Precision of bone mechanoregulation assessment in humans using longitudinal high-resolution peripheral quantitative computed tomography in vivo.

Autor: Walle M; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland., Whittier DE; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland., Schenk D; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland., Atkins PR; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland., Blauth M; Department of Orthopaedics and Traumatology, Medical University Innsbruck, Innsbruck, Austria., Zysset P; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland., Lippuner K; Department of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland., Müller R; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland., Collins CJ; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Virginia Tech, Department of Biomedical Engineering and Mechanics, Blacksburg, VA, United States. Electronic address: caitlyn.collins@hest.ethz.ch.
Jazyk: angličtina
Zdroj: Bone [Bone] 2023 Jul; Vol. 172, pp. 116780. Date of Electronic Publication: 2023 May 01.
DOI: 10.1016/j.bone.2023.116780
Abstrakt: Local mechanical stimuli in the bone microenvironment are essential for the homeostasis and adaptation of the skeleton, with evidence suggesting that disruption of the mechanically-driven bone remodelling process may lead to bone loss. Longitudinal clinical studies have shown the combined use of high-resolution peripheral quantitative computed tomography (HR-pQCT) and micro-finite element analysis can be used to measure load-driven bone remodelling in vivo; however, quantitative markers of bone mechanoregulation and the precision of these analyses methods have not been validated in human subjects. Therefore, this study utilised participants from two cohorts. A same-day cohort (n = 33) was used to develop a filtering strategy to minimise false detections of bone remodelling sites caused by noise and motion artefacts present in HR-pQCT scans. A longitudinal cohort (n = 19) was used to develop bone imaging markers of trabecular bone mechanoregulation and characterise the precision for detecting longitudinal changes in subjects. Specifically, we described local load-driven formation and resorption sites independently using patient-specific odds ratios (OR) and 99 % confidence intervals. Conditional probability curves were computed to link the mechanical environment to the remodelling events detected on the bone surface. To quantify overall mechanoregulation, we calculated a correct classification rate measuring the fraction of remodelling events correctly identified by the mechanical signal. Precision was calculated as root-mean-squared averages of the coefficient of variation (RMS-SD) of repeated measurements using scan-rescan pairs at baseline combined with a one-year follow-up scan. We found no significant mean difference (p < 0.01) between scan-rescan conditional probabilities. RMS-SD was 10.5 % for resorption odds, 6.3 % for formation odds, and 1.3 % for correct classification rates. Bone was most likely to be formed in high-strain and resorbed in low-strain regions for all participants, indicating a consistent, regulated response to mechanical stimuli. For each percent increase in strain, the likelihood of bone resorption decreased by 2.0 ± 0.2 %, and the likelihood of bone formation increased by 1.9 ± 0.2 %, totalling 38.3 ± 1.1 % of strain-driven remodelling events across the entire trabecular compartment. This work provides novel robust bone mechanoregulation markers and their precision for designing future clinical studies.
Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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