IngentaConnect Trabecular bone microarchitecture after alendronate treatment of ...

Abstract:

Objective: To compare the microarchitecture of iliac crest trabecular bone from women treated for two to three years with alendronate versus that of women treated with placebo.

Research design and methods: Three-dimensional microcomputed tomography (micro-CT; resolution 20μm) and two-dimensional histomorphometry (resolution 5–7μm) were used to examine trabecular bone from single transilial biopsies obtained at the completion of clinical trials.

Main outcome measures: Microarchitectural variables, including bone volume, trabecular number, trabecular thickness, and trabecular spacing in specimens from alendronate- and placebo-treated women were examined. Three-dimensional images of trabecular bone from both groups were constructed from CT images. Correlations among variables and between techniques were also calculated.

Results: Eighty-eight specimens were suitable for evaluation by both techniques. As measured by two-dimensional histomorphometry, bone volume fraction (as a proportion of total volume) and trabecular thickness were significantly greater in alendronate specimens, 17.1 ± 5.5% vs. 13.4 ± 5.5% (p = 0.0043) and 127 ± 29 μm vs. 109 ± 28μm (p = 0.0090), respectively, and trabecular spacing was significantly smaller, 729 ± 227μm vs. 862 ± 338μm (p = 0.005). Micro-CT yielded similar findings: bone volume and trabecular number were significantly greater in alendronate specimens: 19.4 ± 6.2% vs. 16.2 ± 6.3% (p = 0.0412) and 1.46^± 0.32 vs. 1.31^± 0.33 per mm (p = 0.0346). Two-dimensional and micro-CT measured characteristics correlated strongly with one another, with Pearson product moment correlation coefficients ranging from 0.60 (for trabecular thickness) to 0.83 (for bone volume).

Conclusions: Trabecular microarchitecture of the ilium, whether studied by two- or three-dimensional methods, is better (greater bone volume, greater trabecular thickness, decreased trabecular spacing) after alendronate treatment than after two to three years of treatment with placebo. Bone volume in a trabecular region is strongly correlated to its microarchitecture, suggesting that bone quantity predicts values for these microarchitectural endpoints.

Keywords: ALENDRONATE; HISTOMORPHOMETRY; MICRO-COMPUTED TOMOGRAPHY; MICROARCHITECTURE; OSTEOPOROSIS

Document Type: Research article

DOI: 10.1185/030079904X20259

Affiliations: 1: Osteoporosis Research Center, Creighton University, Omaha, NE, USA 2: Merck Research Laboratories, Rahway, NJ, USA 3: Faculté de Médecine R. Laënnec, INSERM Unité 403, Lyon, France 4: Formerly of Merck Research Laboratories (now retired)

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Trabecular bone microarchitecture after alendronate treatment of osteoporotic women