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

På svenska

Author

  • Inari S. Tamminen
  • Barbara M. Misof
  • Paul Roschger
  • Mervi K. Mayranpaa
  • Mikael J. Turunen
  • Hanna Isaksson
  • Heikki Kroger
  • Outi Makitie
  • Klaus Klaushofer

Summary, in English

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.

Department/s

Publishing year

2014

Language

English

Pages

1110-1117

Publication/Series

Journal of Bone and Mineral Research

Volume

29

Issue

5

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Mechanical Engineering

Keywords

  • QUANTITATIVE BACKSCATTERED ELECTRON IMAGING
  • QBEI
  • BONE MINERALIZATION
  • DENSITY DISTRIBUTION
  • BMDD
  • IDIOPATHIC OSTEOPOROSIS
  • CHILDREN
  • HISTOMORPHOMETRY
  • VERTEBRAL FRACTURE

Status

Published

ISBN/ISSN/Other

  • ISSN: 1523-4681