microstructural parameters was relatively small (< 25% for CC axis, < 3% for AP, 0% for ML). In stepwise regression analysis including rho and all of the microstructural parameters, rho remained the primary determinant of ultrasonic properties in the transverse axes: Combinations of structural parameters explained, at most, an additional of 6% of the variability in ultrasonic properties in the AP axis, but failed to contribute significantly in the ML axis. In the CC axis, structural parameters played a greater role, but the pattern of associations was complex and the predictive power of the models was generally much less than that for the transverse axes. These data indicate that the ability of ultrasound to reflect aspects of trabecular structure is strongly dependent on the direction in which ultrasonic measurements are made, and provide only qualified support for the hypothesis that ultrasound reflects cancellous bone structure independently of bone density.

Absorptiometry, Photon↗
PubMed1998

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Journal Article↗
PubMed1998

Assessment of femoral bone fragility and fracture risk by ultrasonic measurements at the calcaneus.

BACKGROUND: Quantitative ultrasound measurement (broadband ultrasound attenuation and speed of sound) is emerging as an alternative to photon absorptiometry techniques in the assessment of osteoporosis. OBJECTIVE: To discuss briefly the fundamentals of ultrasound measurement of bone and critically review recent studies on the role of ultrasound in bone quality assessment and hip fracture prediction. CONCLUSIONS: The relationships between ultrasound and bone mineral density are too weak to allow accurate prediction of bone density at any skeletal site--including the hip--from an ultrasound measurement at the calcaneus. However, in vitro evidence indicates that ultrasound provides structural information in addition to density. In line with these in vitro data, recent prospective studies have shown that ultrasound predicts hip fractures strongly and independently of densitometry in older women.

Aged↗
PubMed1998

Relationship between age-associated endocrine deficiencies and muscle function in elderly women: a cross-sectional study.

OBJECTIVE: Muscle receptors and selected anabolic effects have been identified for both insulin-like growth factor I (IGF-I) and 1,25-dihydroxyvitamin D (1,25(OH)2D3). The aim of the present study was to test the hypothesis that the decreasing concentrations of these endocrine factors might be involved in the decline in muscle function that characterizes normal human ageing. DESIGN: Cross-sectional study. STUDY PARTICIPANTS: A community-based sample of 245 healthy elderly women aged 70-90 years. Exclusion criteria were diseases or medications known to affect muscle function or the somatotrophic axis. MEASUREMENTS: Knee extension strength was evaluated using an isokinetic dynamometer. A standardized questionnaire was used to assess habitual physical activity. IGF-I and 1,25(OH)2D3 were measured by radioimmunoassay. Vitamin D binding protein (DBP) was measured by single radial immunodiffusion and the free 1,25(OH)2D3 concentration calculated as the molar ratio of total 1,25(OH)2D3 to DBP. RESULTS: The differences in isometric and isokinetic strength over the age range were equivalent to losses of 0.9-2.4% per year. However, no relationship was found between the somatotrophic axis or vitamin D status and knee extension strength, despite markedly decreasing concentrations of circulating IGF-I and free 1,25(OH)2D3 with age. CONCLUSION: Levels of circulating IGF-I and free 1,25(OH)2D3 appear not to be involved in the loss of muscle function that characterizes normal human ageing.

Aged↗
PubMed1998

Cyclical etidronate increases bone density in the spine and hip of postmenopausal women receiving long term corticosteroid treatment. A double blind, randomised placebo controlled study.

OBJECTIVE: To study the effect of cyclic etidronate in secondary prevention of corticosteroid induced osteoporosis. METHODS: A double blind, randomised placebo controlled study comparing cyclic etidronate and placebo during two years in 37 postmenopausal women receiving long term corticosteroid treatment, mainly for polymyalgia rheumatica (40% of the patients) and rheumatoid arthritis (30%). Bone density was measured in the lumbar spine, femoral neck, and femoral trochanter. RESULTS: After two years of treatment there was a significant difference between the groups in mean per cent change from baseline in bone density in the spine in favour of etidronate (p = 0.003). The estimated treatment difference (mean (SD)) was 9.3 (2.1)%. Etidronate increased bone density in the spine (4.9 (2.1)%, p < 0.05) whereas the placebo group lost bone (-2.4 (1.6)%). At the femoral neck there was an estimated difference of 5.3 (2.6)% between the groups (etidronate: 3.6% (1.4)%, p < 0.05, placebo: -2.4 (2.1)%). The estimated difference at the trochanter was 8.2 (3.0) (etidronate: 9.0 (1.5)%, p < 0.0001, placebo: 0.5 (2.3)%). No significant bone loss occurred in the hip in placebo treated patients. CONCLUSIONS: Cyclic etidronate is an effective treatment for postmenopausal women receiving corticosteroid treatment and is well tolerated.

Aged↗
PubMed1998

Interspecies differences in bone composition, density, and quality: potential implications for in vivo bone research.

This study compares bone composition, density, and quality in bone samples derived from seven vertebrates that are commonly used in bone research: human, dog, pig, cow, sheep, chicken, and rat. Cortical femoral bone samples were analyzed for their content of ash, collagen, extractable proteins, and insulin-like growth factor-I. These parameters were also measured in bone powder fractions that were obtained after separation of bone particles according to their density. Large interspecies differences were observed in all analyses. Of all species included in the biochemical analyses, rat bone was most different, whereas canine bone best resembled human bone. In addition, bone density and mechanical testing analyses were performed on cylindrical trabecular bone cores. Both analyses demonstrated large interspecies variations. The lowest bone density and fracture stress values were found in the human samples; porcine and canine bone best resembled these samples. The relative contribution of bone density to bone mechanical competence was largely species-dependent. Together, the data reported here suggest that interspecies differences are likely to be found in other clinical and experimental bone parameters and should therefore be considered when choosing an appropriate animal model for bone research.

Adult↗
PubMed1998

Prediction of vertebral and femoral strength in vitro by bone mineral density measured at different skeletal sites.

The aim of the present study was to investigate the prediction of vertebral and femoral strength in vitro by bone mineral density (BMD) measured at different skeletal sites. The third lumbar vertebral body, the right proximal femur, and the right calcaneus were removed from 38 male and 32 female cadavers (mean age 69 years, range 23-92 years). Areal BMD of all bone specimens was determined by dual-energy X-ray absorptiometry (DXA). The failure load of the vertebral body and the femur was determined by mechanical testing. Vertebral and femoral strength were both greater in males than females (p < 0.01), as was BMD at all sites (p < 0.01). Vertebral strength correlated well with vertebral BMD (r2 = 0.64) but was only moderately correlated with BMD measured at the femur (r2 = 0.36) or the calcaneus (r2 = 0.18). Femoral strength showed the highest correlations with femoral BMD (r2 = 0.88) and somewhat weaker relationships with BMD at the vertebra (r2 = 0.50) and the calcaneus (r2 = 0.54). BMD values at the vertebra, femur, and calcaneus were only moderately interrelated (r2 = 0.31-0.65), and vertebral strength correlated only modestly with the strength of the femur (r2 = 0.36). These in vitro results support the concept that optimal prediction of vertebral or femoral strength by DXA requires site-specific assessments.

Absorptiometry, Photon↗
PubMed1998

Risk assessment for osteoporosis using bone mineral density determination: a belgian perspective.

The availability of bone densitometry in daily clinical practice has revolutionized the capacity to detect osteoporosis, to estimate the risk of future fracture, and to select those patients who are likely to benefit most from preventive or therapeutic measures. In spite of the high availability of densitometry in Belgium and the high incidence of risk factors for osteoporosis in elderly women, osteoporosis is presumably underdiagnosed. It is likely that the limited use of widely available technology to evaluate osteoporosis results from a complex interaction of numerous factors, some of which are discussed. In spite of many unanswered questions, the main conclusion to be drawn from the Belgian experience is that a high density of densitometry facilities is no guarantee that the majority of women who are at greatest risk of fracture will actually become the focus of preventive measures or therapy.

Journal Article↗
PubMed1997

Bone density and local growth factors in generalized osteoarthritis.

Osteoarthritis is usually considered to be a primary disorder of chondrocyte function with secondary changes in bones. However, a defect in the subchondral bone resulting in loss of its shock absorbing capacity could transfer the stress of loading directly to the articular cartilage with secondary changes in the cartilage. Review of histomorphometric and bone densitometric studies at sites of osteoarthritis at the hip or knee revealed that cartilage fibrillation could not be dissociated from bony changes even in the earliest stages of osteoarthritis and that subchondral trabeculae are thickened and more spaced in osteoarthritis. Microfractures of subchondral trabecular bone were less frequently seen in osteoarthritis compared to controls. Changes of the tidemark were found to be multiform and metabolically active in the osteoarthritic process. Endochondral ossification depletes the calcified cartilage at the cartilage/bone interface and the tidemark has been thought of as a calcification front advancing in the direction of non-calcified cartilage. Duplication of the tidemark is cited as evidence of this advancement. In the few experimental animal studies of subchondral bone in osteoarthritis, thicker trabeculae which were closer together were found in guinea pigs already when only mild cartilage changes were present. In the dog, with cruciate ligament transection, changes in bone were later than in the cartilage, but the changes in bone could still contribute to the progression of osteoarthritis. To study if bone changes may precede injury to the cartilage and if metabolic and systemic influences can also alter the subchondral bone, rendering it less able to withstand normal mechanical stresses, bone at different sites in the body has been studied extensively by the authors. Epidemiological and case control studies have revealed that osteoarthritis cases have more bone at all sites than expected and that bone in cases with generalized osteoarthritis shows both quantitative and qualitative differences, including increased contents of growth factors and hypermineralization. These findings suggest that a more generalized bone alteration may be the basis of the pathogenesis of osteoarthritis.

Animals↗
PubMed1997

Factors associated with cortical and trabecular bone loss as quantified by peripheral computed tomography (pQCT) at the ultradistal radius in aging women.

Peripheral quantitative computed tomography (pQCT) allows the separate determination of cortical and trabecular bone mineral density in the peripheral skeleton. This cross-sectional study was designed to examine the effects of healthy aging on pQCT measurements at the ultradistal radius. In a well-defined sample of 129 community-based women, aged 70-87 years, the differences in cortical and trabecular density over the age range were equivalent to losses of -0.41% and -0.65% per year, respectively. To investigate the mechanism of this age-related decline, we assessed relationships between both parameters and height, weight, body mass index, dietary calcium intake, grip strength, and serum concentrations of insulin-like growth factor-I (IGF-I), calcidiol (25(OH)D3), calcitriol (1,25(OH)2D3), parathyroid hormone (PTH), and sex hormone binding globulin (SHBG). Multiple regression was used to adjust for potential confounders. Age was not significant after controlling for other covariables. Body mass index, grip strength, serum IGF-I, 25(OH)D3, and PTH (1-84) were found to be independent predictors of total bone density. Including (total or free) 1,25(OH)2D3 did not improve the model precision. These findings provide evidence that, among other factors, the activity of the growth hormone-IGF-I-axis is of importance for skeletal integrity. Grip strength, serum IGF-I, and PTH (1-84) were discovered to be significantly related to cortical but not to trabecular density, suggesting that different mechanisms may be involved in compact and cancellous bone loss.

Aged↗
PubMed1997

Prevalence of trabecular microcallus formation in the vertebral body and the femoral neck.

Trabecular microcallus formation (TMF) has been described previously in the human vertebra and femur, but the difference in TMF prevalence at these two sites has not been studied and the role of TMF remains controversial. In this study, the 4th lumbar vertebra (L4) and right proximal femur were removed from 27 male and 23 female cadavers. A 2 cm cube cut from the center of L4 and a 1 cm-thick slice cut from the femoral neck were cleaned, defatted, and dried. The apparent density of the L4 cubes was determined as dry weight/bulk bone volume. Using a dissecting microscope at low magnification (4-60x), TMF were identified and counted in both the vertebral and femoral samples. A 8 mm diameter core was then cut from the center of the L4 cubes in the vertical direction, and selected histomorphometric parameters of the core were evaluated with an X-ray microcomputed tomography system (micro-CT). There was a significantly greater prevalence of TMF in vertebral cubes (82%) than in the femoral slices (11%) (P < 0.001). TMF prevalence did not differ significantly between males and females, but the mean number of TMF in the vertebra was significantly (P < 0.05) greater in females (15.0/vertebra) than in males (7.7/vertebra). In the vertebra, the majority of the observed TMF were in vertical trabeculae. Subjects over 60 years old had a higher TMF prevalence than those under 60 years old (P < 0.01). TMF numbers increased with decreasing apparent density (P < 0.05), whereas no significant correlations were found between TMF and bone volume (BV/TV), trabecular number (Tb.N), or trabecular thickness (Tb.Th) as assessed by micro-CT. In two fractured vertebra, very few TMFs (2 and 4, respectively) were observed. These results demonstrated that the occurrence of TMF is strongly related to the anatomical site, probably due to differences in the applied loads and the trabecular structure between sites. The results were consistent with the hypothesis that TMF is a mechanism acting to maintain bone strength, but further studies are needed to clarify this important issue.

Adult↗
PubMed1997

Age-associated decline in human femoral neck cortical and trabecular content of insulin-like growth factor I: potential implications for age-related (type II) osteoporotic fracture occurrence.

Recent evidence suggests that regulatory peptides such as insulin-like growth factor-I (IGF-I) are released locally from bone during resorption, and may then act in a sequential manner to regulate the cellular events required for the coupling of bone formation to resorption. Among other factors, a decrease in bone-associated IGF-I levels could therefore result in remodeling imbalance and contribute to the gradual loss of bone that occurs with age. As the femoral neck region is of primary concern for the clinical manifestations of osteoporosis, the current study was intended to assess the IGF-I contents in femoral neck cortical and trabecular bone from aging individuals. Bone samples from the neck region were obtained at postmortem from 39 females and 35 males, aged 23-92 years. Concentrations of IGF-I and osteocalcin were measured by radioimmunoassay in the supernatants obtained after EDTA and guanidine hydrochloride extraction. The total amount of protein present in the extracts was determined by spectrophotometry. IGF-I levels were significantly lower in trabecular compared with cortical bone. Though femoral neck total protein did not vary with donor age, both IGF-I and osteocalcin were found to decline markedly. Between the ages of 23 and 92 years, average yearly rates of loss of 0.30 and 0.21 ng IGF-I/mg protein were observed in cortical and trabecular bone, respectively, corresponding with net losses of nearly 35% of the cortical skeletal content of IGF-I and 41% of the trabecular skeletal content of IGF-I. These changes in bone-associated IGF-I paralleled those of osteocalcin, consistent with an overall decrease in osteoblast function with aging. In women, the rate of decline was significantly faster for trabecular than for cortical IGF-I, however in men, age-dependent changes in cortical and trabecular IGF-I were similar. These findings support the hypothesis that changes in the local IGF regulatory system over time could be a pathophysiologic component of the age-related (type II) femoral neck osteoporotic syndrome.

Adult↗
PubMed1997

Ageing and calcium metabolism.

Ageing alters the metabolism of calcium and vitamin D in a number of ways. Intake of calcium and vitamin D, exposure to sunlight, cutaneous production of vitamin D3, renal production of 1,25-dihydroxyvitamin D (1,25(OH)2D3), intestinal absorption of calcium and the ability to adapt to a low calcium diet may all be reduced in elderly subjects. As a consequence, secondary hyperparathyroidism often occurs with ageing and can contribute to accelerated bone loss. In fact, alterations in calcium and vitamin D metabolism may be widespread in the ageing population and play a central role in the pathogenesis of senile (age-related) osteoporosis. From a preventive point of view, recent intervention studies have indicated the need to optimize calcium intake and to maintain serum 25(OH)D3 levels within the normal range in elderly people.

Aged↗
PubMed1997

Structural and material mechanical properties of human vertebral cancellous bone.

The structural Young's modulus (i.e. that of the cancellous framework) was determined by non-destructive compressive mechanical testing in the three orthogonal axes of 48 vertebral bone cubes. In addition, the material Young's modulus (i.e. of the trabeculae themselves) was estimated using an ultrasonic technique. Apparent and true density were determined by direct physical measurements. Significant mechanical anisotropy was observed: mean structural Young's modulus varied from 165 MPa in the supero-inferior direction to 43 MPa in the lateral direction. Structural Young's modulus correlated with apparent density, with power-law regression models giving the best correlations (r2 = 0.52-0.88). Mechanical anisotropy increased as a function of decreasing apparent density (p < 0.001). Material Young's modulus was 10.0 +/- 1.3 GPa, and was negatively correlated with apparent density (p < 0.001). In multiple regression models, material Young's modulus was a significant independent predictor of structural Young's modulus only in the supero-inferior direction. The data suggest the presence of two effects in vertebral bone associated with decreasing apparent density and, by implication, bone loss in general: (a) increased mechanical anisotropy, such that there is relative conservation of stiffness in the axial direction compared with the transverse directions; and (b) increased stiffness of the trabeculae themselves.

Adult↗
PubMed1997

Assessment of the strength of the proximal femur in vitro: relationship with ultrasonic measurements of the calcaneus.

Matched pairs of the right proximal femur and right calcaneus were obtained from 64 cadavers (28 female, 36 male). Ultrasonic velocity and broadband ultrasonic attenuation were measured in the calcaneus using a laboratory ultrasound system. Bone mineral density (BMD) was measured at the calcaneus and at the trochanteric and neck regions of the femur using dual-energy X-ray absorptiometry. Femoral strength was determined in a mechanical test simulating a fall onto the greater trochanter. Femoral BMD was more strongly correlated with femoral strength (r2 = 0.71, 0.88 for neck BMD and trochanteric BMD, respectively) than were any of the other predictive variables investigated (p < 0.05). Calcaneal ultrasonic measurements alone produced correlations with femoral strength of r2 = 0.40-0.47, with no significant differences observed in predictive ability between the various ultrasonic parameters. In multiple regression analysis, ultrasound was, in general, not a significant additional independent predictor of femoral strength when combined with either femoral or calcaneal BMD, and combining ultrasonic parameters did not improve the ability to predict femoral strength. Calcaneal width was found to be significantly correlated with both femoral strength and femoral BMD, and this explained the slightly better correlations with femoral strength found for those ultrasonic parameters which were not effectively normalized for calcaneal width. In summary, calcaneal ultrasound did not significantly enhance the prediction of femoral strength compared to femoral BMD measurements alone. Given the substantial differences between the in vitro and in vivo situations, this finding does not necessarily contradict emerging clinical data indicating that ultrasound and BMD have comparable and independent predictive ability for hip fracture risk. Reasons for the apparent discrepancy are discussed, including the enhanced accuracy of DXA in vitro. Nevertheless, it is suggested that further fundamental investigations into the efficacy of current ultrasonic techniques are warranted.

Biomechanical Phenomena↗
PubMed1997

Assessment of the strength of proximal femur in vitro: relationship to femoral bone mineral density and femoral geometry.

Femoral neck axis length, neck width, and neck-shaft angle were measured on radiographs of right proximal femora from 64 cadavers (28 female, 36 male). Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DXA) for various regions of interest, and quantitative computed tomography (QCT) was used to determine BMD and bone areas for cortical and trabecular bone at the trochanter and femoral neck. The strength of the femur was determined by a mechanical test simulating a fall on the greater trochanter, and the fracture type (cervical or trochanteric) was subsequently determined from radiographs. Twenty-six cervical fractures and 38 trochanteric fractures were observed, with no significant sex difference in the distribution of fracture types. Femoral strength was significantly elevated in males compared to females. DXA trochanteric BMD was more strongly (p < 0.05) correlated with femoral strength (r2 = 0.88) than were any of the other DXA BMD measurements (r2 = 0.59-0.76). In multiple regression models, a combination of different DXA BMD measurements produced only a small increase (1%) in the explained variability of femoral strength. Of the QCT measurements, trochanteric cortical area yielded the optimal correlation with femoral strength (r2 = 0.83). Weak, but significant, correlations were observed between femoral strength and cortical BMD at trochanteric (r2 = 0.28) and neck regions (r2 = 0.07). In multiple regression models, combining QCT parameters yielded, at best, an r2 of 0.87. Of the geometrical parameters, both neck axis length and neck width were significantly correlated with femoral strength (r2 = 0.24, 0.22, respectively), but no significant correlation was found between strength and the neck-shaft angle. Combining DXA trochanteric BMD with femoral neck width resulted in only a small increase in the explained variability (1%) compared to trochanteric BMD alone. The results demonstrated that DXA and QCT had a similar ability to predict femoral strength in vitro. Trochanteric BMD was the best DXA parameter, and cortical area (not cortical BMD) was the optimal QCT parameter. Geometric measurements of the proximal femur were only weakly correlated with the mechanical strength, and combinations of DXA, QCT, and geometric parameters resulted in only small increases in predictive power compared to the use of a single explanatory variable alone.

Absorptiometry, Photon↗