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Increased heterogeneity of bone matrix mineralization in pediatric patients prone to fractures: a biopsy study.
J Bone Miner Res. 2014; 29(5):1110-7.JB

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 < 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.

Authors+Show Affiliations

Bone and Cartilage Research Unit (BCRU), University of Eastern Finland, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; Department of Orthopaedics and Traumatology, Kuopio University Hospital, Kuopio, Finland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24166885

Citation

Tamminen, Inari S., et al. "Increased Heterogeneity of Bone Matrix Mineralization in Pediatric Patients Prone to Fractures: a Biopsy Study." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 29, no. 5, 2014, pp. 1110-7.
Tamminen IS, Misof BM, Roschger P, et al. Increased heterogeneity of bone matrix mineralization in pediatric patients prone to fractures: a biopsy study. J Bone Miner Res. 2014;29(5):1110-7.
Tamminen, I. S., Misof, B. M., Roschger, P., Mäyränpää, M. K., Turunen, M. J., Isaksson, H., Kröger, H., Mäkitie, O., & Klaushofer, K. (2014). Increased heterogeneity of bone matrix mineralization in pediatric patients prone to fractures: a biopsy study. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 29(5), 1110-7. https://doi.org/10.1002/jbmr.2124
Tamminen IS, et al. Increased Heterogeneity of Bone Matrix Mineralization in Pediatric Patients Prone to Fractures: a Biopsy Study. J Bone Miner Res. 2014;29(5):1110-7. PubMed PMID: 24166885.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased heterogeneity of bone matrix mineralization in pediatric patients prone to fractures: a biopsy study. AU - Tamminen,Inari S, AU - Misof,Barbara M, AU - Roschger,Paul, AU - Mäyränpää,Mervi K, AU - Turunen,Mikael J, AU - Isaksson,Hanna, AU - Kröger,Heikki, AU - Mäkitie,Outi, AU - Klaushofer,Klaus, PY - 2013/06/25/received PY - 2013/10/15/revised PY - 2013/10/21/accepted PY - 2013/10/30/entrez PY - 2013/10/30/pubmed PY - 2014/12/15/medline KW - BMDD KW - BONE MINERALIZATION DENSITY DISTRIBUTION KW - CHILDREN KW - HISTOMORPHOMETRY KW - IDIOPATHIC OSTEOPOROSIS KW - QBEI KW - QUANTITATIVE BACKSCATTERED ELECTRON IMAGING KW - VERTEBRAL FRACTURE SP - 1110 EP - 7 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 29 IS - 5 N2 - 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. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/24166885/Increased_heterogeneity_of_bone_matrix_mineralization_in_pediatric_patients_prone_to_fractures:_a_biopsy_study_ L2 - https://doi.org/10.1002/jbmr.2124 DB - PRIME DP - Unbound Medicine ER -