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Comparative Analysis of Femoral Macro- and Micromorphology in Males and Females With and Without Hyperostosis Frontalis Interna: A Cross-Sectional Cadaveric Study

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Abstract

We hypothesized that subjects with hyperostosis frontalis interna (HFI), which represents local, endocranial thickening of the frontal bone, would express extra-calvarial manifestations of this condition. Therefore, we compared femoral bone mineral density, geometry, and microarchitecture of males and females with HFI to those without this condition as well as between males and females with HFI. The sample was taken from human donor cadavers, 38 males (19 with and 19 without HFI) and 34 females (17 with and 17 without HFI) that were age-matched within the same sex. The specimens of femoral bones were scanned using microcomputed tomography and dual-energy X-ray absorptiometry (DXA). Parameters of hip structure analysis (HSA) were calculated from data derived from DXA scans. Females with HFI had increased cortical bone volume fraction and their cortical bone was less porous compared to females without HFI. Males with HFI showed microarchitectural differences only with the trabecular bone. They had increased bone volume fraction and decreased trabecular separation compared to males without HFI, although with borderline significance. These microarchitectural changes did not have significant impact on femoral geometry and bone mineral density. The same, still unknown etiological factor behind HFI might be inducing changes at the level of bone microarchitecture at a remote skeletal site (femoral bone), in both sexes. These alterations still do not have the magnitude to induce obvious, straightforward overall increase of bone mineral density measured by DXA. HFI could be a systemic phenomenon that affects both males and females in a similar manner.

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Acknowledgements

Authors would like to thank Dr. Ivan Zaletel for graphical representation of data.

Funding

This work was supported by Ministry of Education, Science, and Technological Development of the Republic of Serbia [Grant Number 45005].

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Authors and Affiliations

  1. Institute of Forensic Medicine, University of Belgrade – School of Medicine, 31a Deligradska Str., 11000, Belgrade, Serbia

    Danica Cvetković, Slobodan Nikolić & Vladimir Živković

  2. Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, University of Belgrade – School of Medicine, Dr. Subotica 4/2, 11000, Belgrade, Serbia

    Jelena Jadžić, Petar Milovanović, Danijela Djonić & Marija Djurić

  3. Clinic for Endocrinology, Clinical Center of Serbia, Dr. Subotica 13, 11000, Belgrade, Serbia

    Miomira Ivović

Authors
  1. Danica Cvetković
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  2. Jelena Jadžić
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  3. Petar Milovanović
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  4. Danijela Djonić
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  5. Marija Djurić
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  6. Miomira Ivović
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  7. Slobodan Nikolić
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  8. Vladimir Živković
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Contributions

DC involved in collecting resources, investigation, formal analysis, and writing—original draft; JJ performed investigation and formal analysis; PM did methodology and visualization; DD contributed to mmethodology and writing—review & editing; MD performeed project administration, conceptualization, and methodology; MI did investigation and formal analysis; and SN and VZ involved in collecting resources, supervision, conceptualization, methodology, and writing—rreview & editing.

Corresponding author

Correspondence to Vladimir Živković.

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All authors declare that they have no conflicts of interest.

Ethical Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the School of Medicine, University of Belgrade (Approval No. 2650/XII-14).

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Cvetković, D., Jadžić, J., Milovanović, P. et al. Comparative Analysis of Femoral Macro- and Micromorphology in Males and Females With and Without Hyperostosis Frontalis Interna: A Cross-Sectional Cadaveric Study. Calcif Tissue Int 107, 464–473 (2020). https://doi.org/10.1007/s00223-020-00740-0

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  • DOI: https://doi.org/10.1007/s00223-020-00740-0

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